The orthopaedic implications of purpura fulminans.

Canale, S T; Ikard, S T

doi:10.2106/00004623-198466050-00017

Cited by 26 publications

(7 citation statements)

References 3 publications

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“…It has been suggested that these fingers and toes should be allowed to autoamputate, 8,9 and our experiences would support this. The patchy areas of skin necrosis, likewise, should be allowed to demarcate and be débrided with or without skin grafting, usually 2 to 4 weeks after the onset of the disease.…”

Section: Discussionsupporting

confidence: 53%

Orthopaedic Sequelae of Meningococcal Septicemia

Bache

Torode

2006

Journal of Pediatric Orthopaedics

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The records of 143 patients admitted with a diagnosis of meningococcal septicemia were reviewed to identify vascular, cutaneous, and osseous sequelae. During the acute phase of the disease there were 21 deaths and 17 patients lost tissue. Thirty-six digits were allowed to autoamputate and six surgical amputations were performed. Each of the latter developed physeal growth arrests proximal to the level of amputation. Four patients underwent fasciotomies for compartment syndrome. Two of these patients had absent distal pulses and at surgery were found to have nonviable limb segments; the authors conclude that fasciotomy is rarely indicated. Sixteen patients were identified with a total of 41 growth arrests. Twenty-three of these occurred under areas of cutaneous scarring and were diagnosed 2 to 9 years after the index admission. The authors believe that patients requiring débridement and/or skin grafting of areas of skin necrosis should be reviewed regularly during the growth period to identify physeal damage at a stage when less complex surgery may be indicated.

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Section: Discussionsupporting

confidence: 53%

Orthopaedic Sequelae of Meningococcal Septicemia

Bache

Torode

2006

Journal of Pediatric Orthopaedics

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“…It may also be caused by invasive vascular access (Stringel et al 1985). In older children, when it is not of traumatic origin, it is often associated with systemic infections and the syndrome of purpura fulminans may develop (Urbaniak et al 1973;Canale and Ikard 1984;Watson and Ashworth 1983;Jacobsen and Crawford 1984;Grogan et al 1989;Nogi 1989;Cohen et al 1990;Landham, Datta and Nirula 1991;Wyssa, LeCoultre and Kaelin 1992). Although severe ischaemia may necessitate amputation, a less severe insult may cause disturbance of growth.…”

mentioning

confidence: 99%

The Orthopaedic Implications of Peripheral Limb Ischaemia in Infants and Children

Farrar

Bennet

Wilson

et al. 1996

The Journal of Bone and Joint Surgery. British volume

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P eripheral limb ischaemia is rare in children. We have treated only 12 infants and children with this condition in the past 15 years at the Royal Hospital for Sick Children in Glasgow. There were nine neonates and three older children. Most were suffering from life-threatening illnesses or severe infection. Two were born with ischaemic arms with no apparent cause. We have analysed the factors leading to ischaemia, the outcome of the initial treatment and the later orthopaedic problems. Two required amputation of both legs, one of an arm, two of feet and one of toes. Two had skin grafts. All surgery was performed after demarcation was well established and delayed closure was used after amputation. Five children developed limb-length discrepancy or an angular deformity. To date two have required additional corrective surgery.

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“…Acute and chronic orthopaedic sequelae of meningococcal septicaemia are recognized, mainly in the orthopaedic [2,[6][7][8][9][10][11] and radiology [12][13][14] literature. Acute complications include arthritis, osteomyelitis and gangrenous necrosis.…”

Section: Case Reportmentioning

confidence: 99%

Knee pain: an unusual late complication of meningococcal septicaemia

Woolley

Smith²,

Surridge³

2008

European Journal of Emergency Medicine

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Meningococcal disease remains an important cause of mortality and morbidity in the paediatric population. Survivors of invasive meningococcal disease remain at risk from the long-term sequelae of microvascular disease. Chronic orthopaedic sequelae have been reported infrequently in the orthopaedic and radiology literature and there are no reports in the Emergency Medicine literature. We report the case of a 7-year-old boy who presented to the Emergency Department with a limp; having survived invasive meningococcal disease at the age of 14 months. His radiographs revealed some of the long-term sequelae of this severe disease. We review the literature around the long-term orthopaedic sequelae of meningococcal disease.

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The orthopaedic implications of purpura fulminans.

Cited by 26 publications

References 3 publications

Orthopaedic Sequelae of Meningococcal Septicemia

Orthopaedic Sequelae of Meningococcal Septicemia

The Orthopaedic Implications of Peripheral Limb Ischaemia in Infants and Children

Knee pain: an unusual late complication of meningococcal septicaemia

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