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Abstract Objective To explore the effect of two methods of decompression drainage with fenestration and drilling in the treatment of acute long bone osteomyelitis in children.Methods A total of 267 children with acute long bone osteomyelitis were enrolled from June 2015 to June 2020 in the Department of Orthopaedics of Hebei Children's Hospital.According to the different treatment methods，132 patients were divided into fenestration decompression drainage group.There were 65 males and 67 females，with an average age of (6.45±3.78)years，ranging from 2 to 16 years.135 patients were divided into drilling decompression drainage group.There were 69 males and 66 females，with an average age of (7.24±3.46)years，ranging from 2 to 17 years.After 1 year follow-up，the excellent and good rates of the two groups were compared according to Levin Score.The clinical indexes of the two groups were compared，including the days of temperature return to normal，the days of extubation，the days of hospitalization，the total cost of hospitalization and the number of cases of pathological fracture.The laboratory indexes of the two groups included C-reaction protein(CRP)，erythrocyte sedimentation rate(ESR)，procalcitonin (PCT)，interleukin-6(IL-6) and serum amyloid A(SAA) before operation and 1、3、5、7 days after operation.Results At the last follow-up，93.18%(123 cases) of the drainage group and 92.59%(125 cases) of the drainage group had good results.No significant difference was found (P＝0.851).13 cases of fenestration decompression group and 11 cases of drilling decompression group had pathological fracture.There was no significant difference between the two groups (P＝0.627).However，the days of temperature recovery，extubation，hospitalization and total cost of hospitalization were significantly lower in fenestration decompression and drainage group than those in drilling decompression and Drainage Group (P＜0.001).There was no significant difference in CRP，ESR，PCT，IL-6 and SAA between the two groups before operation (P＞0.05).The recovery of CRP，ESR，PCT，IL-6 and SAA at 1，3，5，7 days after operation showed that fenestration decompression and drainage group was significantly better than drilling decompression g roup (P＜0.001).Conclusion There is no difference in the final excellent and good rate between fenestration decompression drainage and drilling decompression drainage in the treatment of acute long bone osteomyelitis in children.However，the recovery of post-operative inflammatory parameters of patients with fenestration decompression and drainage is significantly better than that of patients with decompression and drainage by drilling.The time of temperature returning to normal，the days of indwelling drainage tube are shortened，the days of hospitalization and the total cost of hospitalization are reduced.The treatment of acute long bone osteomyelitis in children is obviously better than drilling decompression and drainage，which is worth popularizing in clinic.
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Corresponding Authors:
Feng Yanhua
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