Growth disturbance after osteomyelitis of femoral condyles in infants

Abstract

Growth disturbance after osteomyelitis in a single femoral condyle was seen in seven infants followed by the author from infancy to maturity. Age at onset of infection was between 10 days and 4 weeks. In three cases the medial condyle was affected and in four the lateral. Angular deformity of 20–50 degrees of varus or valgus was present before correction by supracondylar osteotomy. In all seven cases the radiographic appearance before the first osteotomy was similar. Partial closure of the growth plate appeared in four cases at age 6, 7, 10 and 12 years, respectively, which was decisive for loss of growth in length. These children had 3–6 osteotomies before maturity. In three cases partial closure of the plate did not occur, progression of angulation was slow and only two femoral osteotomies were carried out. Restitution of the epiphysis and growth disturbance are unpredictable on the basis of radiographic findings during infancy. Partial closure of the growth plate may occur at the age of 4 years. Indications for correction of deformity and for epiphyseodesis in the other leg should be considered once or twice every year during the growth period.