Cases reported "Bone Diseases, Infectious"

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1/2. Deep vein thrombosis associated with pediatric musculoskeletal sepsis.

    Deep vein thrombosis (DVT) is uncommon in children but can occur given certain circumstances. The authors describe four children in whom DVT developed in association with musculoskeletal sepsis. One child died. Prothrombotic screens were performed on the three surviving children, showing normal hematologic parameters. The severity of DVT complicating musculoskeletal sepsis is emphasized, particularly the potential for septic embolic complications. Deep vein thrombosis should be considered in any child with musculoskeletal sepsis, particularly when a limb is severely swollen or when there are pulmonary septic emboli.
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ranking = 1
keywords = vein thrombosis, thrombosis, vein
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2/2. Successful management of complications from distraction osteogenesis after osteosarcoma resection: a case report.

    We report a complicated case of osteosarcoma of the proximal tibia. A 15-year-old boy was referred to us and underwent distraction osteogenesis reconstruction. We administered preoperative chemotherapy for five cycles. Clinical response was determined to be complete by radiography. Marginal excision was then performed with preservation of the proximal tibial epiphysis. Metaphyseal reconstruction (type 2) was performed with distraction osteogenesis. Postoperative chemotherapy also was administered for five cycles. Two years later, the patient developed a deep infection. He underwent curettage and a pedicle peroneal flap transfer, which did not cure the infection. Infected tissues were excised, and shortening-distraction was carried out with the Ilizarov frame. The infection was cured; however, a leg length discrepancy and deformity resulted from frame instability. Four years after the initial operation, the patient fractured his reconstructed leg in a traffic accident. We performed osteosynthesis, deformity correction, and lengthening with the Ilizarov method. We were able to correct the defects using distraction osteogenesis, eventually restoring normal function. Epiphyseal preservation and reconstruction by distraction osteogenesis can provide an excellent outcome, resulting in a stable reconstruction that functionally restores the native limb. Distraction osteogenesis avoids some complications but may involve others, which require detection and appropriate management.
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ranking = 0.0028799363242052
keywords = deep
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