Zhang Xiaole,Zhao Guoqiang,Zhao Xufei.Analysis of diagnosis and treatment of 18 cases of hand and foot osteomyelitis in children[J].Journal of Clinical Pediatric Surgery,,19():921-925.[doi:10.3969/j.issn.1671-6353.2020.10.011]
Analysis of diagnosis and treatment of 18 cases of hand and foot osteomyelitis in children
- CLC:
- R681.2;R726.1;R453.2
- Abstract:
- Objective To summarize the diagnosis and treatment of hand and foot osteomyelitis and improve its understanding in children.Methods The clinical data were retrospectively analyzed for 18 hospitalized children with distal extremity osteomyelitis from January 2015 to January 2019.There were 10 boys and 8 girls with an average age of 93.1(18-146) months.There were digital osteomyelitis (n=7) and osteophytes or phalangeal osteomyelitis (n=11).Traumatic history before admission was positive (n=13) and negative (n=5).During hospitalization,11 children were operated while another 7 received conservative measures.Broad-spectrum antibiotics were prescribed and adjusted according to the results of blood culture and wound culture susceptibility assay.Results After an adequate control of local infection,all children were discharged after wound healing.Oral antibiotic treatment continued after discharge.The total course of treatment was 6-8 weeks.During a follow-up period of 5 months to 4 years,5 patients became lost.Clinical symptoms and imaging abnormalities disappeared in 13 children.In three cases with a course of over 1 month before treatment,the symptoms of digits were abnormal.Two fingers had numbness,digital flexibility was lower than that of normal side and radiology indicated a partial defect of phalanx.Conclusion For children with a history of trauma,redness and swelling of distal extremities,limited mobility and having a course of disease >1 week,radiology and MRI should be performed to determine the possibility of osteomyelitis.Early diagnosis and treatment of osteomyelitis are vital for achieving an excellent prognosis in children.With a prolonged disease course of chronic osteomyelitis,it may lead to bone defects,extremity malformations and abnormal senses or motions.
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Memo
收稿日期:2019-07-30。
通讯作者:赵国强,Email:hello@zju.edu.cn