SA Orthopaedic Journal
On-line version ISSN 2309-8309
RASOOL, MN. Pyogenic osteomyelitis of the forearm bones in children. SA orthop. j. [online]. 2011, vol.10, n.4, pp. 18-24. ISSN 2309-8309.
Twelve children, aged 1-10 years at presentation, diagnosed with pyogenic osteomyelitis of the forearm bones, were reviewed retrospectively. The radius was involved in six patients, the ulna in five and both bones in one child. Three children had acute osteomyelitis; the remaining nine had features of chronic osteomyelitis. The acute infections had incision and drainage and healed well. In six patients with chronic osteomyelitis treatment involved curettage, debridement and sequestrectomy, with resulting bone defects. Three children with chronic infection were referred with established defects from outlying hospitals. Corticocancellous iliac bone chips were used in defects <2 cm in two children; and in two children with larger defects (6-8 cm), segmented bicortical iliac bone graft was used over a K wire. Two children with distal ulna resorption had radioulnar synostosis. Two children had radial club hand deformity with loss of the radial shaft. One had transposition of the residual metaphysis of the radius to the distal ulna, and the other had transposition of the carpus to the ulna. The remaining child had shortening of the radius following multifocal osteomyelitis in infancy. All reconstructive procedures healed by 3 months. All children had improved function. Shortening of the forearm ranged from 2-20 cm.
Keywords : Osteomyelitis; forearm bones; radial club hand; radio-ulnar synostosis.