Comparison of Bone Cortex Fenestration Debridement Combined with Antibiotic-Impregnated Calcium Sulfate Implantation versus Drilling Decompression Drainage in Pediatric Acute Hematogenous Osteomyelitis
LIU Tao
ZHANG Chunxu
JIANG Feng
Abstract：Objective To compare the application efficacy of bone cortex fenestration debridement combined with antibiotic-impregnated calcium sulfate implantation versus drilling decompression drainage in pediatric acute hematogenous osteomyelitis.Methods A total of 123 children with acute hematogenous osteomyelitis admitted to Henan Children's Hospital,the Third Affiliated Hospital of Xi'an Medical University,and Zhoukou Orthopedic Hospital from February 2020 to February 2023 were enrolled.The patients were divided into two groups using a double-color ball method:group A(61 cases)underwent cortical fenestration and lesion debridement with implantation of calcium sulfate loaded with vancomycin and gentamicin,and group B(62 cases)received drilling decompression drainage combined with vancomycin therapy.The treatment efficacy,clinical recovery indicators,visual analogue scale(VAS)scores,serum inflammatory responses,and complications were compared between the two groups.Results The total effective rates of group A and group B were 88.52％(54/61)and 91.94％(57/62),respectively,with no statistically significant difference between groups(P＞0.05).There was no statistically significant difference in the positive rate of bacterial culture from the last drainage between the two groups(P＞0.05).The total hospital stay[(11.56±4.16)d],time to normalization of inflammatory markers[(3.31±0.79)weeks],drainage tube placement time[(6.64±1.12)d],and wound healing time[(12.16±1.28)d]in group A were shorter than those in group B[(16.46±3.41)d,(4.12±0.67)weeks,(8.33±2.02)d,(14.44±1.12)d],and the differences were statistically significant(P＜0.05).There were no statistically significant differences in VAS scores between the two groups before surgery and at 1,3,and 7 days after surgery(P＞0.05).However,the pain scores in both groups gradually decreased overtime(P＜0.05).At 7 days after surgery,the white blood cell count[(6.02±1.12)× 109 L-1],neutrophil count[(5.12±1.03)× 109 L-1],erythrocyte sedimentation rate[(8.22±1.31)mm·h-1],and high-sensitivity C-reactive protein level[(12.02±2.44)mg·L-1]in group A were lower than those in group B[(7.12±0.98)× 109 L-1,(7.11±1.36)×109 L-1,(10.33±2.02)mm·h-1,(15.55±1.87)mg·L-1],and the differences were statistically significant(P＜0.05).The overall incidence of complications was 9.84％(6/61)in group A and 11.29％(7/62)in group B,with no statistically significant difference between groups(P＞0.05).Conclusion In the treatment of pediatric acute hematogenous osteomyelitis,both bone cortex fenestration debridement combined with antibiotic-impregnated calcium sulfate implantation and drilling decompression drainage achieve high effective rates.However,the former significantly shortens the total hospital stay,drainage tube placement time,and wound healing time,demonstrating faster clinical recovery and contributing to the alleviation of the inflammatory response.
Keywords：acute hematogenous osteomyelitiscortical fenestrationdebridementantibioticsdrilling decompression drainage
Publication Date：2026-06-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 1952-1957 )