Bone Infection (Osteomyelitis) Treatment
Infections that settle in bone are difficult and lengthy to treat. Accurate diagnosis, the right antibiotics and, when needed, surgical removal of infected bone are combined.
Osteomyelitis is an infection of bone tissue. Bacteria can reach the bone through the bloodstream, from a nearby wound, or directly during a fracture or surgery. Because of the structure and blood supply of bone, these infections are difficult and lengthy to treat. Untreated, they can become chronic and cause bone loss.
Who gets it?
- Patients with diabetic foot wounds
- People who have had open fractures
- Patients with plates, screws or nails for fractures
- People with vascular disease or a weakened immune system
- Children, through infections spread in the blood
Symptoms
- Pain, swelling, redness and warmth in the area
- Fever and weakness
- A wound that does not close, or reopens, with discharge
- A channel from the skin to the bone (fistula)
- In a diabetic foot wound, bone that can be reached with a probe
Diagnosis
Blood tests show markers of infection. X-rays show bone changes in advanced cases; MRI is more useful for early diagnosis and for defining the extent of infection. A bone biopsy and culture are important for a firm diagnosis and choosing the right antibiotic.
Treatment
Antibiotics
The antibiotic is chosen according to the culture result. Treatment for bone infection usually lasts several weeks; part may be given intravenously and the rest by mouth.
Surgery
In chronic osteomyelitis and when dead bone (sequestrum) is present, antibiotics alone are not enough:
- Infected and dead bone is removed surgically.
- The cavity in the bone may be filled with antibiotic-loaded cement or beads.
- Infected implants are removed if necessary and the fracture stabilised another way.
- For large bone losses, bone grafting or bone transport may be used later.
- Plastic surgery support may be needed to provide soft tissue cover.
Supportive care
Blood sugar control, better nutrition, stopping smoking and improving circulation increase the chance of success.
Bone infection in children
In children, bone infection usually spreads through the blood and mostly affects the ends of long bones. Fever, reluctance to use an arm or leg and limping are important signs. With early diagnosis, most children recover with antibiotics; if an abscess has formed, surgical drainage may be needed. Treatment should not be delayed, to protect the growth plate.
Follow-up after treatment
Bone infections can return months or even years after treatment. Regular check-ups and blood tests are therefore recommended after treatment ends. Seek care without delay if pain, swelling or discharge returns in the area.
Frequently asked questions
Can bone infection be cured completely?
Most patients recover with early and appropriate treatment. Chronic infections take longer to treat and need regular follow-up because they can return.
Why do I need antibiotics for so long?
It takes time for antibiotics to reach bone tissue and clear the bacteria completely. Stopping early can let the infection come back.
If my plate or screws become infected, must they be removed?
Not always. If the fracture has not healed, the implant may be left in place for a while and the infection suppressed, then removed after the bone heals. The decision depends on the infection.
Is bone infection contagious?
Bone infection does not spread to others through everyday contact. If there is an open wound, following hygiene rules during dressing changes is enough.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.