Article Text

Download PDFPDF
The skeletal consequences of meningococcal septicaemia
  1. Fergal Monsell
  1. Paediatric Orthopaedic Surgery, Bristol Royal Hospital for Children, Bristol, UK
  1. Correspondence to Fergal Monsell, Paediatric Orthopaedic Surgery, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, Avon BS2 8BJ, UK; fergal. monsell{at}


Meningococcal disease remains a leading cause of childhood mortality in the UK. Advances in resuscitation have resulted in survival of severely affected individuals and the long-term skeletal consequences are being increasingly recognised. The immediate management of the ischaemic limb in the context of a critically ill and haemodynamically unstable child is described and the indications for fasciotomy and amputation are considered. Long-term disability occurs as a consequence of limb malalignment and is often accompanied by significant injury to the soft tissue envelope. The function of surviving limbs can be enhanced using contemporary surgical techniques that involve realignment and lengthening. Amputees present specific difficulties due to the effect of remaining longitudinal growth on the function of the residual limb, and require surgical treatment that often continues throughout childhood. This overview considers the surgical algorithms that have evolved to treat these patients.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.