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Treatment of subperiosteal abscesses in children

is drainage of the intramedullary canal required?

Montgomery, Corey O.a; Porter, Austin IIIb; Sachleben, Branta; Suva, Larry J.c; Rabenhorst, Briana

Journal of Pediatric Orthopaedics B: November 2017 - Volume 26 - Issue 6 - p 497–500
doi: 10.1097/BPB.0000000000000283
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Acute osteomyelitis can be successfully treated with antibiotics alone. Surgery is utilized after failure of antibiotic treatment or if an abscess is present. Limited evidence exists with regard to whether intramedullary drainage is required in addition to the drainage of the subperiosteal abscess. We reviewed our 9-year experience of treating subperiosteal abscesses identifying 68 patients. Thirty patients underwent both intramedullary and abscess drainage, whereas 38 patients underwent drainage of the abscess alone at the initial procedure. Our analysis demonstrated a statistical significance (P=0.012) and odds ratio of 6.46 in favor of an intramedullary drainage to decrease risk for need for repeat surgical treatment.

aDepartment of Orthopaedic Surgery, University of Arkansas Medical Sciences, Arkansas Children’s Hospital

bArkansas Department of Health

cDepartment of Orthopaedic Surgery, Center for Orthopaedic Research, University of Arkansas Medical Sciences, Little Rock, Arkansas, USA

Correspondence to Corey O. Montgomery, MD, MS, Department of Orthopaedic Surgery, University of Arkansas Medical Sciences, Arkansas Children’s Hospital, 4301 W. Markham Street, Slot #531, Little Rock, AR 72205, USA Tel: +1 501 526 6534; fax: +1 501 686 7908; e-mail: comontgomery@uams.edu

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