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Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2021, Number 1-3

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Rev Mex Ortop Ped 2021; 23 (1-3)

Pediatric chronic osteomyelitis: analysis of the clinical and paraclinical presentation and its therapeutic approach. Systematic review of the literature

Puchiele A, Rodríguez M, Pérez ME

Language: Spanish
References: 25
Page: 27-35
PDF size: 187.42 Kb.


ABSTRACT

Introduction: Chronic osteomyelitis (COM) is defined as a bone infection greater than one month, in the presence of devitalized bone. Treatment should always be medical and surgical and guided by a multi-disciplinary team. Surgical treatment is complex and must be planned. Objectives: To analyze the clinical and paraclinical presentation and the therapeutic approach to the variety of surgical techniques. Material and methods: We carried out a systematic review of the literature in the PubMed database with the term "chronic osteomyelitis" and we analyzed 12 articles that coincided with our inclusion and exclusion criteria. Results: The fistula was the most frequent clinical element (70% of the patients). S. aureus was the most frequent germ (72.4%) and of these 39.4% belong to S. aureus methicillin resistant (SAMAR). 22% presented polymicrobial cultures. The paraclinical values were variable and difficult to compare. Intravenous antibiotic treatment was an average of 3.5 weeks, followed by oral route for 7.4 weeks. The surgical techniques were: surgical cleanings, induced membrane technique and other bone reconstruction techniques. Conclusions: Treatment should include germ-directed antibiotic therapy and surgery planned in stages. The first surgical stage should always include radical debridement to healthy bone, followed by a reconstruction stage.


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EVIDENCE LEVEL

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