Lower extremity fractures simulating infection in myelomeningocele

Thirteen patients with myelomeningocele sustained 33 fractures of the lower extremity. Fourteen fractures were accompanied by increased local heat, swelling, redness and a systemic response, including an elevated temperature and leukocyte count. Diagnosis of these fractures, which occur without a significant history of trauma, requires special roentgenographic studies. If routine films fail to reveal a fracture in a swollen red extremity in patients with myelomeningocele, stress films should be obtained in the area of the major swelling or where clinical pseudo-motion is suspected. The proper treatment of these fractures and the associated elevated temperature is immobilization. When these injuries are immobilized, the leukocyte count and temperature quickly return to normal.