Autogenous bone graft in the management of post-osteomyelitis bone defects in children in a limited-resource setting - a retrospective cohort study with a minimum follow-up of 7 years.

Abstract

Background. Post-osteomyelitis bone defects represent a challenging clinical situation. This retrospective cohort study was designed to evaluate the long-term outcome of the use of non-vascularized bone grafts in the management of such defects in children. Methods. Twenty-three children (mean age 7 years, range 2-13 years) were studied. All of the defects were segmental (mean defect length 6 cm, range 3-12 cm), involving the tibia, femur, humerus and radius. Fifteen children presented with an active infection and were managed with a staged protocol. The first stage included sequestrectomy or debridement of the site. The second stage, i.e. the graft procedure, was performed after 12 weeks on average. The mean follow-up was 9.2 years (range 7-15 years). Results. Bone union was primarily achieved in 14 children (61 %). Complications were experienced in the remaining nine children. Conservative and surgical treatment led to bone union in all patients within 5 years of the index procedure. Recurrence of infection was observed in two patients (8.7 %). All of the children were able to use the limb at the final follow-up; only three required the use of a brace. Conclusions. Autogenous non-vascularized bone graft may be considered a valid option in the treatment of bone defects secondary to osteomyelitis in children.