{"id":2398,"date":"2012-03-21T13:29:04","date_gmt":"2012-03-21T13:29:04","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/infost\/"},"modified":"2025-05-13T20:28:23","modified_gmt":"2025-05-13T20:28:23","slug":"infost","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/infost\/","title":{"rendered":"Cierny-Mader Staging System for Long Bone Osteomyelitis"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Cierny and Mader classified osteomyelitis based on the affected portion of the bone, the physiologic status of the host and the local environment. This classification lends itself to the treatment and prognosis of osteomyelitis; stage 1 (medullary osteomyelitis) can usually be treated with antibiotics alone, while stages 2, 3 and 4 (superficial, localized and diffuse osteomyelitis) usually require aggressive debridement, antimicrobial therapy and subsequent orthopedic reconstruction.<br \/>\n<!--more--><br \/>\n<strong>Cierny-Mader staging system for long bone osteomyelitis<\/strong><br \/>\n<strong><br \/>\nAnatomic type<\/strong><br \/>\n<strong><br \/>\nStage 1: <\/strong>Medullary osteomyelitis<br \/>\nMedullary osteomyelitis denotes infection confined to the intramedullary surfaces of the bone. Hematogenous osteomyelitis and infected intramedullary rods are examples of this anatomic type.<br \/>\n<strong><br \/>\nStage 2: <\/strong>Superficial osteomyelitis<br \/>\nSuperficial osteomyelitis is a true contiguous focus infection of bone; it occurs when an exposed infected necrotic surface of bone lies at the base of a soft-tissue wound.<br \/>\n<strong><br \/>\nStage 3: <\/strong>Localized osteomyelitis<br \/>\nLocalized osteomyelitis is usually characterized by a full thickness, cortical sequestration which can be removed surgically without compromising bony stability.<br \/>\n<strong><br \/>\nStage 4: <\/strong>Diffuse osteomyelitis<br \/>\nDiffuse osteomyelitis is a through-and-through process that usually requires an intercalary resection of the bone to arrest the disease process. Diffuse osteomyelitis includes those infections with a loss of bony stability either before or after debridement surgery.<br \/>\n<strong><br \/>\nPhysiologic class of host<\/strong><br \/>\nClass A denotes a normal host<br \/>\nClass B denotes a host with systemic compromise, local compromise, or both<br \/>\nClass C denotes a host for whom the morbidity of treatment is worse than that imposed by the disease itself<br \/>\n<strong><br \/>\nFactors affecting immune surveillance, metabolism, and local vascularity<\/strong><br \/>\n<strong>Systemic factors <\/strong><\/p>\n<ul>\n<li>Malnutrition<\/li>\n<li>Renal or hepatic failure<\/li>\n<li>Diabetes mellitus<\/li>\n<li>Chronic hypoxia<\/li>\n<li>Immune disease<\/li>\n<li>Malignancy<\/li>\n<li>Extremes of age<\/li>\n<li>Immunosuppression or immune deficiency<\/li>\n<\/ul>\n<p><strong> Local factors<\/strong><\/p>\n<ul>\n<li>Chronic lymphedema<\/li>\n<li>Venous stasis<\/li>\n<li>Major vessel compromise<\/li>\n<li>Arteritis<\/li>\n<li>Small vessel disease<\/li>\n<li>Extensive scarring<\/li>\n<li>Radiation fibrosis<\/li>\n<li>Neuropathy<\/li>\n<li>Tobacco abuse (&gt;\/= 2 packs per day)<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Calhoun JH, Manring MM, Shirtliff M. Osteomyelitis of the long bones. Semin Plast Surg. 2009 May;23(2):59-72. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20567728\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Carek PJ, Dickerson LM, Sack JL. Diagnosis and management of osteomyelitis. Am Fam Physician. 2001 Jun 15;63(12):2413-20. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11430456\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Lazzarini L, Mader JT, Calhoun JH. Osteomyelitis in long bones. J Bone Joint Surg Am. 2004 Oct;86-A(10):2305-18. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15466746\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Mar 21, 2012.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[39],"tags":[1115,1114,1071,1113,266,1112,1111,1110,1109,494,835,507],"class_list":["post-2398","post","type-post","status-publish","format-standard","hentry","category-infetious-disease","tag-bone","tag-cierny","tag-estadio","tag-hueso","tag-infeccion","tag-long","tag-mader","tag-osteomielitis","tag-osteomyelitis","tag-sistema","tag-staging","tag-system"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2398","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2398"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2398\/revisions"}],"predecessor-version":[{"id":8976,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2398\/revisions\/8976"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2398"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2398"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2398"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}