Acute osteomyelitis of the distal fibula in children: Treatment options and long-term follow-up

Kaziz, Hamdi; Triki, Mohamed Amine; Chermiti, Wajdi; Mouelhi, Thabet; Naouar, Nader; Ayèche, Mohamed Laziz Ben

doi:10.1016/j.arcped.2020.06.010

Cited by 5 publications

(6 citation statements)

References 31 publications

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“…The consequences of growth disturbances in osteomyelitis are profound. In cases where the growth plate is affected, patients may experience limb length discrepancies [ 7 ], angular deformities, and functional impairments, all of which can have a lasting impact on their quality of life [ 8 ]. Additionally, the economic burden associated with the long-term care and rehabilitation of individuals affected by osteomyelitis-related growth disturbances is substantial.…”

Section: Introductionmentioning

confidence: 99%

Disturbance of Growth in Pediatric Patients Due to Osteomyelitis Caused by Growth Plate Infection

Malik,

Swanson,

Okimoto

et al. 2023

Cureus

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Osteomyelitis, a severe bone infection, poses a multifaceted challenge to healthcare professionals. While its pathophysiology and treatment have been extensively studied, the impact of osteomyelitis on skeletal growth, particularly in pediatric patients, is an area that warrants attention. This abstract highlights the significance of understanding and managing growth disturbances in osteomyelitis, providing key findings and recommendations for clinicians. Understanding growth disturbance in osteomyelitis is essential because it can lead to lifelong consequences for pediatric patients. The infection may affect the growth plate, leading to limb length discrepancies, angular deformities, and functional impairments. These complications not only diminish the quality of life but also pose a substantial economic burden on the healthcare system. Therefore, early recognition and intervention are crucial. Key findings indicate that the risk of growth disturbances in osteomyelitis is particularly high in pediatric patients due to the vulnerability of the growth plate. Timely diagnosis, appropriate management, and targeted interventions can mitigate the long-term sequelae of growth disturbances. These include utilizing advanced imaging techniques to assess the extent of growth plate involvement, optimizing antibiotic therapy, and employing surgical techniques like epiphysiodesis, guided growth, or corrective osteotomies. Additionally, fostering a multidisciplinary approach that involves orthopedic surgeons, infectious disease specialists, and pediatric endocrinologists is vital to achieving successful outcomes. Recommendations for managing growth disturbance in osteomyelitis encompass early detection, meticulous monitoring, and a tailored treatment plan. Healthcare providers should remain vigilant for signs of growth plate involvement in osteomyelitis patients, especially in the pediatric population. A thorough evaluation, including advanced imaging and clinical assessment, is essential for accurate diagnosis. Close collaboration between specialists to address the infection and its skeletal consequences is crucial. Furthermore, patient and family education plays a pivotal role in fostering compliance with the treatment regimen. In conclusion, understanding and managing growth disturbances in osteomyelitis is paramount, particularly in pediatric patients. The implications of growth plate involvement are significant, and timely intervention is essential to prevent lifelong consequences. By implementing a comprehensive approach that combines accurate diagnosis, multidisciplinary collaboration, and patient education, healthcare professionals can enhance the quality of life and well-being of those affected by this challenging condition.

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Section: Introductionmentioning

confidence: 99%

Disturbance of Growth in Pediatric Patients Due to Osteomyelitis Caused by Growth Plate Infection

Malik,

Swanson,

Okimoto

et al. 2023

Cureus

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“…Fibular osteomyelitis is uncommon and the literature is limited to case reports [1][2][3][4] and case series [5][6]. The involvement is usually restricted to the proximal, middle, or distal fibula.…”

Section: Introductionmentioning

confidence: 99%

“…Panfibular osteomyelitis has very rarely been reported in the literature [7]. Staphylococcus aureus is the most commonly reported organism [5] though there are reports of anaerobic, meningococcal, fungal, and mycobacterial cases [4,[8][9][10]. Medical management alone is often successful [2,4] and generally consists of four to six weeks of antibiotics [2,4].…”

Section: Introductionmentioning

confidence: 99%

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Progressive Ankle Subluxation Following Panfibular Osteomyelitis Requiring Fibular Resection

Vij¹,

Ranade²,

Belthur³

2022

Cureus

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A 10-month-old boy presented with fever, a swollen left leg, and septicemic shock. He was diagnosed with panfibular osteomyelitis. Failure of combined medical and surgical treatment to achieve source control necessitated fibular resection. He subsequently developed a progressive superolateral subluxation of his left ankle, valgus deformity, and brace intolerance. Tibiotalar arthrodesis resulted in a stable plantigrade ankle, excellent weight-bearing ability, and a minor leg-length discrepancy at the 14-month postoperative followup.

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“…Some patients will not show the classical symptoms of osteomyelitis, which include fever, local tenderness, gait disturbance, and redness and swelling of the affected area. The pathogen can enter the bone through hematogenous spread, direct inoculation, and spread from a locally infected area (does not occur in all cases of local infection or trauma) 5 .…”

mentioning

confidence: 99%

Ultrasound-Guided Needle Aspiration of Subperiosteal Abscess in a Child with Acute Osteomyelitis of the Fibula

Kanamoto

Mazuka

2022

JBJS Case Connector

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Case: An 8-year-old boy with left lateral ankle pain was diagnosed with acute osteomyelitis after methicillinsusceptible Staphylococcus aureus was identified in a subperiosteal abscess in the distal fibula that had been aspirated using an ultrasound-guided needle. Symptoms improved after 2 weeks of intravenous and 4 weeks of oral antimicrobial therapy; no additional treatment was required. No growth retardation or sequelae were observed at the 6-year follow-up. Conclusions:In acute osteomyelitis, the identification of subperiosteal abscess is key for early diagnosis. Ultrasound evaluation of the distal fibula should also be considered in the diagnosis of lateral ankle pain in children.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B920).

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Acute osteomyelitis of the distal fibula in children: Treatment options and long-term follow-up

Cited by 5 publications

References 31 publications

Disturbance of Growth in Pediatric Patients Due to Osteomyelitis Caused by Growth Plate Infection

Disturbance of Growth in Pediatric Patients Due to Osteomyelitis Caused by Growth Plate Infection

Progressive Ankle Subluxation Following Panfibular Osteomyelitis Requiring Fibular Resection

Ultrasound-Guided Needle Aspiration of Subperiosteal Abscess in a Child with Acute Osteomyelitis of the Fibula

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