EVALUATION OF OUTCOMES OF ACUTE HAEMATOGENOUS OSTEOMYELITIS IN CHILDREN FOLLOWING SURGICAL DECOMPRESSION

Abstract

Outcomes of the surgical decompression in 21 patients of less than 15 years of age with acute haematogenous osteomyelitis attending Tribhuvan University Teaching Hospital during the period Oct. 1998 to Sept. 2000 were evaluated prospectively. Average age of the patients was 9.8 years. (range 3-14 years.) Thirteen Patients were male and 8 were female. Majority (71%) of the cases had involvement of the bones around the knee joint. Pus culture was positive in (71.43%)of the cases. Among 21 cases who underwent surgical decompression, three patients were in inflammatory stage. Staphylococcus aureus was the causative organism in all culture positive cases and was sensitive to cephalexin in 86% and Cloxacillin in 100% of the cases. Xray changes of chronic osteomyelitis developed in the 2nd week in most cases (70%). Overall rate of conversion to chronic osteomyelitis was 47.62%. Chronic osteomyelitis developed more in patients aged >10 years of age (P=0.0015). Also chronic osteomyelitis developed more in patients who underwent surgical decompression after 10 days (P=0.0634). The study concluded that early surgical decompression prevents chronicity and prognosis is better in young children. Key Words: Acute haematogenous osteomyelitis, Children, Chronic osteomyelitis, Surgical decompression.