Manche E, Rombouts-Godin V, Rombouts J J
Service d'Orthopédie et de Traumatologie de l'Appareil Locomoteur, Cliniques Universitaires Saint-Luc, Bruxelles, Belgique.
Acta Orthop Belg. 1991;57(2):91-6.
The retrospective study of a series of 44 cases of acute hematogenous osteomyelitis in infants and children has shown that 16 out of the 44 patients (36%) have a history of previous trauma at the site of bone infection. Seven infants were less than one year of age. For the remaining 37 children the incidence of previous local trauma rose to 43% (16/37). This incidence is similar to that in previous studies. Acute hematogenous osteomyelitis follows blood-borne spread of a pathogen from a portal of entry. Why hematogenous infection selects a particular bone is an enigma. Trauma has been said to predispose to the localization of infection but the association between trauma and hematogenous osteomyelitis is only found in one-third of the cases in both this study and in previous series. However these cases with a history of local trauma raise questions regarding the concept of "locus minoris resistentiae" and its medicolegal consequences.
对一系列44例婴幼儿急性血源性骨髓炎病例的回顾性研究表明，44例患者中有16例（36%）在骨感染部位有既往创伤史。7名婴儿年龄小于1岁。在其余37名儿童中，既往局部创伤的发生率升至43%（16/37）。这一发生率与先前研究中的发生率相似。急性血源性骨髓炎是病原体从入口处经血行播散所致。为何血源性感染会选择特定的骨骼仍是一个谜。创伤被认为易导致感染定位，但本研究和先前系列研究中均仅在三分之一的病例中发现创伤与急性血源性骨髓炎之间存在关联。然而，这些有局部创伤史的病例引发了关于“抵抗力较弱部位”概念及其法医学后果的问题。
