Tabrizi Ali, Afshar Ahmadreza, Shishavan Seyed Amir Mahlisha Kazemi
Department of Orthopedics, Urmia University of Medical Sciences, Imam Khomeini Hospital, Urmia, Iran.
Department of Orthopedics, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
J Hand Microsurg. 2020 Dec;12(3):204-207. doi: 10.1055/s-0039-1683947. Epub 2019 Apr 17.
Distal radius fractures are among the most common pediatric fractures. In unstable fractures, treatment methods include closed or open reduction and percutaneous pinning with Kirschner wire (K-wire). This report presents a 13-year-old boy with an unstable distal radius and ulnar fractures, following an accident, who was treated with open reduction and K-wire fixation. He had pain and limited wrist range of motion for 6 months. Conventional radiography revealed a lytic lesion with evident sclerotic margin. Chronic osteomyelitis and Brodie's abscess were also indicated. A complete curettage and antibiotic therapy for 3 months was successful. Culturing results showed that and pathologic findings were in favor of chronic osteomyelitis. Subacute osteomyelitis and Brodie's abscess are rare retarded complications in percutaneous pinning of distal radius pediatric fractures. The curettage of the lesion and antibiotic therapy for at least 3 months would be successful and could result in good prognosis among children.
桡骨远端骨折是最常见的儿童骨折之一。对于不稳定骨折,治疗方法包括闭合或切开复位以及克氏针经皮内固定。本报告介绍了一名13岁男孩,在一次事故后发生了不稳定的桡骨远端和尺骨骨折,接受了切开复位和克氏针内固定治疗。他持续疼痛且腕关节活动范围受限6个月。传统X线摄影显示有一个边界硬化明显的溶骨性病变。还提示有慢性骨髓炎和布罗迪脓肿。进行了彻底刮除术并给予3个月的抗生素治疗,治疗成功。培养结果及病理检查结果均支持慢性骨髓炎的诊断。亚急性骨髓炎和布罗迪脓肿是儿童桡骨远端骨折经皮穿针固定术后罕见的延迟并发症。对病变进行刮除并给予至少3个月的抗生素治疗会取得成功,且可使儿童获得良好预后。