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Article

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

by
Yun Gao
1,†,
Ruikang Liu
2,†,
Saroj Rai
3,
Qingtuan Liang
1,
Yuan Liu
1,
Xiaoliang Xiao
1 and
Pan Hong
4,*
1
Department of Orthopaedic Surgery, Zhuhai Center for Maternal and Child Health Care, Zhuhai 519000, China
2
Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
3
Department of Orthopaedics and Trauma Surgery, Blue Cross Hospital, Tripureswor, Kathmandu 44600, Nepal
4
Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
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)
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Abstract

Objective: To review the treatment experience of neonatal humeral epiphyseal osteomyelitis retrospectively. Study design: Retrospective cohort study of infants with neonatal humeral epiphyseal osteomyelitis. Patients were divided into conservative group and surgical group, and the surgical group was subdivided into early and delayed surgical group. Results: In total, there were 7 patients in the conservative group and 24 in the surgical group. The length of hospital stay and intravenous course of antibiotic therapy were both significantly shorter in the surgical group (p < 0.001). The full recovery rate was also higher in the surgical group (83.3%) than the conservative group (14.3%) (p < 0.001). Early surgery group (n = 14) had an insignificantly higher positive rate of pus/aspirate culture and full recovery rate than delayed surgery group (n = 10). Conclusion: Surgical treatment for neonatal humeral epiphyseal osteomyelitis demonstrated significantly higher rates of positive culture for the pathogen, a shorter course of intravenous oral antibiotics, and lower incidence of growth abnormality than conservative treatment. In our institution, most of culture outcome Gram-positive bacteria, and early surgical treatment was recommended with better outcome than delayed surgical group. Empirical antibiotics should be tailored to the epidemiological characteristics of local virulent bacteria.
Keywords: neonatal humeral epiphyseal osteomyelitis; surgery; septic arthritis neonatal humeral epiphyseal osteomyelitis; surgery; septic arthritis

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MDPI and ACS Style

Gao, Y.; Liu, R.; Rai, S.; Liang, Q.; Liu, Y.; Xiao, X.; Hong, P. Is Early Surgical Intervention Necessary for Acute Neonatal Humeral Epiphyseal Osteomyelitis: A Retrospective Study of 31 Patients. Children 2022, 9, 527. https://doi.org/10.3390/children9040527

AMA Style

Gao Y, Liu R, Rai S, Liang Q, Liu Y, Xiao X, Hong P. 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

Chicago/Turabian Style

Gao, Yun, Ruikang Liu, Saroj Rai, Qingtuan Liang, Yuan Liu, Xiaoliang Xiao, and Pan Hong. 2022. "Is Early Surgical Intervention Necessary for Acute Neonatal Humeral Epiphyseal Osteomyelitis: A Retrospective Study of 31 Patients" Children 9, no. 4: 527. https://doi.org/10.3390/children9040527

APA Style

Gao, Y., Liu, R., Rai, S., Liang, Q., Liu, Y., Xiao, X., & Hong, P. (2022). Is Early Surgical Intervention Necessary for Acute Neonatal Humeral Epiphyseal Osteomyelitis: A Retrospective Study of 31 Patients. Children, 9(4), 527. https://doi.org/10.3390/children9040527

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