# Pedal Amputation for Metatarsal Osteomyelitis Following a Neglected Open Salter-Harris Type 1 Metatarsal Fracture: A Case Report

## TL;DR

A child developed metatarsal osteomyelitis after an untreated fracture, requiring amputation and successful recovery.

## Contribution

This case report highlights the management of a rare pediatric osteomyelitis following a neglected Salter-Harris type 1 fracture.

## Key findings

- Osteomyelitis occurred after a neglected Salter-Harris type 1 fracture in a five-year-old child.
- Treatment included sequestrum removal, wound healing, and antibiotic therapy, leading to recovery.
- Five months of follow-up showed favorable outcomes with restored mobility.

## Abstract

Metatarsal osteomyelitis in children is a rare condition. Its management is a challenge in developing countries. The aim of this case report is to present the diagnostic and therapeutic challenge of a case of osteomyelitis on a neglected open Salter-Harris type 1 fracture of the first metatarsal in a small child, which occurred after treatment by a bone setter. This is a five-year-old child who presented to our clinic with an exposed piece of bone on the medial border of the left forefoot for two months. The latter presented a functional impotence of the left lower limb related to pain. Osteomyelitis over a neglected Salter-Harris type 1 fracture of the first metatarsal was the diagnostic hypothesis retained on the basis of clinical examination and foot radiography. After removal of the sequestrum, curettage, and cleaning of the residual cavity under sedation, regular dressings allowed the wound to heal. The patient received antibiotic therapy. Pathological findings were consistent with inflammatory and necrotic bone tissue, with no evidence of malignancy. Evolution was good, with healing of the skin wound and recovery of walking. The prognosis after five months of clinical follow-up was favorable.