Changes

|a1=Infective (septic) osteomyelitis of the fourth metacarpal bone secondary to a contaminated, open fracture of this structure. <br><br>

|a1=Infective (septic) osteomyelitis of the fourth metacarpal bone secondary to a contaminated, open fracture of this structure. <br><br>

At this stage, radiography would reveal irregular radiolucent areas surrounding the fracture associated with florid periosteal new bone formation. (A foreign body is a less likely possibility.)

At this stage, radiography would reveal irregular radiolucent areas surrounding the fracture associated with florid periosteal new bone formation. (A foreign body is a less likely possibility.)

|l1=

|l1=Fractures

|q2=How would you treat this case?

|q2=How would you treat this case?

|a2=

|a2=

Surgical excision of the infected portion of bone in combination with a course of systemic antibiotics, ideally selected on the basis of the sensitivity of organisms cultured from the depths of the wound.

Surgical excision of the infected portion of bone in combination with a course of systemic antibiotics, ideally selected on the basis of the sensitivity of organisms cultured from the depths of the wound.

|l2=

|l2=Bacteriology Sample Collection

|q3=With the benefit of hindsight, could the case have been managed more effectively?

|q3=With the benefit of hindsight, could the case have been managed more effectively?

|a3= Yes. Radiographic examination of the region at the time of injury would have revealed damage to the fourth metacarpal bone and the risk of infective osteomyelitis could have been anticipated. <br><br>

|a3= Yes. Radiographic examination of the region at the time of injury would have revealed damage to the fourth metacarpal bone and the risk of infective osteomyelitis could have been anticipated. <br><br>