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Late sequelae of neonatal septic arthritis of the shoulder
C F Bos1, L J Mol, W R Obermann
1Leiden University Medical Centre, The Netherlands.
Insights
Early diagnosis and treatment of neonatal septic arthritis in the shoulder lead to better outcomes. Delayed treatment can cause cosmetic deformities but minimal functional loss in children.
Area of Science:
- Pediatrics
- Orthopedic Surgery
- Infectious Diseases
Background:
- Neonatal sepsis can lead to septic arthritis, a serious joint infection.
- Septic arthritis of the shoulder in neonates is uncommon and can have long-term consequences.
Purpose of the Study:
- To evaluate the long-term outcomes of septic arthritis of the shoulder in children treated after neonatal sepsis.
- To determine the impact of diagnostic and treatment delays on functional and cosmetic results.
Main Methods:
- Retrospective review of eight children (ten shoulders) with a history of neonatal sepsis.
- Analysis of treatment methods (aspiration, arthrotomy) and follow-up duration (mean 14 years).
- Assessment of range of motion, humeral head deformation, and humerus length.
Main Results:
- Five of ten shoulders had a full range of motion at follow-up.
- Minimal restriction of external rotation was observed in the remaining shoulders.
- Significant humerus shortening (up to 10 cm) and humeral head deformation occurred in cases with delayed diagnosis.
Conclusions:
- Early diagnosis and prompt treatment are crucial for favorable outcomes in neonatal shoulder septic arthritis.
- Late diagnosis may lead to cosmetic abnormalities but generally results in negligible functional impairment.
Abstract:
We reviewed eight children (ten shoulders) who had suffered neonatal sepsis, after a mean follow-up of 14 years (11 to 15). The delay between the onset of symptoms and diagnosis was one day in five patients, two days in three and seven days in one. All ten shoulders were treated by aspiration, followed by arthrotomy in two. At follow-up, five of the ten shoulders had a full range of movement and the others had minimal restriction of external rotation. Shortening of 10 cm was present in one patient, while two with bilateral involvement had disproportionally short humeri. Early diagnosis and treatment favour the outcome in septic arthritis of the shoulder. With late diagnosis, deformation of the humeral head and shortening of the humerus cause marked cosmetic abnormality but negligible functional loss.