Tag Archive for: Sequelae

Sequelae of Paediatric Musculoskeletal Infections

Volume 9 | Issue 3 | September-December 2023 | Page: 22-27 | Prateek Behera, Vikas Gupta, Shubhangi Gupta

DOI- https://doi.org/10.13107/ijpo.2023.v09.i03.159

Authors: Prateek Behera MS Ortho [1], Vikas Gupta MS Ortho [2], Shubhangi Gupta MS Ortho [3]

[1] Department of Orthopaedics, AIIMS Bhopal, Madhya Pradesh, India.
[2] Department of Orthopaedics, Central Institute of Orthopaedics, VMMC and Safdarjung Hospital, New Delhi, India.
[3] University of North Dakota, USA.

Address of Correspondence

Dr. Prateek Behera
Department of Orthopaedics, AIIMS Bhopal, Madhya Pradesh, India.
E-mail: pbehera15@outlook.com

Abstract

Musculoskeletal infections (MskI) are one of the leading causes of morbidity in children. In neonates and infants, they can result in deaths, too, if timely
treatment is not initiated. Of the several factors contributing to the development of sequelae, late presentation, delay in diagnosis, and failure in initiation of appropriate treatment are considered important. Chronic osteomyelitis is often a continuation of untreated or incompletely treated osteomyelitis. The management of chronic osteomyelitis rests on the pillars of extensive surgical debridement and appropriate antibiotic therapy. The diseased bones might get fractured and need to be supported till union, which invariably happens inappropriately treated patients. In young children, osteomyelitis and septic arthritis tend to be frequently present concomitantly, and the infection can result in the destruction of the epiphysis, too. These children with damaged epiphysis have poor outcomes despite best of the efforts to restore function. Physis can also be involved in MskI, resulting in formation of physeal bar that can result in growth arrest. This bar can result in a shortened limb, angular deformity, or both. Management of these conditions includes physeal bar excision wherever suitable or correction of angular deformity by osteotomies. Length can be gained concomitantly using ring external fixators.
Keywords: Musculoskeletal infections, Osteomyelitis, Sequelae, Growth arrest, Physeal bar

References

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How to Cite this Article:  Behera P, Gupta V, Gupta S | Sequelae of Paediatric Musculoskeletal Infections | International Journal of Paediatric Orthopaedics | September-December 2023; 9(3): 22-27.| https://doi.org/10.13107/ijpo.2023.v09.i03.159

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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

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