Tag Archive for: Sepsis

Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip

Volume 9 | Issue 1 | January-April 2023 | Page: 21-25 | Abdus Sami, Anil Agarwal, Lokesh Sharma., Yogesh Patel, Varun Garg 

DOI- https://doi.org/10.13107/ijpo.2023.v09.i01.151


Authors: Abdus Sami [1]  MS Orth., Anil Agarwal [1] MS Orth., Lokesh Sharma [1] MS Orth., Yogesh Patel [1] MS Orth., Varun Garg [1] MS Orth.

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.

Address of Correspondence

Dr. Anil Agarwal,
Specialist, Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.
E-mail: anilrachna@gmail.com


Abstract

Purpose: We assessed the functional and radiological outcomes of children with sequelae of bilateral septic hips. Additionally, we attempted to determine the impact of radiological unstable hips on clinical functionality of the child.
Material and methods: The retrospective case series included 9 children minimum 2 years post infection. The functional outcomes were assessed using Lower Extremity Function Score (LEFS) and Children Health Assessment Questionnaire (CHAQ). Follow up hip radiographs were classified according to the Choi’s classification. We labelled the patient as having instability if either hip had a Choi type >3A.
Results: The mean age at final follow-up was 7.6 years. Five patients had multiple joints affection. The mean LEFS score was 62.7 and CHAQ-DI 0.2. The mean LEFS values for radiological stable hips (n= 5 patients) was 66 ± 19.4 and 58.5 ± 15.3 for unstable hips (p=0.5487) while corresponding CHAQ-DI scores were 0.12 ± 0.13 and 0.27 ± 0.12 respectively (p=0.1098) indicating poor relatability between functional capabilities of the child and the radiological appearances of the hips. A strong negative correlation however existed between LEFS/ CHAQ-DI values (R= -0.897; p=0.001).
Conclusions: Septic hip sequelae in children leads to various degrees of functional limitations and patients with multiple joint involvement have worse outcomes. The hip radiological findings do not relate with the overall functional status of the child.
Keywords: Functional outcome, Disability, Hip, Sepsis, Child


References

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How to Cite this Article: Sami A, Agarwal A, Sharma L, Patel Y, Garg V | Functionality Against Odds: Lower Extremity Functional Scale and Children Health Assessment Questionnaire in Children with Bilateral Septic Sequelae of Hip | International Journal of Paediatric Orthopaedics| January-April 2023; 9(1): 21-25 | https://doi.org/10.13107/ijpo.2023.v09.i01.151

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Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis

Volume 8 | Issue 3 | September-December 2022 | Page: 16-21| Anil Agarwal

DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.145


Authors: Anil Agarwal [1] MS Ortho.

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.

Address of Correspondence
Dr. Anil Agarwal,
Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.
E-mail: anilrachna@gmail.com


Abstract

Background: The septic sequelae of knee following infantile infection is scantily described in literature. This case series depicts the various anatomical zones affected, the radiological presentation and proposes a vascular hypothesis for the sequelae.
Methods and results: Sequelae presented with three distinct radiological findings namely, unicondylar loss of lateral distal femur (n=4), hemicondylar loss of anterior portion of proximal tibia (n=3), and epiphyseal overgrowth and deficient tibial metaphysis of medial/ lateral side (n=4). The anatomical zones for above findings were seen approximately matching with the supply of specific genicular arteries around knee. On corroborating the early post infective radiographs and the sequelae radiographs, it was found that most patients had concomitant osteomyelitis, sometimes extensive.
Conclusions: We could recognize three distinct anatomical patterns of septic sequelae of knee following osteoarticular knee infection in infancy. An ischemic etiopathogenesis is suggested based on consistent radiological findings and the vascular supply zones. Most cases followed concomitant occurrence of septic arthritis and extensive osteomyelitis.
Keywords: Knee, Sepsis, Sequelae, Ischemia, Infants


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How to Cite this Article: Agarwal A | Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis | International Journal of Paediatric Orthopaedics | September-December 2022; 8(3): 16-21 | https://doi.org/10.13107/ijpo.2022.v08.i03.145

(Article Text HTML)      (Full Text PDF)