Humeral pseudoarthrosis in obstetric fracture after acute hematogenic osteomyelitis
López Martínez JJ, Salcedo Cánovas C, Alarcón Zamora A
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen de la Arrixaca, Murcia, España.
Neonatal infection is an important morbimortality cause that occurs in the first week of life and it is a consequence to maternal genital microorganisms during partus. Neonatal sepsis is a sudden and multisystemic disease, standing out the infection by klebsiella pneumoniae, with an approximate mortality of 60%. Its association with acute hematogenic osteomyelitis has a difficult diagnose with severe income complications. Acute hematogenic osteomyelitis associated with an obstetric fracture needs surgical treatment because of its infectious importance and its possible evolution to pseudoarthrosis.
Newborn with a loss of fetal wellness and entrance to intensivity care unit because of neonatal sepsis, with an abscess in his left arm that drains spontaneously and a positive biopsy to klebsiella pneumoniae. Antibiotic treatment with cefotaxime and vancomycin is started without any improvement after 20 days. Surgical treatment is decided with a cleaning procedure and stabilisation with external fixator, with a proper evolution of his sistemic clinic. Related to the obstetric fracture, non-union is appreciated with an evolution to atrophic pseudoarthrosis. A new surgical intervention is decided with the contribution of autologous bone graft from iliac crest and a new external fixator, with a complete bone union in two months and the clinical case solution.
Obstetric fracture associated to acute hematogenic osteomyelitis is a low frequency episode that must be diagnosed and surgically treated with external fixation and autologous bone graft, with possible complications as pseudoarthrosis.
Acute hematogenic osteomyelitis, neonatal sepsis, pseudoarthrosis, obstetric fracture
Correspondencia: JJ López Martínez Servicio de Cirugía Ortopédica y Traumatología Carretera Madrid-Cartagena s/n. 30120 El Palmar, Murcia, España. e-mail: email@example.com