[Acute hematogenous osteomyelitis due to ordinary germs in children with closed injuries. Study of a series of 44 cases]


Published online: Jun 27 1991

E Manche, V Rombouts-Godin, and J J Rombouts.

Service d'Orthop├ędie et de Traumatologie de l'Appareil Locomoteur, Cliniques Universitaires Saint-Luc, Bruxelles, Belgique.

Abstract

The retrospective study of a series of 44 cases of acute hematogenous osteomyelitis in infants and children has shown that 16 out of the 44 patients (36%) have a history of previous trauma at the site of bone infection. Seven infants were less than one year of age. For the remaining 37 children the incidence of previous local trauma rose to 43% (16/37). This incidence is similar to that in previous studies. Acute hematogenous osteomyelitis follows blood-borne spread of a pathogen from a portal of entry. Why hematogenous infection selects a particular bone is an enigma. Trauma has been said to predispose to the localization of infection but the association between trauma and hematogenous osteomyelitis is only found in one-third of the cases in both this study and in previous series. However these cases with a history of local trauma raise questions regarding the concept of "locus minoris resistentiae" and its medicolegal consequences.