Diffuse osteomyelitis (type IV) causes widespread areas of infected and/or necrotic bone, so that extensive surgical clearance is necessary. This may result in a segmental defect. Such defects will require bone grafting, bone transport, or fixing in a shortened position if loss of length is acceptable.
Wounds associated with type IV posttraumatic osteomyelitis often need complex soft-tissue flaps for closure. Such widespread infection may justify amputation, especially in under-resourced healthcare environments.