Osteomyelitis - Clinical Scenario

A 70-year-old active runner, previously treated with internal fixation for an open tibial fracture on his right leg three months ago, now presents with progressive pain, swelling, and difficulty in weight-bearing. His initial injury was managed with a tibial plate fixation and direct wound closure. He reported gradual improvement until six weeks ago when he began experiencing increasing pain and weight-bearing difficulties.

Objectives:

1. Describe the comprehensive management approach for a patient with osteomyelitis.
2. Explain the different classifications of osteomyelitis and their clinical relevance.
3. Outline the pathophysiology of subacute and chronic osteomyelitis.
4. Identify and justify appropriate investigations for suspected osteomyelitis.
5. Discuss the orthoplastic principles in managing this case.