Anterior mini-bikini incision for surgical drainage in pediatric septic arthritis of the hip.

purposeOpen arthrotomy is the standard treatment for septic arthritis of the hip (SAH) in pediatric patients. The anterior and medial approaches are commonly employed; however, these techniques result in substantial tissue trauma and unfavourable scarring. The bikini incision technique has also been documented in several studies. This study evaluated the efficacy of open drainage via a mini-bikini anterior approach for pediatric SAH patients.

methodsThis was a single-centre retrospective analysis. From January 2020 to March 2024, pediatric patients diagnosed with SAH were enrolled and underwent open drainage via an anterior approach with a mini-bikini incision. Postoperatively, all patients received initial intravenous antibiotic therapy, followed by a transition to oral antibiotics. Patients were followed for a minimum of 12 months, during which time clinical outcomes were assessed, including hip joint function, sensory evaluation, radiological sequelae, and both subjective and objective assessments of scar appearance.

resultsA total of 25 pediatric patients with SAH were included in this study, including 14 females, with a mean age of 32 months. The left hip joint was involved in 15 patients, with a mean surgical time of 31 min, average intraoperative blood loss of 13 ml, and an average hospital stay of 12 days. The overall pathogen detection rate was 64%, with methicillin-sensitive Staphylococcus aureus (MSSA) being the most prevalent pathogen in this cohort. No complications occurred during or after surgery, and the surgical incisions of all patients healed in the first stage. The average follow-up time was 23 months, and at the last follow-up, according to Bennett's classification, 21 patients (84%) achieved excellent clinical outcomes, the remaining 4 children (16%) had good clinical results, and the range of motion of the affected hip joint returned to normal. All patients achieved infection clearance with excellent/good clinical outcomes (Bennett's classification). The mean incision length was 2.3 cm, the mean Vancouver scar scale score was 4.5, and 100% parental satisfaction was reported.

conclusionOur findings suggest that anterior mini-bikini approach is a potential safe and effective treatment for septic arthritis of the hip in children, offering minimal tissue trauma and improved cosmetic outcomes. These results support future investigation in larger, prospective cohorts to establish broader clinical applicability.