Clinical Observation of Acute Suppurative Arthritis of Hip in Infants and Children

Choi, Ik Soo; Park, Dong Ryeoul

Abstract

Suppurative arthritis of the hip joint in infants and children is always a serious disease. In management of suppurative arthritis of the hip joint, early diagnosis and treatment is far most important. Authors had treated 22 cases with acute suppurative arthritis of the hip joint in infants and children at the Department of Orthopedic Surgery, St. Benedict Hospital during period from January 1976 to December 1982, and clinically analyzed these 22 cases. The following results were obtained: 1. The incidence of suppurative arthritis of the hip joint was higher in infants and children less than 4 years old, and male predominated by a 2.7:1 ratio. 2. Lag period to diagnosis and treatment in 3 cases was within 4 days, 6 cases within 8 days: usually lag period was long. 3. In general, leukocytosis and elevated ESR were noted, but in infants, these were not always noted. 4. Sometimes, the classic signs of fever, chills, sweats, and prostration were not seen in affected infants. 5. Causative oraganisms were isolated in diseased hip joint: positive cultures were 55%, and most ommon organism was Staphylococ'cus aureus. 6. After diagnosis, immediate arthrotomy, continuous irrigation with normal saline solution, through the irrigation tube, parenteral administration of specific antibiotics, and immobilization with Bucks extension traction were performed in all cases without serious complications. The results were acceptable. 7. Authors concluded as follows: a. Infants and young children are more likely to have poor result than older children. b. When treatment was performed beyond 4 days, more likely to have poor result. c. Associated osteomyelitis of the femoral neck increases the possibility that the patient will have a poor result.