Khurana Ankit, Vardhan Anand, Negi Deepak
Department of Orthopaedics, AIIMS, New Delhi, India.
Department of Orthopaedics, PGIMER, Chandigarh, India.
J Clin Orthop Trauma. 2019 Jul-Aug;10(4):811-815. doi: 10.1016/j.jcot.2018.08.005. Epub 2018 Aug 8.
Orthopedic manifestations and sequelae of small pox disease are largely forgotten. Presening features in the modern era are not only the classical deformities but also includes precocious arthritis, pathological fractures and joint instability.
To conduct a thorough and systematic review of the literature for all articles reporting osteomyelitis variolosa and its sequelae post eradication and to present an additional case as an illustration.
Systematic review and case report.
ology: PubMed, EMBASE and Google Scholar databases were searched for relevant articles using different combinations of the keywords till 20th June 2017. All articles reporting cases of osteomyelitis variolosa following small pox eradication were included. Pearling of the bibliographies of selected articles was conducted to locate articles missed by the primary database search. Data from these reports were collected on pre-defined forms and the results were analysed.
A total of 8 cases have been reported in the literature so far post-eradication of small pox and all cases are from India. These cases have predominant involvement of elbow followed by hands, feet and ankle. Characteristic clinical signs in the present era are secondary arthritis, pathological fractures, joint instability and some cases even have incidental presentation.The diagnosis is further confirmed by plain radiographs which show pathognomonic features of this condition. Rate of missed/misdiagnosis is very high due to rarity of this condition. All cases in the published literature were managed conservatively except those presenting with pathological fracture.
The purpose of this study is to remind clinicians of an easily recognised sequelae of an eradicated disease and make them aware of its complications.
天花疾病的骨科表现和后遗症在很大程度上已被遗忘。现代的表现特征不仅包括典型畸形，还包括早熟性关节炎、病理性骨折和关节不稳定。
对所有报道天花根除后痘疮性骨髓炎及其后遗症的文章进行全面系统的文献综述，并举例介绍一个额外病例。
系统综述和病例报告。
截至2017年6月20日，使用不同关键词组合在PubMed、EMBASE和谷歌学术数据库中搜索相关文章。纳入所有报道天花根除后痘疮性骨髓炎病例的文章。对所选文章的参考文献进行筛选，以查找在主要数据库搜索中遗漏的文章。从这些报告中收集的数据填写在预定义表格上，并对结果进行分析。
迄今为止，天花根除后文献中共报道了8例病例，所有病例均来自印度。这些病例主要累及肘部，其次是手、脚和脚踝。现代的特征性临床体征为继发性关节炎、病理性骨折、关节不稳定，有些病例甚至为偶然发现。X线平片显示该病的特征性表现，进一步证实了诊断。由于该病罕见，漏诊/误诊率很高。除病理性骨折患者外，已发表文献中的所有病例均采用保守治疗。
本研究的目的是提醒临床医生注意一种已根除疾病的易于识别的后遗症，并让他们了解其并发症。
