{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:53:48Z","timestamp":1790934828370,"version":"4.1.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To summarize and analyze the clinical characteristics, diagnosis, treatment, and prognosis of pediatric fibular osteomyelitis, and to analyze related influencing factors, providing evidence for clinical management of pediatric osteomyelitis in rare locations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on the clinical data of pediatric patients with fibular osteomyelitis from January 2018 to December 2024, including demographic characteristics, clinical manifestations, laboratory and imaging examinations, microbiological results, treatment modalities, and follow-up outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 13 patients were included (9 males, 4 females) with a median age of onset of 7.3 years. There were 11 acute cases and 2 chronic cases. The main clinical manifestations were bone pain, fever, and local abscess formation. The positive rate of microbiological culture was 76.9%, with Staphylococcus aureus being the most common pathogen (including 1 case of MRSA). Two patients responded effectively to antibiotic therapy alone, while 11 cases required surgical intervention, including fibular fenestration, debridement, segmental resection, and VSD therapy. All patients showed significant reduction in inflammatory markers after treatment. During 3\u201324 months of follow-up, 3 cases experienced recurrence requiring repeat surgery, with no severe disability or deformity observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric fibular osteomyelitis has an insidious onset and poses diagnostic challenges. Staphylococcus aureus, particularly MRSA, represents the primary pathogen, with higher rates of surgical intervention and recurrence compared to other long bones. Early accurate diagnosis, adequate antibiotic therapy, and individualized surgical intervention are crucial for improving prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1671156","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T06:33:11Z","timestamp":1762842791000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Experience in diagnosis and treatment of pediatric fibular osteomyelitis"],"prefix":"10.3389","volume":"12","author":[{"given":"Yuan","family":"Liang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenjiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e20180387","DOI":"10.1542\/peds.2018-0387","article-title":"Use of a clinical care algorithm to improve care for children with hematogenous osteomyelitis","volume":"143","author":"Robinette","year":"2019","journal-title":"Pediatrics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e19617","DOI":"10.1097\/MD.0000000000019617","article-title":"Hematogenous osteomyelitis in childhood can relapse many years later into adulthood: a retrospective multicentric cohort study in France","volume":"99","author":"Clerc","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e41345","DOI":"10.7759\/cureus.41345","article-title":"Primary fibular osteomyelitis in children: a systematic review","volume":"15","author":"Nikkhahmanesh","year":"2023","journal-title":"Cureus"},{"key":"B4","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3810\/psm.2008.12.11","article-title":"Osteomyelitis: approach to diagnosis and treatment","volume":"36","author":"Fritz","year":"2008","journal-title":"Phys Sportsmed"},{"key":"B5","doi-asserted-by":"publisher","first-page":"184","DOI":"10.21037\/qims.2016.04.01","article-title":"The imaging of osteomyelitis","volume":"6","author":"Lee","year":"2016","journal-title":"Quant Imaging Med Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1093\/jpids\/piab027","article-title":"Clinical practice guideline by the pediatric infectious diseases society and the Infectious Diseases Society of America: 2021 guideline on diagnosis and management of acute hematogenous osteomyelitis in pediatrics","volume":"10","author":"Woods","year":"2021","journal-title":"J Pediatric Infect Dis Soc"},{"key":"B7","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.arcped.2020.06.010","article-title":"Acute osteomyelitis of the distal fibula in children: treatment options and long-term follow-up","volume":"27","author":"Kaziz","year":"2020","journal-title":"Arch Pediatr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e323","DOI":"10.1017\/S0950268819002127","article-title":"Characterisation of community-acquired Staphylococcus aureus causing skin and soft tissue infections in a children\u2019s hospital in Shanghai, China","volume":"147","author":"Wang","year":"2019","journal-title":"Epidemiol Infect"},{"key":"B9","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12880-023-01010-9","article-title":"Application of magnetic resonance image compilation (MAGiC) in the diagnosis of middle-aged and elderly women with osteoporosis","volume":"23","author":"Chen","year":"2023","journal-title":"BMC Med Imaging"},{"key":"B10","doi-asserted-by":"publisher","first-page":"527","DOI":"10.3390\/children9040527","article-title":"Is early surgical intervention necessary for acute neonatal humeral epiphyseal osteomyelitis: a retrospective study of 31 patients","volume":"9","author":"Gao","year":"2022","journal-title":"Children (Basel)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.3892\/etm.2013.999","article-title":"Free dermatoplasty combined with vacuum sealing drainage for the treatment of large-area soft tissue defects accompanied by bone exposure in the lower leg","volume":"5","author":"Qu","year":"2013","journal-title":"Exp Ther Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1007\/s00402-005-0054-9","article-title":"Dynamic function of the fibula. 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