Goldberg I, Shauer L, Klier I, Seelenfreund M
Clin Orthop Relat Res. 1981 Jul-Aug(158):195-7.
Osteomyelitis of the calcaneus developed in a 6-day-old girl subsequent to heel pad puncture for taking blood samples. A review of the literature indicates that as a complication, osteomyelitis is very rare, considering the thousands of punctures performed. There is no mention in the orthopedic literature of such cases being treated in neonatal units. The present case, like others reported thus far, is characterized by the benign course of the disease. Theoretically, it is possible that infectious process could spread from the heel primary site to other bones or joints. Some difficulty in early diagnosis may be encountered in the incipient stages of the disease because of the benign course and lack of radiologic findings. In such cases, when local findings and the history of heel pad punctures suggest an infectious process involving the bone, a bone scan is helpful inasmuch as it is positive before the radiologic signs become manifest. An adequate course of antibiotic therapy, immediately administered, is usually successful, with normal X-ray of the healed os calcis being evident after two to three months. Nevertheless, prophylactic therapy is strongly recommended.
一名6天大的女婴在足跟采血穿刺后发生跟骨骨髓炎。文献回顾表明，作为一种并发症，考虑到进行了数千次穿刺，骨髓炎非常罕见。骨科文献中未提及此类病例在新生儿病房的治疗情况。与迄今报道的其他病例一样，本例的特点是病程良性。理论上，感染过程有可能从足跟原发部位扩散到其他骨骼或关节。由于病程良性且缺乏放射学表现，在疾病初期可能会遇到早期诊断困难。在这种情况下，当局部表现和足跟穿刺史提示骨感染时，骨扫描有助于诊断，因为在放射学征象出现之前骨扫描呈阳性。立即给予足够疗程的抗生素治疗通常会成功，两到三个月后跟骨愈合的X线表现正常。尽管如此，强烈建议进行预防性治疗。
