In Cierny-Mader classification of chronic osteomyelitis, Stage III (localised) is characterised by:
- A Medullary osteomyelitis with involvement limited to the endosteal surface
- B Full-thickness cortical and medullary involvement (sequestrum) that can be surgically removed while maintaining bone stability ✓
- C Superficial cortical involvement only at the external surface
- D Diffuse involvement of the entire bone segment requiring resection for cure
Correct answer: B. Full-thickness cortical and medullary involvement (sequestrum) that can be surgically removed while maintaining bone stability
Explanation
Cierny-Mader classifies osteomyelitis by anatomy: Stage I (medullary — haematogenous), Stage II (superficial — periosteal/cortical surface), Stage III (localised — full-thickness cortical disease with sequestrum that can be excised without destabilising the bone), Stage IV (diffuse — circumferential full-thickness involvement requiring bone resection). Stage III is a surgical lesion but the bone remains mechanically intact after debridement, unlike Stage IV which requires segmental resection and reconstruction.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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