To study the clinical efficacy and influencing factors of staged treatment in patients with chronic osteomyelitis complicated with bone nonunion and bone defect after femoral fracture surgery.

A retrospective analysis of 17 patients with chronic osteomyelitis after femoral fractures treated by stages from May 2012 to July 2020 in the department of orthopedics, second hospital of shanxi medical university, including 13 males and 4 females, aged 9-59 years, mean (30±15) years old; The original trauma was open injury in 10 cases and closed injury in 7 cases; the primary fixation was internal fixation in 11 cases and external fixation in 6 cases. In the first stage, the infection was controlled; in the second stage, according to the bone defect, bone transfer was utilized in 6 cases to reconstruct bone tissue, and 11 cases were treated with bone graft.

Seventeen cases were followed up for 17-33 months. The time of the patients with the external frame was 11-30 months; the time of the second-stage bone transport with the frame was 15-28 months, and the median was 27 (17.25, 28.5) months, the time of the second-stage bone grafting with the frame was 11-20 months, and the median was 18 (17, 19) months. The number of operations for patients who received two-stage bone transport was 2-3 times, with an average of 2 (2, 3) times, and the number of operations for patients who received two-stage bone grafting was 3 times, with an average of 3 (3, 3) times. Infections were cured. The Paley evaluation of bone healing at the last follow-up was excellent.

Staged treatment of chronic osteomyelitis after femoral fracture is reliable. Accurately judging the scope of infection before surgery can effectively control the infection while reducing the scope of tissue defects and shortening the treatment time.