Abstract
Chronic osteomyelitis is serious because of the orthopedic sequels that they could cause. Extended diaphyseal sequestrations could cause bone loss and their management is delicate. Here we report a case of right ulnar diaphyseal reconstruction by non-vascularized fibula transfer. This was a three-year-old girl, non-sickle cell, who had chronic osteomyelitis of the right ulna. The evolution was towards an almost total ulnar diaphyseal sequestration with externalization of the distal extremity. The removal of this large sequestrum occurred almost spontaneously, leaving a significant bone loss over a length of about 6 cm. Secondarily, we reconstructed the right ulnar diaphysis by transfer of a free non-vascularized graft of the left fibula, maintained by a pin. The follow up was favorable with almost complete recovery of prono-supination. Fibular ossification has evolved as well and we did not notice any complications at the graft collection site. Non-vascularized fibula graft transfer is a useful therapeutic option in the management of significant bone defects secondary to chronic osteomyelitis of one of the two forearm bones.
Highlights
In contrast to the industrialized countries, chronic osteomyelitis is seen much more frequently in developing countries and places a significant burden on their health services [1]-[7]
We report a case of right ulnar diaphyseal reconstruction by non-vascularized fibula transfer
A specialist orthopaedic hospital in Malawi reported that 6.7% of all orthopaedic procedures in children were for chronic osteomyelitis, the majority being a sequestrectomy [9]
Summary
In contrast to the industrialized countries, chronic osteomyelitis is seen much more frequently in developing countries and places a significant burden on their health services [1]-[7]. In Uganda [8], 3.5% of surgical procedures in children. A specialist orthopaedic hospital in Malawi reported that 6.7% of all orthopaedic procedures in children were for chronic osteomyelitis, the majority being a sequestrectomy [9]. Tekou [10] Akakpo-Numado [11] reported respectively 77.24% and 59.38% of chronic osteomyelitis in hospital series in Lomé (Togo)
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