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儿童肩胛骨急性血源性骨髓炎。

Acute hematogenous osteomyelitis of the scapula in children.

机构信息

Service d'orthopédie, CHU Monastir, Monastir, Tunisia.

出版信息

Orthop Traumatol Surg Res. 2009 Dec;95(8):632-5. doi: 10.1016/j.otsr.2009.08.006.

Abstract

PURPOSE OF THE STUDY

Osteomyelitis of the scapula is uncommon, often with a misleading clinical presentation. We report four cases of osteomyelitis of the scapula to illustrate the particular clinical imaging findings and treatment related to this location.

CASE REPORTS

Between 1996 and 2006, four children were treated for osteomyelitis of the scapula, three boys and one girl, with a mean age of 8 years (range, 5-11 years). The time from symptom onset to hospitalization was 2 days. Pain was noted for all patients and total functional incapacity of the upper extremity was noted for three patients. The diagnosis of osteomyelitis of the scapula was established on the basis of imaging (ultrasound and CT scan). All patients were given medical treatment and underwent surgery. A positive bacteriology was noted in all patients. The bacterium isolated from blood cultures (two cases) and local samples obtained at the surgical site (four cases) were Meti-S Staphylococcus aureus.

RESULTS

The results were analyzed by studying the anatomic and functional outcome at a mean follow-up of 36 months (range, 16-60 months). The patients were pain-free and had full range of motion in their shoulders. There were no complications.

DISCUSSION

Few reports are available in the literature on osteomyelitis of the scapula. We discuss the specific clinical and imaging features as well as the treatment for this location.

摘要

研究目的

肩胛骨骨髓炎并不常见,常伴有误导性的临床表现。我们报告了 4 例肩胛骨骨髓炎病例,以说明该部位的特殊临床影像学表现和治疗方法。

病例报告

1996 年至 2006 年间,4 名儿童因肩胛骨骨髓炎接受治疗,其中 3 名男孩,1 名女孩,平均年龄为 8 岁(范围,5-11 岁)。从症状出现到住院的时间为 2 天。所有患者均出现疼痛,3 名患者上肢完全丧失功能。根据影像学(超声和 CT 扫描)诊断为肩胛骨骨髓炎。所有患者均接受了药物治疗和手术治疗。所有患者的细菌培养均呈阳性。从血液培养物(2 例)和手术部位获得的局部样本(4 例)中分离出的细菌均为酿脓链球菌金黄色葡萄球菌。

结果

通过对 36 个月(16-60 个月)的平均随访进行分析,评估了患者的解剖和功能结果。患者无疼痛,肩部活动范围完全正常。无并发症。

讨论

文献中关于肩胛骨骨髓炎的报道很少。我们讨论了该部位的特定临床和影像学特征以及治疗方法。

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