Lowden C M, Walsh S J
Starship Children's Hospital, Auckland, New Zealand.
J Pediatr Orthop. 1997 Jul-Aug;17(4):467-9.
Osteomyelitis of the clavicle is a rare condition that is difficult to diagnose. We have reviewed five cases of acute staphylococcal osteomyelitis of the clavicle that have been collected over a 3-year period in our center. All patients had pain, fever, and swelling over the clavicle. All had a raised erythrocyte sedimentation rate with positive Staphylococcus aureus blood cultures at presentation. Three of our five patients required surgical drainage. Two of these patients had pathologic fracture of the clavicle while receiving treatment and then went on to develop complete resorption of the medial clavicle. Isolated reports of acute staphylococcal osteomyelitis of the clavicle in children occur in the literature. This behaves very differently from chronic sclerosing osteomyelitis and tuberculous osteomyelitis of the clavicle, which are more commonly reported. Our impression is that early treatment with high-dose intravenous antistaphylococcal antibiotics helps avoid the complication of pathologic fracture. The functional result after resorption of the medial clavicle is very good in the short term.
锁骨骨髓炎是一种罕见且难以诊断的病症。我们回顾了在我们中心3年期间收集的5例急性金黄色葡萄球菌性锁骨骨髓炎病例。所有患者均有锁骨部位疼痛、发热和肿胀。所有患者就诊时红细胞沉降率升高，血培养金黄色葡萄球菌呈阳性。我们的5例患者中有3例需要手术引流。其中2例患者在接受治疗时发生锁骨病理性骨折，随后锁骨内侧完全吸收。文献中有儿童急性金黄色葡萄球菌性锁骨骨髓炎的个别报道。其表现与更常见报道的慢性硬化性骨髓炎和结核性锁骨骨髓炎有很大不同。我们的印象是，早期使用大剂量静脉注射抗葡萄球菌抗生素有助于避免病理性骨折的并发症。锁骨内侧吸收后的短期功能结果非常好。
