Table 4.
Data on diagnostic performance of histopathology.
| Author | NT | Histopathology Criteria | Test | Sens (%) | Spec (%) | PPV (%) | NPV (%) | Reference |
|---|---|---|---|---|---|---|---|---|
| Simpson et al.2002 | 60 ununited fracture cases | Highly suggestive: >1 PMN/HPF on average after examination of 10 HPF Definite infection: Organisms seen on Gram's staining |
Soft tissue histopathology | 87 | 100 | 100 | 78 | Definition: positive microbiological and clinical diagnosis.Microbiological diagnosis based on the culture of ≥5 deep specimens of tissue from the non-union site. Positive result if at least two separate specimens yielded the same organism. Clinical diagnosis: ≥1 of the following: Open wound or draining sinus pre-operatively Purulence encountered intraoperatively |
| Chadayammuri et al.2017 | 159 cases with post traumatic osteomyelitis of the long bones | Not provided | Soft tissue histopathology | 69,8 | 38,9 | / | / | Open bone biopsy and culture |
| Deep wound swab culture | 66 | 28,1 | / | / | ||||
| Egol et al. 2002 | 51 cases with delayed or non-union | Infected: >10 PMN's/HPF Not infected: <5 PMN's/HPF Equivocal: 5-10 PMN's/HPF |
Frozen section histopathology | 0 | 98 | 0 | 88 | Positive intraoperative tissue culture |
| Permanent section histopathology | 33 | 95 | 50 | 91 |
NT: total number of study participants, Sens: sensitivity, Spec: specificity, PPV: positive predictive value, NPV: negative predictive value, PMN('s): polymorphonuclear neutrophil(s), HPF: high power field, CDC: Centers for Disease Control, HC: hemoculture.