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New treatment option for sclerosing osteomyelitis of Garré

Nikomarov, Davidb; Zaidman, Michaela; Katzman, Alexandera; Keren, Yanivb; Eidelman, Marka

Journal of Pediatric Orthopaedics B: November 2013 - Volume 22 - Issue 6 - p 577–582
doi: 10.1097/BPB.0b013e32836330a6
Knee & Leg

Sclerosing osteomyelitis of Garré continues to be a puzzling entity, with a nonspecific clinical description and course, an obscure pathogenesis, and no consensus on a predictable and helpful method of treatment. The proposed treatment options according to the literature are observation, analgesics and NSAIDs, and bone curettage. Here we present a 15-year-old girl treated by resection of a 12 cm-long lesion after failed conservative treatment, followed by bone transport using a circular external fixator. This treatment method has not been described previously for this condition. The duration of bone transport was 3 months, and the total duration of the frame treatment was 12 months. After hardware removal, and at 2.5-year follow-up, the patient was asymptomatic and achieved good functional results. To the best of our knowledge, this is the first description of bone resection and transport for the treatment of this condition, even though it is well described for the treatment of chronic osteomyelitis and other conditions necessitating bone resection. On the basis of this case we suggest that resection and bone transport using a circular external fixator for the treatment of sclerosing osteomyelitis of Garré might be an effective and safe method. Of course, being a rare entity, large cohorts are difficult to obtain, and more data and longer follow-up are required to form a convincing recommendation. Level IV evidence.

aPediatric Orthopedic Surgery Unit

bDepartment of Orthopedic Surgery, Rambam Healthcare Campus, Haifa, Israel

Correspondence to David Nikomarov, MD, Department of Orthopedic Surgery, Rambam Healthcare Campus, PO Box 9602, Haifa 31096, Israel Tel: +972 4 854 2018; fax: +972 4 854 2022; e-mail: d_nikomarov@rambam.health.gov.il

© 2013 by Lippincott Williams & Wilkins, Inc.