The purpose of our study is to report the incidence of osteomyelitis during the last 10 years in our department. Diagnosis, management and follow-up are also discussed. We carried out a retrospective study on 40 children who were hospitalised in our clinic between the years 1995–2006 suffering from osteomyelitis. There were 29 male and 11 female children with a mean age 6.8 years. A full blood count, CRP, ESR were measured and X-rays and ultrasound were performed in all patients. Blood cultures were also taken. Additionally, bone scan and CT scan were also performed in 6 and 3 children respectively. The lesion involved in 7 cases the tibia, 9 cases the lower end of the femur and the knee joint, 4 cases the head of the femur and the hip, 7 cases the patella, 4 cases the neck of the humerus, 3 cases the lower end of the fibula, 3 cases the 5th finger of the hand, 2 cases the 4th and 5th metatarsal bones and in 1 case the clavicle. All patients were initially commenced to double antibiotic scheme iv. The microorganisms isolated were Staphylococcus Aureus (27 children-67.5%), Pseudomonas Aeruginosa (9 children-22.5%), Streptococcus Pneumoniae (4 children-10%) The majority of children (80%) were managed conservatively with intravenous and then oral antibiotic therapy. In 8 cases (20%) surgical debridement was performed due to persisting symptoms and/or aggressive radiologic appearance of the lesion. The mean days of hospitalisation were 17.4 days/patient. A 1.2 year mean follow-up was achieved in all the above patients. All children gradually improved and became pain free, while complete bone resolution appeared in the X-Rays. Staphylococcus aureus remains the most common organism causing acute osteomyelitis. If left untreated the condition can lead to serious sequelae. The optimal approach in uncomplicated cases may be a combination of aspiration for diagnostic purposes and prolonged antibiotic therapy. A patient’s lack of response to antibiotic treatment and evidence of aggressive radiologic features are indications for surgery.
The purpose of this paper is the overview of 92 cases with slipped capital femoral epiphysis (S.C.F.E.), treated in inic within the last 18 years (1985–2003).The paper reports the method of treatment and early complications concerning ischaemic necrosis and chondrolysis. During this time, 80 children with S.C.F.E. aged 10–14 years, were treated in our clinic.Of our patients, 50 were boys and 30 girls.With regard to the degree of the slippage, 59 cases 1st degree, 32 were 2nd degree and 1 was 3rd degree;as regards the type, 63 cases were chronic, 17 acute and 12 chronicacute.They were treated surgically by pinning (use of 2 or 3 Moore-Knowls, Steinmann pins and cannulated screws) while in one case osteotomy of the femoral neck was performed.In 11 cases with 2nd degree slippage, total or partial reduction took place on the surgical table,with mild traction and strong internal rotation of the limb.In addition, in 20 cases cannulation was performed. There has been a follow-up period of 1–10 years after surgery. Complications: In 11 hips (in most of which Steinmann pins had been used) occurred slippage of the material inside the joint and the pin was removed (within 2 weeks).During follow-up no signs of either vascular necrosis or chondrolysis were present, with the exception of one case with 2nd degree S.C.F.E. where reduction was also attempted. In total, 2 cases of chondrolysis occurred, in one of which signs of chondrolysis were present even before surgery, and 2 cases of vascular necrosis.The results were evaluated on clinical criteria (limping, pain, reduction in length, range of movement of hip joint) and radiological criteria (articular space, appearance of the femoral head, neck-femoral angle).
