Chronic Osteomyelitis after Seven Years Neglected Bone Exposed in 12-Year-Old Boy: A Case Report

Authors

  • - Handayani Department of Pediatrics, Gunungsitoli General Hospital, Nias, North Sumatera, Indonesia
  • Faldi Yaputra Department of Neurology, Faculty of Medicine, Udayana University, Sanglah General Hospital, Bali, Indonesia
  • Berkat Hia Department of Neurology, Gunungsitoli General Hospital, Nias, North Sumatera, Indonesia
  • Victor Telaumbanua Department of Surgery, Gunungsitoli General Hospital, Nias, North Sumatera, Indonesia
  • I Putu Eka Widyadharma Department of Neurology, Faculty of Medicine, Udayana University, Sanglah General Hospital, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2019.100

Keywords:

Bone Exposed, Chronic Post Traumatic Osteomyelitis, Neglected, Radial Nerve Injury

Abstract

BACKGROUND: Access to modern medicine is still limited in some rural areas in Indonesia. This is mostly due to lack of people’s knowledge and concern for their health, especially in orthopaedic cases. Osteomyelitis is generally described as infection and inflammation of the bone, which results in local bone destruction, necrosis, and apposition of new bone. Chronic post-traumatic osteomyelitis (CPTO) is a complex condition and one of the most challenging problems in orthopaedic surgery that cause considerable morbidity.

CASE PRESENTATION: We present a case of chronic post-traumatic osteomyelitis with radial nerve injury, in which radical surgical debridement and broad-spectrum antibiotic administration were done. A 12-year-old boy with a history of falling from the three-meter-high tree had swollen, deformed, and neglected humerus bone exposed. After stabilisation in the emergency room, surgical limb amputation was scheduled, yet the family refused this medical care and chose debridement instead.

CONCLUSION: This case is an important addition to the literature about chronic post-traumatic osteomyelitis with neglected bone exposed and the lacking of society’s concern in regards to orthopaedic cases.

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References

Haidar R, Der Boghossian A, Atiyeh B. Duration of post-surgical antibiotics in chronic osteomyelitis: empiric or evidence-based? International Journal of Infectious Diseases. 2010; 14(9):e752-8. https://doi.org/10.1016/j.ijid.2010.01.005

Handy ED, Manfo AA, Gonsu KH, Essi MJ, Ngo Nonga B, Sosso MA. Clinical and microbiological profile of post-traumatic osteomyelitis in a tertiary hospital in Yaoundé–Cameroon. International Journal of Orthopaedics. 2017; 3(3):1180-4.

Prasad DDV, et al. Management of chronic osteomyelitis by wide debridement and closed suction: Drainage technique. International Journal of Orthopaedics Sciences. 2017; 3:163–168. https://doi.org/10.22271/ortho.2017.v3.i2c.25

Hotchen AJ, McNally MA, Sendi P. The classification of long bone osteomyelitis: a systemic review of the literature. Journal of bone and joint infection. 2017; 2(4):167. https://doi.org/10.7150/jbji.21050 PMCid:PMC5671929

Lima AL, Oliveira PR, Carvalho VC, Cimerman S, Savio E. Recommendations for the treatment of osteomyelitis. Brazilian Journal of Infectious Diseases. 2014; 18(5):526-34. https://doi.org/10.1016/j.bjid.2013.12.005

Scheri RP. Washington Manual of Surgery 20, 312.

van Schuppen J, van Doorn MM, Van Rijn RR. Childhood osteomyelitis: imaging characteristics. Insights into imaging. 2012; 3(5):519-33. https://doi.org/10.1007/s13244-012-0186-8

Birt MC, Anderson DW, Toby EB, Wang J. Osteomyelitis: Recent advances in pathophysiology and therapeutic strategies. Journal of orthopaedics. 2017; 14(1):45-52. https://doi.org/10.1016/j.jor.2016.10.004

