[Selection of treatment modalities in children with chronic osteomyelitis].
OBJECTIVE
We evaluated clinical and follow-up findings and treatment methods of pediatric patients with chronic osteomyelitis.


METHODS
The study included 22 children (14 boys, 8 girls; mean age 8+/-7 years) who were treated for chronic osteomyelitis. Infection sites were the femur, tibia, ulna, and radius in 11, 8, 1, and 2 patients, respectively. Sixteen patients had a history of trauma. Fourteen patients had fractures, nine of which were associated with segmentary bone defects. All the patients underwent at least one debridement and received antibiotic treatment for at least six weeks. When necessary, medications were modified according to the antibiogram results. Cast immobilization was applied, but external fixation was used when bone instability existed. The mean follow-up period was 54 months.


RESULTS
Clinical improvement was achieved in 13 patients following surgical debridement procedures, antibiotic treatment for six weeks, secondary grafting (5 patients), and cast immobilization. Of nine patients with segmentary bone losses, seven patients needed bone reconstruction procedures. Spontaneous shaft regeneration was observed in one patient with ulnar osteomyelitis.


CONCLUSIONS
The results of surgical debridement and antibiotic treatment are satisfactory in more than half of the pediatric patients with chronic osteomyelitis. However, those developing segmentary bone defects after surgical debridement require bone reconstruction procedures.
Unal
Vuslat Sema
VS
Department of Orthopedics and Traumatology (1. Ortopedi ve Travmatoloji Kliniği), Ankara Numune Training and Research Hospital, Ankara, Turkey. vuslatsema@yahoo.com
Dayican
Avni
A
Demirel
Murat
M
Portakal
Süleyman
S
Ozkan
Güray
G
Uçaner
Ahmet
A
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002370:Casts, Surgical; D002648:Child; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D005260:Female; D005269:Femur; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011183:Postoperative Complications; D011859:Radiography; D011884:Radius; D012720:Severity of Illness Index; D013977:Tibia; D016896:Treatment Outcome; D014457:Ulna
D000900:Anti-Bacterial Agents