Abstract
Aim
Diagnosis of clavicle osteomyelitis (OM) is often difficult with delayed treatment due to the lower incidence of this disease. The present study aimed to summarize clinical experience with clinical features and treatment of clavicle OM.
Method
We systematically searched the Pubmed database to identify studies regarding clinical characteristics and management of clavicle OM from 1980 to 2016, with publication language limited to English. Effective data were collected and pooled for analysis.
Results
Altogether 69 reports comprising 188 cases were included for analysis. The average age of included patients was 24.95 years, 57.98% of whom were younger than 20 years. According to different etiologies, 86 cases (45.74%) were categorized as infectious OM with 102 cases (54.26%) as noninfectious. Of all the 102 noninfectious OM, 62.13% were diagnosed as chronic recurrent multifocal osteomyelitis (CRMO). The female-to-male ratio of infectious clavicle OM was 1.09, with 3.43 of noninfectious clavicle OM. The most common and earliest clinical symptom was pain, which occurred in 86.81% of the patients. Positive rate of serum erythrocyte sedimentation rate (ESR) was the highest among serum inflammatory biomarkers reported (92.47%). Staphylococcus aureus (46.94%) was the most frequently detected pathogen among patients with infectious clavicle OM. A total of 50 patients received surgical interventions finally (42.37 %). The most frequently used antibiotic was cephalosporin. Most cases achieved favorable outcomes (89.91%).
Conclusions
Clavicle OM, classified as infectious and noninfectious, mostly occurred in the young people and females. The most frequently identified clinical symptom was pain. Despite different treatment strategies, most patients could achieve favorable outcomes.