Optimizing methods of diagnostics and treatment of acute hematogenous osteomyelitis in newborns

He article presents the new method of treating acute hematogenousosteomyelitis in newborns, aiming at internidal decompression with the use of laser osteoperforation. The treatment of 34 children has been analyzed: 22 were in the main group treated by means of laser osteoperforation and 12 - in the control group treated by means of traditional methods. There was no statistically relevant difference found in the clinical course, terms of admission, character of complications in the groups analyzed except for methods of local treatment. The primary lesion of the inflammation was found mainly in long bone epiphysis (79,8 %). 9 children had multiple bone affection. The septicopyemic form of acute hematogenous osteomyelitis was diagnosed in 7 children, and local form - in 27 children. All the patients irrespective of the terms of admission, were made US screening and monitoring of the inflammatory nidus. Changes in epiphysis echogenicity were revealed on the 1-3 day of the disease, thus corresponding to the early signs of theintramedullary phase of hematogenous osteomyelitis. Articular surface deformation and change in articular cartilage form were revealed at the later term (5-7 day). These signs corresponded to the beginning of extramedullary phase of inflammation. The method sensitivity during the first 7 days of the disease was 91 % and increased with the duration of inflammation. At the stage of local complications, when the inflammatory process spread outside the limits of metaphysis (stage of subperiostalphlegmon and septic arthrytis) joint puncture and osteoperforation with the help of needle- “screw” or laser were made. Permanent remission after laser technology operations is revealed in 97,3 % children, after traditional treatment -in 91,2 %.