Increased Pathologic Fracture Risk in Staph Osteomyelitis

Staphylococcus aureus osteomyelitis tied to fractures, associated complications in children

MONDAY, Jan. 16 (HealthDay News) -- Children with osteomyelitis secondary to Staphylococcus aureus infection have increased risk of pathologic fracture, according to a study published in the Jan. 4 issue of The Journal of Bone & Joint Surgery.

Mohan V. Belthur, M.D., of the Sinai Hospital of Baltimore, and colleagues conducted a retrospective study comparing 17 children treated for pathologic fractures due to acute osteomyelitis caused by Staphylococcus aureus infection with 49 children with Staphylococcus aureus osteomyelitis, but without fracture. Medical records, magnetic resonance imaging (MRI), and microbiologic laboratory results were reviewed.

The researchers found that methicillin-resistant Staphylococcus aureus isolates were identified in 15 of the 17 children with a fracture. Fractures occurred an average of 72.1 days after disease onset. Significant between-group differences were observed for length of hospital stay, duration of antibiotic treatment, and number of surgical procedures and complications. Based on MRI results at the time of admission, patients with a fracture were significantly more likely to have a subperiosteal abscess and, if present, the abscess tended to be larger in these patients. Patients with fractures were also more likely to display a zone of abnormally diminished enhancement of the marrow.

"Staphylococcus aureus osteomyelitis is a serious infection that may predispose children to pathologic fractures. Protected weight-bearing and activity restriction are recommended in children with Staphylococcus aureus osteomyelitis who have the risk factors demonstrated in this study," the authors write.

The study was partially funded by Pfizer.

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