Despite recent clinical and scientific advances in orthopaedic care, pyogenic arthritis of hip in infancy and childhood remains a vexing and controversial problem. Although advent of antibiotic therapy decreased mortality and morbidity, but disastrous results still occur mainly in infancy and early childhood with delayed presentation. The sequelae of septic hip in children have been well documented in literature. Septic arthritis of the hip can lead to severe deformity by dislocating or damaging the femoral head and/or epiphyseal plate. Prognosis is associated with delay in treatment such as surgical decompression of the joint and administration of appropriate antibiotics. Permanent sequelae due to septic arthritis can be prevented by early diagnosis and aggressive treatment.
Materials & Methods: Prospective interventional study consisted of 24 patients with 25 Hips. Study carried out at Department of Orthopaedics of a tertiary care centre during Aug 2005 to Dec 2007. Risk factors and related laboratory investigations were carried out. Treatment completed by aspiration and anterior arthrotomy. Data entry and analysis was done by M.S. Excel 3.0.
Results: In our study about 63% patients were less than 3 months of age and 75% patients were up to 3yrs of age. More than 70% patients presented after one week and three were presented after 1 month. In many of our patients there were more than one risks factors likes septicemia, low birth weight, jaundice and ventilator support. Most of the children (88%) had high CRP level at the time of admission. Elevated CRP was seen in 81.3% patients and suspension test was positive among all neonates and infants. Normalization of movement comparable to normal side in most of the patients was observed.
Conclusion: Septic arthritis of the hip in infancy and early childhood can be devastating and can lead to serious musculoskeletal sequelae, so all NICU neonates should be handling with strict aseptic precaution and should be screened daily. Early proper detection and adequate treatment can avert serious complications such as avascular necrosis and destruction of the hip especially in early childhood. We hypothesized that socio-economic problems and access to health-care facilities, as well as previous visit to traditional healers, may delay presentation.