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Peer-Review Record

Is Early Surgical Intervention Necessary for Acute Neonatal Humeral Epiphyseal Osteomyelitis: A Retrospective Study of 31 Patients

Children 2022, 9(4), 527; https://doi.org/10.3390/children9040527
by Yun Gao 1,†, Ruikang Liu 2,†, Saroj Rai 3, Qingtuan Liang 1, Yuan Liu 1, Xiaoliang Xiao 1 and Pan Hong 4,*
Reviewer 1:
Vincenzo De Rosa
Reviewer 2: Anonymous
Children 2022, 9(4), 527; https://doi.org/10.3390/children9040527
Submission received: 7 March 2022 / Revised: 3 April 2022 / Accepted: 4 April 2022 / Published: 7 April 2022
(This article belongs to the Special Issue Childhood Innate Immunity and Infectious Diseases)

Round 1

Reviewer 1 Report

Congratulation for the good paper. I agree totally with your position and your conclusions

Author Response

Thanks for your valuable advice. The manuscript has been reviewed and revised by an English native medical practitioner.

Reviewer 2 Report

This is a well written manuscript on a topic for which additional information is needed.  There are several things the authors can do to improve the value of this manuscript and expand its generalizability/utility for others.

  1. Provide more detail on how you defined the presence of epiphyseal osteomyelitis.
  2. Provide detail on the presence or absence of associated metaphyseal osteomyelitis with and without evidence of physeal injury.
  3. How many of your cases arose from primary bacterial arthritis versus from initial osteomyelitis?
  4. What were your definitions/criteria for lack of improvement used to justify surgical intervention?  (Answering this would simply help readers understand--I am not concerned that you did not use appropriate criteria.)
  5. Did you have a protocol for guiding clinical decision-making? If so, would be helpful to provide as a supplementary figure.
  6. How many of the 31 children had a positive culture (joint fluid, blood, bone, etc) or molecular test for a microbial etiology?
  7. What were the most common microbes detected?
  8. Given your small sample size, it is of course difficult to detect a lot of potentially meaningful differences between your subgroups.  The primary value of your results truly relates to the focus on epiphyseal involvement of a specific bone (humerus) in a specific age group (neonates).  Can you clarify that the focus is on proximal humerus (shoulder), or do your cases also include distal humerus (elbow)?  My presumption is proximal/shoulder, but just make this clear either way.

 

 

Author Response

Thanks for you valuable advises. Please see the attachment.

Author Response File: Author Response.docx

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