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Limb length discrepancy in chronic osteomyelities: a
prospective series of 42 patients Abstract A number of series report limb length discrepancy in long bone chronic osteomyelitis with the cause thought to be damage to the affected growth plates leading to early growth arrest. However, it is known that the inflammatory state of chronic osteomyelitis results in an increased blood supply and in other conditions the increased blood supply results in overgrowth of the affected bone. In order to study the effect of long bone chronic osteomyelitis on limb length we designed a prospective trial of 42 consecutive patients presenting to our unit with chronic osteomyelitis of a long bone. The mean age at presentation was 10.3 years. The mean duration of symptoms of 18.2 months. For 37 (88%) of patients the cause of osteomyelitis was haematogenous. On examination, 3 (7%) patients had shortening of the long bone compared to the unaffected side (of average of 2.5cm), whilst 13 (31%) patients had overgrowth of the affected bone (average overgrowth 2.2cm). The most common bone affected was the tibia (20/42. 48%), followed by the femur (8/42 (12%) of patients had at least one physis affected (2 of these patients had undergrowth and 1 had overgrowth). This large prospective series of patients is the first in the world literature to show the effected of osteomyelitis on the growth of long bones, in particular an overgrowth rate of 31%. |
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