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Published on: February 25, 2022
Surgical intervention for treatment of septic arthritis in infancy and childhood; a retrospective study
Mohammad Hossein Kariminasab1, Masoud Shayesteh Azar, Majid Sajjadi Saravi
1Department of Orthopaedic Surgery, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Insights
Early diagnosis and intervention in pediatric septic arthritis, especially hip sepsis, significantly improve outcomes. Delayed diagnosis and younger age are key risk factors for poor results in children.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
Background:
- Septic arthritis in children poses risks of mortality and long-term skeletal complications.
- Potential sequelae include limb shortening, osteomyelitis, joint destruction, limited motion, and dislocation.
Purpose of the Study:
- To determine the final outcomes of pediatric septic arthritis cases.
- To identify risk factors associated with poor outcomes in pediatric septic arthritis.
Main Methods:
- Retrospective study of 243 children diagnosed with septic arthritis between 1996-2005.
- Diagnosis confirmed via clinical, ultrasound, and smear findings (67% positive).
- Focus on 162 cases with definite septic arthritis requiring surgical intervention, particularly hip involvement.
Main Results:
- Six severe complications occurred among 162 surgically treated cases, indicating favorable outcomes with early intervention.
- Hip sepsis was the primary site of involvement and complications, linked to four of six poor outcomes.
- Grave prognostic factors identified: delayed diagnosis, infantile age, and hip joint sepsis.
Conclusions:
- Early diagnosis and prompt intervention are crucial for favorable outcomes in pediatric septic arthritis.
- Hip joint involvement and younger age are significant risk factors for poorer outcomes.
- Continued vigilance and timely treatment are essential to mitigate severe complications.
Abstract:
Septic arthritis is a fearful condition because of its mortality and the potentially late sequels on immature skeleton including limb shortening, osteomyelitis, destruction of joint surface, severe limitation of motion, and dislocation.This study was performed to reveal the final outcome of our patients and find out the possible risk factors of poor result. The case records of 243 children who were admitted with the diagnosis of septic arthritis in Imam Khomeini and Bu Ali Sina Hospitals, Mazandaran Province, were studied between 1996 and 2005. The diagnosis was based on clinical and ultrasound findings in all patients and positive smear in 67% of them. Among these patients, we had access to 162 cases who had definitely septic arthritis and went through surgical interventions because of the involvement of the hip joint or uncertain response to medical treatments. As four out of six poor outcome cases were related to hip sepsis, hip was the main site of involvement and complications.Six cases of severe complications out of 162 showed the favorite result due to early diagnosis and intervention and highlighted the grave prognostic factors which were delayed diagnosis, infantile age and hip sepsis.
