Chronic osteomyelitis accompanying soft tissue defect treated with continuous local antibiotics perfusion (CLAP): A case report

Severe fracture-related infections demand extended infection control treatment and bone-soft tissue reconstruction. We present a case of chronic osteomyelitis and soft-tissue loss treated using continuous local antibiotic perfusion. A 67-year-old woman underwent osteosynthesis for a left tibial diaphysis fracture and subsequent implant removal upon bone union. At age 63, she developed skin ulcers with distal tibial bone exposure, and 4 years later, sustained another left tibial diaphysis fracture, diagnosed as a chronic osteomyelitis pathological fracture. We initiated continuous local antibiotic perfusion to control infection, followed by osteosynthesis, latissimus dorsi flap placement, and bone grafting after 2 weeks. Five months post-injury, the infection resolved, and her original walking ability was restored. Continuous local antibiotic perfusion shows promise in significantly shortening the treatment duration for fracture-related infections with chronic osteomyelitis and soft tissue loss.