• Screening monitoring of early prophylaxis of the orthopedic complications in children after acute haematogenous osteomyelitis

Screening monitoring of early prophylaxis of the orthopedic complications in children after acute haematogenous osteomyelitis

PAEDIATRIC SURGERY.UKRAINE.2018.2(59):59-63; doi 10.15574/PS.2018.59.59

Lebedevich О. В., Kulik E. N., Karpiv A. I.
Municipal Clinical Hospital, Lviv, Ukraine
Danylo Halytsky Lviv National Medical University, Ukraine

Objective: to establish screening observation over the children after acute haematogenous osteomyelitis (AHO) with the purpose of an early detection and prevention of orthopaedic complications development.
Material and methods. A total of 135 children with AHO aged from birth to 18 years, who were treated in 2003–2017, were examined in Lviv. The control group comprised 53 (39.2%) patients without the orthopaedic complications after AHO. The main (reference) group included 82 (60.7%) children with the developed orthopaedic complications of AHO.
Results. Analysis of densitometric values showed that after the termination of the inflammatory process, there were signs of bone density dysfunction in all patients. In 56.25±7.16% of children, the violations of bone arterectonics and delay of the enchondral ossification from the passport age for 3–5 years were revealed; the signs of severe osteopenia were detected in 35.42±6.90 % of patients, and the signs of osteoporosis – in 10.42±4.41%. Frequent violations in the mineral metabolism in patients of all the examined groups after AHO were the tendency to hypocalcaemia and hypercalciuria. The increase of parathyroid hormone concentration in patients after AHO indicates early loss of bone mass.
Conclusions. During the period from 3 to 12 months after AHO, the dynamic densitometric monitoring is needed to detect the degree of bone tissue changes and timely treatment of osteopenia and osteoporosis, which are the predictors of the orthopaedic complications development in children.
Key words: ultrasound densitometry, orthopaedic complications, acute haematogenous osteomyelitis.


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