Summary
Seventeen patients with haematogenous osteomyelitis and long diaphyseal sequestra are reported. Treatment was incision and drainage with antibiotics for at least 6 to 8 weeks, the limb being protected in plaster for a long time. The sequestra became incorporated in every case. Sequestrectomy should only be undertaken when successive radiographs show no reduction in size of the sequestrum and an increase in the amount of the involucrum.
Résumé
Etude de 17 patients, le plus jeune âgé de 7 mois et le plus vieux de 20 ans porteurs d'une ostéomyélite hématogène avec grande séquestration diaphysaire. L'incorporation du séquestre diaphysaire sera finalement obtenue dans tous les cas. Nous pensons que l'ostéomyélite hématogène chronique avec séquestration diaphysaire doit être traitée avec une intervention chirurgicale à minima sous forme d'incision et de drainage et d'un traitement antibiotique (de 6 à 8 semaines initialement et éventuellement répété selon l'évolution) et d'une immobilisation plâtrée de longue durée. L'indication de séquestrectomie sera posée seulement si la surveillance radiologique ne montre pas de réduction en taille du séquestre et une augmentation de l'involucrum.
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Jain, A.K., Sharma, D.K., Kumar, S. et al. Incorporation of diaphyseal sequestra in chronic haematogenous osteomyelitis. International Orthopaedics 19, 238–241 (1995). https://doi.org/10.1007/BF00185230
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DOI: https://doi.org/10.1007/BF00185230