There is apparently considerable confusion and disagreement among physicians regarding the treatment of osteomyelitis. Most of the difference can be explained on the basis that there are many types and various stages and, therefore, more than one method of treatment. A discussion of treatment should specify the type of osteomyelitis and the stage of the disease. There would be a more general agreement if this principle were followed instead of considering the entire subject.
The distinct entity to be considered in this paper is the acute stage of hematogenous osteomyelitis in children. The methods of treatment of chronic hematogenous osteomyelitis are separate and distinct problems. Likewise, the treatment of osteomyelitis, which is secondary to and a complication of compound fractures, amputations, empyema, felons, abscessed teeth, metal bone plates and screws, is based on different surgical and anatomic principles.
Acute hematogenous osteomyelitis is a local manifestation of a blood stream infection