[Osteoarthritis in infants. Follow-up and treatment].
For 25 years, 102 hematogenous septic arthritis have been observed in 82 newborns and infants. The hip joint was the most commun site of involvement (63 cases), than the knee (23 cases), the shoulder (7 cases), the elbow (5 cases), the ankle (3 cases) and one wrist. 14 times, two or more joints were involved. When the diagnosis was made early, an aspiration of pus and an irrigation of the joint was done. But in severe and delayed arthritis, an arthrotomy was preferred. In all cases, joints were immobilized in a post-operative cast or with a traction management, and parenteral antibiotics were prescribed. 52 sequellae were noted, two third of these were seen in second hand. Sequellae are detailed joint by joint, and the authors describe different stages from minor dysplasia and abnormal growth of the epiphysis to severe destruction of the bones and persistent dislocation. Treatment of sequellae is proposed: 1. The hip joint. Dysplasia and deformities of the head and/or the neck were corrected with femoral osteotomy. In 2 cases, a pelvic innominate osteotomy was performed. Progressive coxa vara with short neck and greater trochanteric overgrowth were treated with femoral neck lengthening (personal technic). Dislocations needed open reduction of the hip and extensive excision of the acetabular fibro-fatty tissue. In a few cases, a Colonna's procedure was made. In total destructions of the upper femoral extremity, the treatment consisted in trochanteroplasty. In partial epiphysiodesis of a femoral condyle, disepiphysiodesis was obtained with resection of the physeal bone bridge (2 cases) or with free free physeal transplantation with microvascular anastomosis (2 cases).(ABSTRACT TRUNCATED AT 250 WORDS)
D001170:Arthritis, Infectious / Q000628:therapy*; D001852:Bone Lengthening / Q000379:methods; D002675:Child, Preschool; D006130:Growth Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010003:Osteoarthritis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D010027:Osteotomy / Q000379:methods; D011859:Radiography
Ostéo-arthrites du nourrisson. Aspects séquellaires et traitements.