ABSTRACT
Osteomyelitis of the pelvis is rare in children as well as in adults. This explains why the diagnosis is often missed, so that the infection becomes chronic. The authors report five chronic paediatric cases, seen between 1993 and 2003. The diagnosis was initially missed in two patients. In two others, the osteomyelitis was recognised but insufficiently treated, so that it also became chronic. The fifth patient developed exogenous osteomyelitis 6 months after an open pelvic fracture. The bone scan was useful for the differential diagnosis, but laboratory and radiographic findings were not. Treatment was the same for all patients, including wide surgical debridement, antibiotic therapy and prolonged immobilisation. Four patients were free of symptoms at the last clinical evaluation, after an average follow-up period of 7 years. Only one patient had a recurrence 3 months postoperatively and was re-operated. This study demonstrates that surgical treatment of chronic pelvic osteomyelitis in children and adolescents yields encouraging results.
Subject(s)
Ilium , Osteomyelitis/diagnosis , Adolescent , Child , Combined Modality Therapy , Debridement , Female , Humans , Ilium/diagnostic imaging , Male , Osteomyelitis/diagnostic imaging , Osteomyelitis/drug therapy , Osteomyelitis/surgery , RadiographyABSTRACT
A total of 233 Autophor 900-S fully porous coated stems were implanted in 220 patients with an average age of 47.5 years and an average follow-up of 13.5 years. The mean d' Aubigne-Postel score improved from 7.9 points preoperatively to 16.9 points postoperatively (P < .001). The overall result was excellent in 74.6%, good in 18.1%, fair in 5.8%, and poor in 1.5% of cases. One hip was revised for septic and two for aseptic loosening. The overall survival rate of this prosthesis was 98.1% in 17 years. The Autophor 900-S femoral stem has offered a very satisfactory clinical outcome together with considerable prosthesis longevity in the young patient population studied. It combines adequate initial stability, satisfactory subsequent bone ingrowth, smooth load transfer, and low-friction bearing surfaces.
