Factors affecting the outcome of Chronic Osteomyelitis in Children
Volume 7 | Issue 1 | January-April 2021 | Page: 16-21 | Gaurav Gupta, Maulin M. Shah, Akash S. Makadia, Qaisur Rabbi
Authors: Gaurav Gupta MS Ortho. [1], Maulin M. Shah MBBS, M.S.Orth., DNB Orth. [1],
Akash S. Makadia MS Ortho. [2], Qaisur Rabbi D-Ortho. [2]
[1] Consultant Paediatric Orthopaedic Surgeon at OrthoKids Clinic, Ahmedabad, Gujarat, India.
[2] Consultant, Paediatric Orthopaedic Surgeon, Child Ortho Clinic, New Delhi, India.
[3] Clinical Fellow (Paediatric Orthopaedics), OrthoKids Clinic, Ahmedabad, Gujarat, India.
Address of Correspondence
Dr. Maulin M Shah,
Consultant Paediatric Orthopaedic Surgeon at OrthoKids Clinic, Ahmedabad, India
E-mail: maulinmshah@gmail.com
Abstract
Background: Treatment of Chronic Osteomyelitis in children results in varied outcome ranging from uneventful bone healing to gap non-union. We evaluated the factors associated with adverse outcome after a uniform treatment executed at a single centre.
Methods: 40 patients (1.5 -14 years) with Chronic Osteomyelitis managed with debridement & splintage were included in this study. Detailed history, laboratory investigations, local x rays & MRI were available for all the patients. Average follow up was of 2.5 years. Patients who ended up having healing of the bone after primary treatment were defined as ‘Good Outcome’, patients who required additional procedures to improve function of limb or morphology of bone were defined as ‘Fair Outcome’ and patients who resulted in gap non-union were defined as ‘Poor Outcome’.
Results: Delay in surgical intervention beyond 6 weeks after beginning of symptoms, multiple local debridement without pan-medullary decompression & presence of concomitant soft tissue abscess on MRI were the statistically significant factors associated with poor outcome.
Conclusion: Aggressive & early surgical debridement is suggested for patients with failed conservative treatment to avoid long term complications. Current study will help in identifying the patients who are likely to have long-term sequelae of Chronic Osteomyelitis.
Keywords: Chronic Osteomyelitis, pan-osseous, non-union, debridement, outcome.
Level of Evidence: IV, retrospective analytical study.
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| How to Cite this Article: Gupta G, Shah MM, Makadia AS, Rabbi Q | Factors affecting the outcome of Chronic Osteomyelitis in Children | International Journal of Paediatric Orthopaedics | January-April 2021; 7(1): 16-21. |
