Neonatal hematogenous osteomyelitis: risk factors for long-term sequelae.

The findings in 40 infants with neonatal osteomyelitis were examined to evaluate factors that may predict the development of sequelae. On follow-up at 1-11 years of age, 16 children were found to have moderate (six) and severe (10) sequelae. Thirteen of these 16 children were among the 21 infants who had perinatal risk factors. On the other hand, there were only three handicapped infants in the group of 19 who had no risk factors. The high-risk infants were, on the average, younger at onset of osteomyelitis than the previously healthy babies. No differences were found between those two groups that could be ascribed to the causative organisms. Fifty-five osteomyelitic sites involving the large joints were diagnosed. Growth disturbance was evident in 20 of 36 nonoperated foci and four of 19 operated foci. To achieve the best result, the joint and abscess should be drained, and this should be supplemented by drainage of the metaphysis.