{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:58:40Z","timestamp":1790348320244,"version":"4.1.0"},"reference-count":9,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,5]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>This case report presents the management of chronic osteomyelitis of femur in a 6-year-old male child, emphasising the role of prophylactic stabilisation using a monolateral rail fixator. The child presented with persistent pus discharge, pain and difficulty in walking following an initial drainage procedure for thigh swelling at another hospital. Clinical, radiological and laboratory findings confirmed the diagnosis of chronic osteomyelitis. During surgery, a large portion of the posterolateral femoral cortex needed to be removed for thorough debridement. To maintain limb stability, a monolateral rail fixator was applied. The patient showed progressive healing on follow-up visits, with restoration of bony architecture and full return to function. The case demonstrates that monolateral rail fixators offer biomechanically superior and a patient-friendly alternative to conventional universal external fixators especially in children. Their use permits early weight bearing and thus better psychosocial outcomes and simplified postoperative care.<\/jats:p>","DOI":"10.1136\/bcr-2025-270422","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:00:20Z","timestamp":1790344820000},"page":"e270422","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Monolateral rail fixator in paediatric femoral osteomyelitis can be a patient-friendly alternative to conventional fixator"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8055-9549","authenticated-orcid":false,"given":"Hem Raj","family":"Gujar","sequence":"first","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3882-8975","authenticated-orcid":false,"given":"Rajesh","family":"Ratan","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prateek","family":"Behera","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5513-7727","authenticated-orcid":false,"given":"Aravind","family":"Balachandran","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"2026092507001151000_19.9.e270422.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16727-5"},{"key":"2026092507001151000_19.9.e270422.2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.mporth.2019.03.005","article-title":"Chronic osteomyelitis: a review on current concepts and trends in treatment","volume":"33","author":"Barakat","year":"2019","journal-title":"Orthop Trauma"},{"key":"2026092507001151000_19.9.e270422.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0189743","article-title":"Population study evaluating fracture risk among patients with chronic osteomyelitis","volume":"12","author":"Lo","year":"2017","journal-title":"PLoS One"},{"key":"2026092507001151000_19.9.e270422.4","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5005\/JPMER-51-1-17","article-title":"Prospective Role of Uniplanar Compressible External Fixation Devices in the Management of Pathological Diaphyseal Fractures Secondary to Osteomyelitis in Children","volume":"51","author":"Dhillon","year":"2017","journal-title":"J Postgrad Med Educ Res"},{"key":"2026092507001151000_19.9.e270422.5","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198912000-00027"},{"key":"2026092507001151000_19.9.e270422.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-025-08900-9","article-title":"Management of pathologic fracture of long bones as a complication of acute osteomyelitis: a challenging task for orthopedic surgeons","volume":"26","author":"Zargarbashi","year":"2025","journal-title":"BMC Musculoskelet Disord"},{"key":"2026092507001151000_19.9.e270422.7","first-page":"448","article-title":"Prophylactic external fixation and extensive bone debridement for chronic osteomyelitis","volume":"72","author":"Fodor","year":"2006","journal-title":"Acta Orthop Belg"},{"key":"2026092507001151000_19.9.e270422.8","first-page":"437","article-title":"Mono-Lateral External Fixation for Treatment of Femoral Osteomyelitis. Orthopedic research and reviews","volume":"14","author":"Mohd Yusof","year":"2022","journal-title":"Orthop Res Rev"},{"key":"2026092507001151000_19.9.e270422.9","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/9070216","article-title":"Management of Osteomyelitis-Induced Massive Tibial Bone Defect by Monolateral External Fixator Combined with Antibiotics-Impregnated Calcium Sulphate: A Retrospective Study","volume":"2018","author":"Qin","year":"2018","journal-title":"Biomed Res Int"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270422","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:00:22Z","timestamp":1790344822000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270422"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":9,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,25]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2025-270422"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270422","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}