{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T09:30:43Z","timestamp":1758274243319},"reference-count":19,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"7","license":[{"start":{"date-parts":[[2011,7,1]],"date-time":"2011-07-01T00:00:00Z","timestamp":1309478400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:p> Septicaemia resulting from meningococcal infection is a devastating illness affecting children. Those who survive can develop late orthopaedic sequelae from growth plate arrests, with resultant complex deformities. Our aim in this study was to review the case histories of a series of patients with late orthopaedic sequelae, all treated by the senior author (CFB). We also describe a treatment strategy to address the multiple deformities that may occur in these patients. <\/jats:p><jats:p> Between 1997 and 2009, ten patients (seven girls and three boys) were treated for late orthopaedic sequelae following meningococcal septicaemia. All had involvement of the lower limbs, and one also had involvement of the upper limbs. Each patient had a median of three operations (one to nine). Methods of treatment included a combination of angular deformity correction, limb lengthening and epiphysiodesis. All patients were skeletally mature at the final follow-up. One patient with bilateral below-knee amputations had satisfactory correction of her right amputation stump deformity, and has complete ablation of both her proximal tibial growth plates. In eight patients length discrepancy in the lower limb was corrected to within 1 cm, with normalisation of the mechanical axis of the lower limb. <\/jats:p><jats:p> Meningococcal septicaemia can lead to late orthopaedic sequelae due to growth plate arrests. Central growth plate arrests lead to limb-length discrepancy and the need for lengthening procedures, and peripheral growth plate arrests lead to angular deformities requiring corrective osteotomies and ablation of the damaged physis. In addition, limb amputations may be necessary and there may be altered growth of the stump requiring further surgery. Long-term follow-up of these patients is essential to recognise and treat any recurrence of deformity. <\/jats:p>","DOI":"10.1302\/0301-620x.93b7.26128","type":"journal-article","created":{"date-parts":[[2011,6,25]],"date-time":"2011-06-25T21:07:37Z","timestamp":1309036057000},"page":"984-989","source":"Crossref","is-referenced-by-count":9,"title":["The management of the orthopaedic sequelae of meningococcal septicaemia"],"prefix":"10.1302","volume":"93-B","author":[{"given":"D. H.","family":"Park","sequence":"first","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. F.","family":"Bradish","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1586\/erv.10.3"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Grogan DP, Love SM, Ogden JA, Millar EA, Johnson LO. Chondro-osseous growth abnormalities after meningococcemia: a clinical and histopathological study. J Bone Joint Surg [Am] 1989;71-A:920\u20138.","DOI":"10.2106\/00004623-198971060-00018"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198509000-00016"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Canale ST, Ikard ST. The orthopaedic implications of purpura fulminans. 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