Sin ttulo de diapositiva

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SURGICAL TREATMENT FOR THE SEQUELAE OF
MENINGOCOCCAL SEPSIS
L Peña, JL Barroso, JL Monasterio, JL
Beguiristain Hospital de Basurto (Bilbao-
Spain) Clínica Universitaria de Navarra
(Pamplona- Spain)
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Introduction

• Meningococcal sepsis is responsible for physeal
  plates disturbances at multiple sites affecting
  axial and longitudinal limb growth and therefore
  requiring correction with different surgical
  techniques

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Material and Methods

• We carried out a retrospective study of 14
  patients suffering sequealae of meningococcal
  sepsis (8 excluded due to failure to attend
  follow up). 6 patients were treated, 4 boys and
  2 girls with an average time of 12 months after
  the diagnosis of sepsis was established (8-20 m)
  and 4 years after the first visit to the clinic
  (2-10 y). We reviewed the symptoms, radiological
  findings, types of treatments performed,
  complications and clinical situation at the last
  follow up. The average follow up was 12 years
  (5-17 y)

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Results

• The most common reason for attending the
  clinic was varus deformity of the knees (10),
  ankles (2) and hip (1), followed by lower limb
  length discrepancy (2)
• The most frequent surgical techniques were
  valgus osteotomies of the tibia (18) and femur
  (3), leg lengthening with correction of tibial
  (4) and femoral (2) axis, physeal distractions
  (2) and 2 epiphysiodesis (distal femoral and
  proximal tibial)

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Treatment
Valgus osteotomies (21)
Tibia (18) Femur (3)
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Lengthening (6)
Tibia (4) Femur (2)
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Physeal distraction (2)
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Epiphysiodesis (2)
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Results

• For the treatment of complications we carried
  out 1 calcaneo-stop procedure for a valgus foot
  and a Krogius-Lecene procedure for a recurrent
  patella dislocation. Amongst the sequelae found
  at last follow up were 2 patients with minimal
  leg length discrepancy (1,6 cm), a valgus knee, a
  varus knee and a varus ankle deformity.

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Conclusions

• We want to remark the importance of
  appropriate follow up of these patients until
  skeletal maturity in order to avoid the high
  number of musculoskeletal disturbances that they
  can present and their tendency to recur and
  therefore reduce the number of surgical
  procedures required.