Osteomyelitis of the Clavicle

Srivastava, K. K.; Garg, Love; Kochhar, V. L.

doi:10.3109/17453677408989675

Cited by 15 publications

(8 citation statements)

References 2 publications

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“…Lowden and Walsh 6 had good functional results in 3 of 5 chil-dren with acute staphylococcal osteomyelitis who underwent surgical drainage. Srivastava et al 15 reported no functional deficit in their 10 patients undergoing total claviculectomy, which they recommended as the treatment of choice for pyogenic osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

Primary Osteomyelitis of the Clavicle in Children

Ghate¹,

Thabet²,

Gosey³

et al. 2016

Orthopedics

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Osteomyelitis of the clavicle is a rare entity with a broad differential diagnosis and high potential for complications if not diagnosed promptly and treated appropriately. The threshold for surgical intervention should be low to prevent osteonecrosis and bony resorption. In addition, although rare, life-threatening complications have been reported. This report describes primary osteomyelitis of the clavicle that was diagnosed in a 22-month-old girl on her third clinical evaluation after 4 days of symptoms. She presented to a children's tertiary care emergency department with fever and acute pain and swelling of her right shoulder and arm. The diagnosis was confirmed through clinical, laboratory, and imaging studies including ultrasound; these revealed subperiosteal abscess formation, which may have developed in part as the result of a delayed diagnosis from the 2 prior emergency department visits. The patient was treated initially with intravenous antibiotics and underwent therapeutic as well as diagnostic needle-guided tissue aspiration under ultrasound guidance. This ruled out malignancy but was not curative, and the subperiosteal abscess recurred within 24 hours, prompting formal operative irrigation and debridement. The patient was seen for 12-month follow-up and has had no complications or evidence of recurrence. This case emphasizes the need for a high index of suspicion to prevent diagnostic delays as well as the importance of a low threshold for surgical debridement to minimize the potential for complications that could prolong the treatment course. [Orthopedics. 2016; 39(4):e760-e763.].

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Section: Discussionmentioning

confidence: 99%

Primary Osteomyelitis of the Clavicle in Children

Ghate¹,

Thabet²,

Gosey³

et al. 2016

Orthopedics

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“…The routine treatment of chronic osteomyelitis is long-term antibiotherapy together with excision of the sequestrum including aggressive and if necessary, repeated surgical debridement. 6,16 …”

Section: Discussionmentioning

confidence: 99%

“…Despite modern surgical techniques and advanced antimicrobial therapy, osteomyelitis remains a difficult and challenging problem. 6,7 In the treatment of clavicular osteomyelitis which occurs following surgery, the fixation material is removed and following aggressive debridement and a long period of antibiotic therapy, if there is defective soft tissue, a muscle flap can be applied. 3,4 …”

Section: Introductionmentioning

confidence: 99%

Bilateral clavicle osteomyelitis: A case report

Sağlam¹,

Saglam²,

Gülabi³

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONOsteomyelitis of the clavicle is rare. Infection occurs from hematogenous spread or trauma. In adults infection is usually secondary due to an exogenous cause such as open fractures, surgery (iatrogenic) or spread from local tissue with infection.PRESENTATION OF CASEThe case is presented here of a 50-year old female with bilateral clavicular fractures, who was operated on with open reduction and internal fixation. At the 6-month follow-up, she had complaints of bilateral osteomyelitis which was successfully treated with resection of the infected segment of the bone, and antibiotic impregnated collagen.DISCUSSIONPredisposing factors include diabetes, intravenous drug abuse, tuberculosis or immune suppression. Management involves the removal of bone fixation, debridement of the bone and if there is a defect, coverage with a muscle flap is applied.CONCLUSIONIn cases of clavicular osteomyelitis where infection continues despite debridement and antibiotic therapy, excision of the sequestered clavicular section is a successful treatment approach and has been seen to improve quality of life without any functional loss.

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“…A total of 89 articles were retrieved from literature search, of which 6 [2, 3, 7–10] reported 16 cases of acute clavicle osteomyelitis in children and adolescents (ages ranging between 0 and 16 years) that were included in the analysis. We excluded chronic cases of clavicle osteomyelitis and those for which the age and gender of patients were not reported.…”

Section: Review Of the Literaturementioning

confidence: 99%

A Rare Case of Clavicle Osteomyelitis in a Child and Literature Review

Chrysochoou

Antachopoulos

Badekas

et al. 2016

Case Reports in Pediatrics

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Acute clavicle osteomyelitis in children is rare representing <3% of osteomyelitis cases. We treated a 12-year-old boy who presented with acute pain in the right clavicle and high fever for 4 days. MRI showed abnormal signal in the right clavicle with periosteal reaction. Staphylococcus aureus isolated from blood was susceptible to methicillin, clindamycin, and macrolides. Clindamycin was given intravenously for 3 wks and orally for another 3 wks with no recurrence. We reviewed clavicle osteomyelitis cases in children searching PubMed English literature. From a total of 89 studies retrieved, only 6 fulfilled the criteria and were analyzed. Sixteen patients (56% female) were included with a median age of 9 yrs (range 2 wks–16 yrs). Osteomyelitis was hematogenous in most cases, with S. aureus being the most frequent cause, isolated from either blood or tissue. Symptoms included fever, swelling, and localized bone tenderness. Antimicrobial therapy lasted for 4–12 weeks (median 7.5). Three patients required drainage or curettage. Recurrence occurred in 1/16 cases (6.2%) and persistence of symptoms occurred to 2/16 cases (12.5%) reported before 90s with unknown antimicrobial susceptibility of the pathogen. Acute clavicle osteomyelitis mainly affects older children and has generally good prognosis. Staphylococcus aureus is most commonly implicated and surgery may be needed.

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Osteomyelitis of the Clavicle

Cited by 15 publications

References 2 publications

Primary Osteomyelitis of the Clavicle in Children

Primary Osteomyelitis of the Clavicle in Children

Bilateral clavicle osteomyelitis: A case report

A Rare Case of Clavicle Osteomyelitis in a Child and Literature Review

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