Time to Bone Healing After Intraosseous Placement in Children is Ill Defined.

Time to bone healing after intraosseous (IO) insertion in children has not been clearly established. This report documents the case of a 23-month-old male infant with previous IO placement of the tibia, presenting 3 weeks later to our emergency department with radiographic evidence of previous IO insertion. This report reviews relevant literature on complications of IO insertion, contraindications to IO insertion, and evidentiary support for such recommendations. Time to bone healing after IO insertion and recommendations regarding time to safe cannulation of previously cannulated areas are based on animal models. This case demonstrates 1 instance in which radiographic evidence of bone healing at 3 weeks after IO insertion is not complete, in contradiction to previously reported data. Although the clinical significance of this finding is unknown, further work is needed to define safe timing for IO reinsertion in children.