Delayed Idiopathic Hardware-Associated Osteomyelitis of the Scaphoid

Abstract

Osteomyelitis of the carpal bones is rare and usually occurs in the setting of penetrating wounds or immune compromise. A case of hardware-associated scaphoid osteomyelitis is reported in a 33-year-old man who underwent screw fixation of a scaphoid fracture more than 20 years prior to presentation. The patient was treated with operative debridement including a total scaphoidectomy as well as intravenous antibiotics. Methicillin-sensitive Staphylococcus aureus was isolated from intraoperative cultures. A secondary proximal row carpectomy was performed to provide a stable wrist. Delayed presentation of isolated hardware-associated scaphoid osteomyelitis is exceedingly rare, and little is reported regarding the incidence or management of this entity in the current literature.

Keywords: Osteomyelitis; proximal row carpectomy; scaphoid fracture; septic arthritis; variable pitch cannulated screw.