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Brodie's abscess following percutaneous fixation of distal radius fracture in a child.

Rajakulendran K, Picardo NE, El-Daly I, Hussein R - Strategies Trauma Limb Reconstr (2016)

Bottom Line: The index surgery was complicated by a pin site infection that was treated successfully with antibiotics.Previous trauma or surgery has been implicated as predisposing factors.Ours is the first reported case in an adolescent.

View Article: PubMed Central - PubMed

Affiliation: Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK.

ABSTRACT
We report the case of a Brodie's abscess presenting five and a half years following closed reduction and percutaneous pinning of a distal radius fracture. The index surgery was complicated by a pin site infection that was treated successfully with antibiotics. The patient represented with forearm pain years later, and radiological investigations revealed a Brodie's abscess in the distal radius at the site of the previous Kirschner wires. The Brodie's abscess was managed through surgical curettage and antibiotics. Staphylococcus aureus and diphtheroid organisms were cultured from the intraoperative specimens. A Brodie's abscess is a form of localised subacute osteomyelitis, which usually occurs in the metaphysis of long bones and can mimic malignancy. Previous trauma or surgery has been implicated as predisposing factors. We have only identified one previously reported case of Brodie's abscess following percutaneous pinning. Ours is the first reported case in an adolescent. The aim of this paper is to raise awareness of this rare complication and review the current literature.

No MeSH data available.


Related in: MedlinePlus

AP radiograph of the left forearm showing percutaneous K-wire fixation of a distal radius fracture
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Fig1: AP radiograph of the left forearm showing percutaneous K-wire fixation of a distal radius fracture

Mentions: A 16-year-old, right-hand-dominant school boy attended the accident and emergency department with a 2-week history of increasing left forearm pain and swelling. There was no significant trauma, and the patient denied any systemic symptoms. He had sustained a closed fracture of the left distal radius five and a half years previously, whilst playing rugby. The fracture was managed at the time of injury with closed reduction and stabilisation using two percutaneous K-wires (Fig. 1), and one dose of antibiotics was given on induction. The patient had developed an infection at the radial styloid pin site 1 month following the original surgery. The K-wires were removed at the time, and he was given a 10-day course of oral flucloxacillin and placed into a full cast. Wound swabs grew Staphylococcus aureus. The infection resolved, but he developed an area of excess granulation tissue around the infected pin site that was treated with silver nitrate.Fig. 1


Brodie's abscess following percutaneous fixation of distal radius fracture in a child.

Rajakulendran K, Picardo NE, El-Daly I, Hussein R - Strategies Trauma Limb Reconstr (2016)

AP radiograph of the left forearm showing percutaneous K-wire fixation of a distal radius fracture
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4814380&req=5

Fig1: AP radiograph of the left forearm showing percutaneous K-wire fixation of a distal radius fracture
Mentions: A 16-year-old, right-hand-dominant school boy attended the accident and emergency department with a 2-week history of increasing left forearm pain and swelling. There was no significant trauma, and the patient denied any systemic symptoms. He had sustained a closed fracture of the left distal radius five and a half years previously, whilst playing rugby. The fracture was managed at the time of injury with closed reduction and stabilisation using two percutaneous K-wires (Fig. 1), and one dose of antibiotics was given on induction. The patient had developed an infection at the radial styloid pin site 1 month following the original surgery. The K-wires were removed at the time, and he was given a 10-day course of oral flucloxacillin and placed into a full cast. Wound swabs grew Staphylococcus aureus. The infection resolved, but he developed an area of excess granulation tissue around the infected pin site that was treated with silver nitrate.Fig. 1

Bottom Line: The index surgery was complicated by a pin site infection that was treated successfully with antibiotics.Previous trauma or surgery has been implicated as predisposing factors.Ours is the first reported case in an adolescent.

View Article: PubMed Central - PubMed

Affiliation: Basildon and Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Essex, SS16 5NL, UK.

ABSTRACT
We report the case of a Brodie's abscess presenting five and a half years following closed reduction and percutaneous pinning of a distal radius fracture. The index surgery was complicated by a pin site infection that was treated successfully with antibiotics. The patient represented with forearm pain years later, and radiological investigations revealed a Brodie's abscess in the distal radius at the site of the previous Kirschner wires. The Brodie's abscess was managed through surgical curettage and antibiotics. Staphylococcus aureus and diphtheroid organisms were cultured from the intraoperative specimens. A Brodie's abscess is a form of localised subacute osteomyelitis, which usually occurs in the metaphysis of long bones and can mimic malignancy. Previous trauma or surgery has been implicated as predisposing factors. We have only identified one previously reported case of Brodie's abscess following percutaneous pinning. Ours is the first reported case in an adolescent. The aim of this paper is to raise awareness of this rare complication and review the current literature.

No MeSH data available.


Related in: MedlinePlus