Functional Outcomes of Surgical Versus Non-Surgical Management of Chronic Osteomyelitis of Lower Limb Bones in Children: A Retrospective Comparative Study

Background: Chronic osteomyelitis in children remains a significant clinical challenge, particularly in resource-limited settings. Surgical debridement is considered the cornerstone of treatment, yet conservative antibiotic-only protocols are sometimes attempted when resources are constrained. Objective: To compare functional outcomes of surgical versus non-surgical treatment for pediatric chronic osteomyelitis of the lower limbs. Methods: A retrospective study was conducted at Kanti Devi Medical College Hospital and Research Center from January to December 2024. Fifty children (mean age 8 years) were included: 25 underwent surgical debridement with antibiotics, while 25 received antibiotics alone. Outcomes analyzed were infection resolution, recurrence, limb length discrepancy (LLD), range of motion (ROM), and school attendance. Results: Surgical management resulted in higher infection resolution (92% vs. 72%), lower recurrence (8% vs. 28%), and fewer functional restrictions compared to non-surgical treatment. These findings align with published literature, including Wirbel & Hermans (2014) and Disch et al. (2023). Conclusion: Surgical debridement combined with antibiotic therapy provides superior infection control and functional outcomes compared to conservative treatment alone in children with chronic osteomyelitis of the lower limbs.