Elhessy Ahmed H, Said Mohamed, Abdelgawad Amr
Orthopedic Surgery, Nemours Children's Hospital, Jacksonville, USA.
Medicine, State University of New York (SUNY) Downstate Health Sciences University, New York, USA.
Cureus. 2024 Nov 7;16(11):e73221. doi: 10.7759/cureus.73221. eCollection 2024 Nov.
Epiphyseal Brodie's abscesses represent a rare, slow-progressing form of osteomyelitis that contrasts with the more aggressive types of infection typically seen in bone. These abscesses develop from a low-grade infection and progress gradually, posing unique challenges for treatment due to their proximity to the growth plate and joint structures. While the literature on managing epiphyseal Brodie's abscesses is limited, common treatments include antibiotics and surgical drainage. However, removing these lesions can be complicated by the risk of growth plate damage. This case report describes a patient with an epiphyseal Brodie's abscess that persisted despite standard curettage. We employed an acute-angle trans-physical curettage technique, which allowed for complete lesion excision while preserving the integrity of the growth plate and minimizing the risk of growth disturbance. By accessing the abscess through the diaphysis, metaphysis, and physis, this method proved to be an effective treatment option for Brodie's abscesses located near the physis.
骨骺部布罗迪脓肿是一种罕见的、进展缓慢的骨髓炎形式，与通常在骨骼中所见的侵袭性更强的感染类型形成对比。这些脓肿由低度感染发展而来，并逐渐进展，由于其靠近生长板和关节结构，给治疗带来了独特的挑战。虽然关于治疗骨骺部布罗迪脓肿的文献有限，但常见的治疗方法包括抗生素和手术引流。然而，切除这些病变可能因生长板受损的风险而变得复杂。本病例报告描述了一名尽管进行了标准刮除术但骨骺部布罗迪脓肿仍持续存在的患者。我们采用了锐角经物理刮除技术，该技术能够在保留生长板完整性并将生长紊乱风险降至最低的同时完整切除病变。通过经骨干、干骺端和骨骺进入脓肿，这种方法被证明是治疗位于骨骺附近的布罗迪脓肿的有效选择。
