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The management of bone and joint infections at Moi Teaching and Referral Hospital
Abstract
Background: Bone (cortex and marrow) and joint infection are not uncommon in this health institution. The management of patients with the lesion has posed a challenge yet the institution is in top gear training the surgeons in the field of orthopaedic and trauma surgery. This study aims to lay foundation for development of the management protocol, and further research.
Objective: To evaluate the management of Bone and Joint infection in children. Design: Retrospective descriptive study. Setting: Moi Teaching and Refferal Hospital, Eldoret, Kenya. Methods: The relevant data of 85 consecutive patients on aspects of demography and the management in the period 2001- 2006 were recorded into the data sheet (proforma), then analyzed and presented in statistical patterns. Results: Eighty five consecutive patients (47 males, 38 females), ratio M: F =1.24:1. Admission rated at least 14±2SD patients per year. Age: 2weeks-13 years, mean= 7.53 ±3.98SD. Major risk/predisposing factor-trauma. Duration of symptoms: 1 day-2 years, mean=16.44± 11.28SD. Commonest symptomatology included pain, swelling and loss of function more so in the joints than in bones. Of investigations- Laboratory: anaemia, bacterial isolates(33 and 14 patients respectively), while radiological/ imaging: lesions identified in patients’ radiographs, CT- scans and ultrasound scans (49, 3 and 3 respectively). Fifty six patients were diagnosed with arthritis and 39 with osteomyelitis. Treatment of 26 patients was non- operative and 59 were operated. All the patients survived. Hospital stay ranged from 2- 159 days, mean=14.16 ±9.46SD. Follow-up in clinic- 12 patients defaulted, 26 inconsistent while 47 consistent.
Conclusion: Bone and joint infections were associated with significant morbidity as shown by high operative intervention and long hospital stay. Delayed presentation as noted could be responsible for the high morbidity.
Objective: To evaluate the management of Bone and Joint infection in children. Design: Retrospective descriptive study. Setting: Moi Teaching and Refferal Hospital, Eldoret, Kenya. Methods: The relevant data of 85 consecutive patients on aspects of demography and the management in the period 2001- 2006 were recorded into the data sheet (proforma), then analyzed and presented in statistical patterns. Results: Eighty five consecutive patients (47 males, 38 females), ratio M: F =1.24:1. Admission rated at least 14±2SD patients per year. Age: 2weeks-13 years, mean= 7.53 ±3.98SD. Major risk/predisposing factor-trauma. Duration of symptoms: 1 day-2 years, mean=16.44± 11.28SD. Commonest symptomatology included pain, swelling and loss of function more so in the joints than in bones. Of investigations- Laboratory: anaemia, bacterial isolates(33 and 14 patients respectively), while radiological/ imaging: lesions identified in patients’ radiographs, CT- scans and ultrasound scans (49, 3 and 3 respectively). Fifty six patients were diagnosed with arthritis and 39 with osteomyelitis. Treatment of 26 patients was non- operative and 59 were operated. All the patients survived. Hospital stay ranged from 2- 159 days, mean=14.16 ±9.46SD. Follow-up in clinic- 12 patients defaulted, 26 inconsistent while 47 consistent.
Conclusion: Bone and joint infections were associated with significant morbidity as shown by high operative intervention and long hospital stay. Delayed presentation as noted could be responsible for the high morbidity.
