A Rare Case of Chronic Pan-Diaphyseal Osteomyelitis of the Fibula in a Child Treated by Near Total Fibulectomy: A Case Report

Introduction: Osteomyelitis in children typically affects the metaphysis of long bones, most commonly the femur and tibia. Fibular involvement is rare, accounting for <10% of pediatric osteomyelitis cases. Pan-diaphyseal involvement is even rarer. Case Report: A 7-year-old girl presented with a chronic discharging sinus, pain, and swelling in the right leg for 10 months following minor trauma. Radiographs and magnetic resonance imaging revealed chronic pan-diaphyseal osteomyelitis of the fibula with a pathological fracture. After failed conservative management, she underwent sequestrectomy and near-total fibulectomy, preserving the distal 5 cm to maintain ankle stability. Intraoperative cultures confirmed methicillin-sensitive Staphylococcus aureus, and she received targeted antibiotic therapy. She achieved full recovery with a normal gait and no recurrence at 3-month follow-up. Conclusion: This case highlights the importance of early suspicion and aggressive surgical management for chronic fibular osteomyelitis in children. Near-total fibulectomy is feasible and functionally successful when the distal fibula is preserved.