title: A case of chronic osteomyelitis after flexible intramedullary nailing of the femur in 14-year-old boy.
abstract: This report presents a case of chronic osteomyelitis occurring in a young adolescent, following a left midshaft femoral fracture that was treated with flexible intramedullary nailing. Appropriate therapy for chronic osteomyelitis complicating a fracture is based on a multimodality approach even if there is no set algorithm to take in charge the two central problems related to it, namely the eradication of infection and the osseous union. The surgical technique and choice of fracture fixation should be determined according to the patient's weight and age. Careful monitoring after surgery is important. Clinical signs and investigations should alert the surgeon to the possibility of an underlying infection, and appropriate treatment should be undertaken promptly. It is important not to underestimate local skin irritation or inflammatory results that remain elevated. If a nail has penetrated through the skin and the fracture has united, metalware should be removed promptly as the risk of developing osteomyelitis is high even in an otherwise healthy child.
authors.affiliation: Service de Chirurgie Infantile, Centre Hospitalier Universitaire Estaing, 1, Place Lucie Aubrac, 63003, Clermont Ferrand, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Villatte
authors.affiliation: Service de Chirurgie Infantile, Centre Hospitalier Universitaire Estaing, 1, Place Lucie Aubrac, 63003, Clermont Ferrand, France.
authors.forename: Roger
authors.initials: R
authors.lastname: Erivan
authors.affiliation: Service de Chirurgie Infantile, Centre Hospitalier Universitaire Estaing, 1, Place Lucie Aubrac, 63003, Clermont Ferrand, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Mondon
authors.affiliation: Service de Chirurgie Infantile, Centre Hospitalier Universitaire Estaing, 1, Place Lucie Aubrac, 63003, Clermont Ferrand, France. canavese_federico@yahoo.fr.|Department of Pediatric Surgery, CHU Estaing, 1, Place Lucie Aubrac, 63003, Clermont Ferrand, France. canavese_federico@yahoo.fr.
authors.forename: Federico
authors.initials: F
authors.lastname: Canavese
keywords: Chronic osteomyelitis; Complication; Femur fracture; Flexible intramedullary nailing