Related Experiment Videos
Septic arthritis of the wrist in infancy
Insights
Septic wrists in infants and children, even with delayed diagnosis, can achieve good functional recovery. Long-term follow-up shows preserved wrist function despite potential radiographic abnormalities.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Hand Surgery
Background:
- Septic arthritis of the wrist is a rare but serious condition in pediatric patients.
- Early diagnosis and treatment are crucial to prevent long-term joint damage and functional impairment.
Purpose of the Study:
- To evaluate the long-term outcomes of septic wrists in pediatric patients.
- To assess the relationship between treatment methods and functional and radiographic results.
Main Methods:
- Retrospective review of seven septic wrists in six pediatric patients.
- Analysis of diagnostic methods, treatment approaches (aspiration, antibiotics, surgical intervention), and follow-up duration (average 7 years, 5 months).
- Assessment of patient-reported pain, functional range of motion (palmarflexion and dorsiflexion), and radiographic findings.
Main Results:
- Patients aged 3 days to 145 days at diagnosis; all had other infected joints.
- Three patients had positive cultures; three wrists were initially undiagnosed and untreated surgically.
- Four wrists underwent multiple aspirations; all received prolonged antibiotic therapy (35-48 days).
- No patient reported pain or functional deficits at follow-up.
- All wrists achieved combined palmarflexion and dorsiflexion of at least 50 degrees.
- Two wrists were radiographically normal; five showed abnormalities, including marked anatomical distortion in three.
Conclusions:
- Septic wrists in children can achieve excellent functional outcomes and range of motion despite delayed diagnosis or non-surgical management.
- Radiographic abnormalities may persist long-term, but do not necessarily correlate with poor functional results.
- Aggressive antibiotic treatment and joint aspiration appear effective in managing pediatric wrist sepsis.
Abstract:
Seven septic wrists in six patients were examined. The average follow-up was 7 years 5 months. The ages at diagnosis ranged from 3-145 days. All patients had one or more joints infected other than the wrist. Three patients cultured organisms. Three wrists were not diagnosed at the time of infection and had no surgical treatment. Four wrists were treated with multiple aspiration. All received antibiotics for 35-48 days. On follow-up no patient complained of pain or lack of function. Combined palmarflexion and dorsiflexion was > or = 50 degrees in all wrists. Two wrists were radiographically normal, whereas five were not. Three of these five had marked distortion of anatomy.