Our Experiences with Hyperbaric Oxygen Therapy in Paediatric Orthopaedics

Objective: The main uses of hyperbaric oxygen therapy (HBOT) in orthopaedics are acute traumatic ischemia such as crush injuries and compartment syndrome, reimplantations, chronic osteomyelitis, grafts and flaps with suspected involvement, gas gangrene, necrotizing soft tissue infections, avascular necrosis and delayed post-op wound healing. The aim of this study was to determine the most common orthopaedic indications for HBOT in pediatrics. We also aimed to share information about HBOT with pediatric orthopaedic surgeons. Method: By reviewing our files and system records, we documented all pediatric patients who underwent HBOT between 01.01.2006 and 01.01.2016 with the indications of crush injury, compartment syndrome, chronic osteomyelitis and delayed wound healing. We recorded the demographic characteristics, indications, outcomes, problems encountered, complications and side effects of patients aged 0-18 years who received at least 15 sessions of HBOT. Results: A total of 1029 HBOT sessions were performed in 31 patients. Treatment was completed as planned in 24 patients (77.4%). Cure was achieved in 19 patients (61.3%). Two patients (6.4%) had improvement with minor morbidity, and three (9.7%) had no improvement as a result of the treatment. Anxiety symptoms were observed in only six patients during the first session (0.6% patient sessions). The sessions did not result in any complications that required treatment to be discontinued. Conclusion: HBOT in patients with orthopaedic indications was completed without complications. We believe that HBOT can be safely used in pediatric orthopaedics. However, larger patient series are needed.