Ketonis C, Dwyer J, Ilyas AM. Timing of debridement and infection rates in open fractures of the hand: a systematic review. Hand. 2017; 12(2):119-26. https://doi.org/10.1177/1558944716643294 PMid:28344521

Pinheiro AC. Radial Nerve Palsy after Humeral Fracture: T o Explore or Not to Explore?-A Case Report. Int J Phys Med Rehabil. 2016; 4(326):2. https://doi.org/10.4172/2329-9096.1000326

Schwab TR, Stillhard PF, Schibli S, Furrer M, Sommer C. Radial nerve palsy in humeral shaft fractures with internal fixation: analysis of management and outcome. European Journal of Trauma and Emergency Surgery. 2018; 44(2):235-43. https://doi.org/10.1007/s00068-017-0775-9 PMid:28280873

Hoa YY, Chen LW, Yang KC, Hsu KC, Liu WC, Lin CT. Prognostic factors for radial nerve palsy associated with humeral shaft fracture. Formosan Journal of Surgery. 2017; 50(1):1. https://doi.org/10.4103/fjs.fjs_3_17

Bumbasirevic M, Palibrk T, Lesic A, Atkinson HD. Radial nerve palsy. EFORT Open Reviews. 2016; 1:286–294. https://doi.org/10.1302/2058-5241.1.000028 PMid:28461960

Han BR, Cho YJ, Yang JS, Kang SH, Choi HJ. Clinical features of wrist drop caused by compressive radial neuropathy and its anatomical considerations. Journal of Korean Neurosurgical Society. 2014; 55(3):148. https://doi.org/10.3340/jkns.2014.55.3.148

Latef TJ, Bilal M, Vetter M, Iwanaga J, Oskouian RJ, Tubbs RS. Injury of the Radial Nerve in the Arm: A Review. Cureus. 2018; 10(2). https://doi.org/10.7759/cureus.2199

Wang LH, Weiss MD. Anatomical, clinical, and electrodiagnostic features of radial neuropathies. Physical Medicine and Rehabilitation Clinics. 2013; 24(1):33-47. https://doi.org/10.1016/j.pmr.2012.08.018

Giordano V, Belangero W, Pires RE, Labronici PJ, the Clinical Decision Rules Group. Humerus shaft fracture associated with traumatic radial nerve palsy: An international survey among orthopedic trauma surgeons from Latin America and Asia/Pacific. Journal of Orthopaedic Surgery. 2017; 25:230949901772791. https://doi.org/10.1177/2309499017727914 PMid:28847240

Kim PH, Leopold SS. Gustilo-Anderson Classification. Clinical Orthopaedics and Related Research. 2012; 470(12):3624. https://doi.org/10.1007/s11999-012-2642-7

RD. Correlations Between Degree of Limb Ischemia in MESS (Mangled Extremity Severity Score) Score in Predicting Amputation or Limb Salvage in Crush Injury at Hasan Sadikin Hospital, Bandung`. Biomedical Journal of Scientific & Technical Research. 2017; 1.

Calhoun JH, Manring MM, Shirtliff M. Osteomyelitis of the long bones. InSeminars in plastic surgery 2009 (Vol. 23, No. 2, p. 59). Thieme Medical Publishers.

Ryan S, Eward W, Brigman B, Zura R. Chronic Osteomyelitis of the Distal Femur Treated with Resection and Delayed Endoprosthetic Reconstruction: A Report of Three Cases. Case Reports in Orthopedics. 2017; 1–6. https://doi.org/10.1155/2017/5141032 PMid:28894615

Published

2019-02-25

How to Cite

1.
Handayani -, Yaputra F, Hia B, Telaumbanua V, Widyadharma IPE. Chronic Osteomyelitis after Seven Years Neglected Bone Exposed in 12-Year-Old Boy: A Case Report. Open Access Maced J Med Sci [Internet]. 2019 Feb. 25 [cited 2023 Jan. 27];7(4):610-3. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.100

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Section

C- Case Reports

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