A Case of Brodie's Abscess in Distal Radius of Pediatric following Percutaneous Fixation

Abstract

Distal radius fractures are among the most common pediatric fractures. In unstable fractures, treatment methods include closed or open reduction and percutaneous pinning with Kirschner wire (K-wire). This report presents a 13-year-old boy with an unstable distal radius and ulnar fractures, following an accident, who was treated with open reduction and K-wire fixation. He had pain and limited wrist range of motion for 6 months. Conventional radiography revealed a lytic lesion with evident sclerotic margin. Chronic osteomyelitis and Brodie's abscess were also indicated. A complete curettage and antibiotic therapy for 3 months was successful. Culturing results showed that Staphylococcus aureus and pathologic findings were in favor of chronic osteomyelitis. Subacute osteomyelitis and Brodie's abscess are rare retarded complications in percutaneous pinning of distal radius pediatric fractures. The curettage of the lesion and antibiotic therapy for at least 3 months would be successful and could result in good prognosis among children.

Keywords: Brodie's abscess; distal radius; percutaneous pinning.

Fig. 1

Distal radius and ulnar fracture before and after treatment with open reduction and percutaneous pinning.

Fig. 2

Conventional radiography of distal radius 6 months after treatment showing a lytic lesion with evident sclerotic margins and a hyperintense lesion in the central region and formation of the sequester.

Fig. 3

CT scan of distal radius showing a central intramedullary hypodense cystic lesion with thick ossification.

Fig. 4

MRI findings revealing a well-defined central intramedullary cystic lesion in the distal radius. The central section of the lesion was hypointense on T1-weighted images and hyperintense on T2-weighted images.

Fig. 5

Radiography 3 months after treatment with curettage and antibiotic therapy.