Abstract
Osteoarticular infections in paediatric population are primarily hematogenous in origin, although cases secondary to penetrating trauma, surgery or contiguous site are also reported.
Despite being rare, numerous studies report infection relapse rates around 5 %. Osteomyelitis complications in children include septic arthritis, osteonecrosis of the bone segment, impaired growth.
7 years old male patient presented with history of traffic injury in January 2004. He sustained closed diaphyseal fracture of the right femur initially treated by elastic osteosynthesis.
Four years after traffic injury he was diagnosed at our Institution of chronic femoral Osteomyelitis with positive cultures for methicillin sensible Staphylococcus aureus, requiring multiple surgical debridements and systemic antibiotic therapy.
Five years follow- up the patient developed valgus deformity of his right knee (mechanical axis 11° genu valgum) with limb length discrepancy of 15 mm, intermalleolar distance of 15 cm and bone edema in external compartment of the knee (MRI). At this time the patient did not present any recurrence of septic process with normalization of laboratory parameters (ESR and CRP) and clinically asymptomatic.
In February 2014, at the end of growth, a distal femoral varus osteotomy was used to treat valgus knee malalignment. Medial closing wedge osteotomy was performed satisfactorily using Tomofix® Osteotomy System (DePuySynthes).
18 months follow- up after varus osteotomy the patient progressed satisfactorily without pain and a normal function of his right knee. Correction limb length discrepancy was achieved (5 mm) with a normal alignment of his right limb (mechanical axis 3° genu valgum).
Although Osteomyelitis is not very frequent in children population, its treatment requires not only prolonged antibiotic therapy but also multiple surgical debridements.
We recommend monitoring over a long period of time children affected with Osteomyelitis in order to prevent and treat correctly impaired growth.
