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DRG Category: 515
Mean LOS: 10.1 days
Description SURGICAL: Other Musculoskeletal System and Connective Tissue O. R. Procedure with Major CC
DRG Category: 539
Mean LOS: 10.5 days
Description MEDICAL: Osteomyelitis with Major CC
Osteomyelitis is an infection of bone, bone marrow, and the soft tissue that surrounds the bone. It is generally caused by pyogenic (pus-producing) bacteria but may be the result of a viral or fungal infection. Osteomyelitis may be an acute or chronic condition. Acute osteomyelitis refers to an infection that is less than 1 month in duration from the time of the initial infection. Chronic osteomyelitis refers to a bone infection that persists for longer than 4 weeks or represents a persistent problem with periods of remission and exacerbations; the prevalence of chronic osteomyelitis is 2 cases per 10,000 people.
Osteomyelitis most commonly occurs in the long bones and, in particular, the tibia, femur, and fibula. The metaphysis (growing portion of a bone) of the distal portion of the femur and the proximal portion of the tibia are the most frequent sites because of the sluggish blood supply that occurs in those areas. After gaining entrance to the bone, the bacteria grow and form an abscess, which spreads along the shaft of the bone under the periosteum. Pressure elevates the periosteum, destroying its blood vessels and causing bone necrosis. The dead bone tissue (sequestra) cannot easily be liquefied and removed. The body's healing response is to lay new bone (involucrum) over the sequestra. However, the sequestra is a perfect environment for bacteria, and chronic osteomyelitis occurs if the bacteria are not eliminated. Complications from osteomyelitis include chronic infection, skeletal and joint deformities, immobility, and altered growth and development.