Management of Salter–Harris Type 1 Fracture Complicated with Osteomyelitis in a Sickle Cell Disease Patient: A Case Report and Review of Literature

Salter–Harris fractures may occur due to a single injury or repetitive stress fractures on the extremities. Type I to III fractures are managed medically, while types IV and V, which are rare, are treated surgically. In the pediatric population, Salter–Harris I fractures of the distal tibia are comm...

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Bibliographic Details
Published in:Medicines (Basel, Switzerland) Switzerland), 2022-09, Vol.9 (10), p.50
Main Authors: Opara, Nnennaya U, Osuala, Emmanuella C, Nwagbara, Ugochinyere I
Format: Article
Language:English
Subjects:
Antibiotics
Blood
Bones
Care and treatment
Case Report
Case reports
Cell death
Closed reduction
Development and progression
Disease susceptibility
fracture
Fractures
Health aspects
Hemoglobin
Hospitals
Injuries
Orthopedic surgery
Osteomyelitis
Pain
Patients
Pediatrics
Physical therapy
Range of motion
Salter–Harris type
Sickle cell anemia
Sickle cell disease
Skin & tissue grafts
Ticarcillin
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Summary:Salter–Harris fractures may occur due to a single injury or repetitive stress fractures on the extremities. Type I to III fractures are managed medically, while types IV and V, which are rare, are treated surgically. In the pediatric population, Salter–Harris I fractures of the distal tibia are commonly seen, and management of such fractures are well established in the literature. Despite the availability of a wide range of treatment for such fractures, osteonecrosis or avascular necrosis of the proximal femur can subsequently develop. Avascular necrosis is cell death secondary to metabolic disturbances, trauma, adverse effects of certain medications, or sickle cell disease. Avascular necrosis commonly affects the talus, humerus, or tibia in addition to the femoral head. Radiographic images are essential for prompt diagnosis and to minimize negative health outcomes in these patients. However, Salter–Harris I fracture in sickle cell patients can be very challenging due to these patients’ vulnerability to bone infections and sickle cell crisis. In this case report, our patient with a history of sickle cell disease and with a diagnosis of Salter–Harris I fracture was treated with surgical intervention as type V, which is discussed in this article, and responded well to treatment. Thus, this case suggests a new approach to managing Salter–Harris I fractures complicated with osteomyelitis in sickle cell patients.
ISSN:2305-6320
2305-6320
DOI:10.3390/medicines9100050