I just started back working at BMC and I have been treating many ailments of the extremities. Tumors, ulcers and gangrene of legs and arms have kept me busy.
One young woman came to the hospital with a chronic wound of her right upper arm. As a young girl, multiple wounds opened up on both arms and she has been dealing with the wounds ever since. These wounds were attributed to osteomyelitis or infection of the bones.
The wounds on her left arm had finally closed, but the right upper arm was still draining purulent fluid from 2 lateral wounds and another medial wound closer to the elbow. A small bony fragment could be seen protruding from one of the upper wounds.
An X-ray of the right arm was astounding. It appeared that she had a small dead bone (sequestrum) within a new healed bone (involucrum).
I discussed the case with an orthopedic surgeon who has spent some time in West Africa. He explained that because this problem started when she was very small, the dead bone was actually the shaft of her humerus from when she was a child!
We gave her antibiotics and took her to the operating room. I pulled out the dead bone, cleaned out the “tunnel” through her arm and packed the wound with gauze. She has healed very well.
The follow up x-rays show that indeed we removed all the dead bone. Sequestrectomy success!