THE PLACE OF IMMOBILIZATION DURING TREATMENT OF SEPTIC ARTHRITIS. RETROSPECTIVE REVIEW OF A SERIES OF 28 CHILDREN TREATED WITH AND WITHOUT IMMOBILIZATION.

Abstract

Immobilization of septic arthritis is an ancient and always recommended notion. Before discovery of antibiotics, immobilization allowed an articular ankylosis in functional position. Since discovery of antibiotic chemotherapy, immobilization is justified for its antalgic and anti-inflammatory qualities. However, Salter demonstrated experimentally the interest of continuous passive mobilization during septic arthritis. The authors also demonstrated the deleterious effects of immobilization on articular cartilage during Staphylococcus aureus induced arthritis in a rabbit model. The authors compared two series of children treated for septic arthritis. All children were treated by articular lavage, and by intravenous antibiotic chemotherapy during 10 days, then by enteral antibiotic chemotherapy for 6 supplementary weeks. 14 children were immobilized during 1 month, while 14 others were mobilized from the first days. Consumption and class of antalgic chemotherapy, inflammatory balances (Blood Count, C Reactiv Protein), articular range motion during of the first and sixth month clinical review, were compared. Only articular range motion noted during the clinical review of the first month were significantly different in the two groups. Articular range motion of the not immobilized children were close of normal, while the other children suffered from articular stiffness. Immobilization had no beneficial effects either in pain or in correction of the inflam-matory process.