Jardaly Achraf H, LaCoste Ketrick, Gilbert Shawn R, Conklin Michael J
University of Alabama at Birmingham, Department of Orthopaedics, Birmingham, AL, USA.
Children's Hospital of Alabama, Department of Pediatric Orthopaedics, Birmingham, AL, USA.
Case Rep Orthop. 2021 Sep 30;2021:7915516. doi: 10.1155/2021/7915516. eCollection 2021.
Complications following treatment of supracondylar humerus fractures are typically seen shortly postoperatively. Late complications occurring years after percutaneous pinning are rare but can be indolent and have permanent sequelae. We present cases of children presenting with late deep infections to discuss their diagnosis and treatment.
After institutional review board approval, we retrospectively reviewed records of three children who developed deep infections at least one year after percutaneous pinning of their supracondylar humerus fracture. Patient details and outcomes were analyzed. Radiographs and magnetic resonance imaging were reviewed along with each patient's clinical course and treatment.
We report 3 cases of osteomyelitis and/or septic arthritis presenting at least one year after supracondylar humerus fractures treated with closed reduction and percutaneous pinning. The patients required several irrigation and debridement procedures with placement of antibiotic beads in addition to a prolonged course of antibiotics.
Delayed deep infections can occur after closed reduction and percutaneous pinning of supracondylar humerus fractures in children. Vigilance is required to diagnose and treat such occurrences, and prolonged follow-up is needed to monitor for recurrent or intractable infections.
肱骨髁上骨折治疗后的并发症通常在术后不久出现。经皮穿针固定数年之后出现的晚期并发症罕见，但可能进展缓慢并产生永久性后遗症。我们报告了出现晚期深部感染的儿童病例，以探讨其诊断和治疗方法。
经机构审查委员会批准后，我们回顾性分析了3例肱骨髁上骨折经皮穿针固定至少1年后发生深部感染的儿童病例记录。分析了患者的详细情况和治疗结果。结合每位患者的临床病程和治疗过程，对X线片和磁共振成像进行了评估。
我们报告了3例肱骨髁上骨折经闭合复位和经皮穿针固定至少1年后出现骨髓炎和/或化脓性关节炎的病例。患者除了需要长时间使用抗生素外，还需要多次进行冲洗和清创手术，并放置抗生素骨珠。
儿童肱骨髁上骨折闭合复位和经皮穿针固定后可能发生延迟性深部感染。需要保持警惕以诊断和治疗此类情况，并且需要长期随访以监测是否复发或出现难治性感染。
