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Septic arthritis of the shoulder during the first 18 months of life
Insights
Septic shoulder infections in infants can lead to long-term issues, including significant humeral length discrepancies and variable shoulder range of motion, even years after treatment.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
Background:
- Septic arthritis of the shoulder is a rare but serious condition in infants.
- Early diagnosis and treatment are crucial to prevent long-term complications.
Purpose of the Study:
- To evaluate the long-term functional and structural outcomes of septic shoulders in young children.
- To identify factors influencing prognosis and range of motion after shoulder sepsis.
Main Methods:
- A retrospective study followed 42 patients diagnosed with septic shoulders before 18 months of age.
- Average follow-up was 6 years, assessing range of motion, humeral length, and humeral head morphology.
- Patient-reported pain and functional limitations were also recorded.
Main Results:
- Significant humeral length discrepancies (average 2.4 cm) were observed in most patients.
- Shoulder range of motion was generally good, but 19% had limited flexion (<130 degrees).
- Humeral head morphology was abnormal in 93% of cases, with variable shapes unrelated to range of motion.
Conclusions:
- Septic shoulder in infants frequently results in long-term humeral deformities.
- Functional outcomes are often satisfactory despite radiographic abnormalities.
- Predicting range of motion based on humeral head shape is unreliable.
Abstract:
Forty-six septic shoulders in 42 patients < 18 months old at diagnosis were followed for an average of 6 +/- 10 years. Eight were not diagnosed at the time of infection. Five patients complained of intermittent, mild pain with use. All could touch their mouth and back of their head with the hand on their affected side. Flexion and abduction averaged 150 degrees; internal and external rotation averaged 60 degrees. Nineteen percent of the shoulders had < 130 degrees of flexion. Discrepancy in humeral length was 0-9 cm (average 2.4 cm). Only 7% of the humeral heads were entirely normal. The shapes of the remainder were quite variable, and range of motion could not be predicted from these shapes.