Management of a Garré Sclerosing Osteomyelitis of Forearm: Report of a Resistant Case

Reza Shahryar  Kamrani; Hossein  Azaditalab; Hesam  Alitaleshi; Mohammadreza  Abbaszadeh

doi:10.18502/jost.v10i4.17371

Reza Shahryar Kamrani Professor, Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hossein Azaditalab Hand Surgery Fellowship, Department of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hesam Alitaleshi Hand Surgery Fellowship, Department of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mohammadreza Abbaszadeh Hand Surgery Fellowship, Department of Orthopedic Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v10i4.17371

Keywords: Case Study; Osteomyelitis; Radius; Sclerosis

Abstract

Background: Garre’s sclerosing osteomyelitis (GSO) is a rare chronic inflammatory condition characterized by sclerosis and thickening of bone cortices with mandibular affection in children and young adults. It involves periosteal reactions without abscess formation in young adults. Treatment typically includes analgesics and antibiotics, with surgery for non-responders. In this study, we report a rare case of GSO of the upper extremity involving radius and ulna bones.

Case Report: A young man with a history of forearm trauma treated by a bonesetter developed worsening pain and swelling over two years. At age 34, he underwent debridement for chronic osteomyelitis, followed by four additional surgeries. In 2004, a non- vascularized fibular graft was applied, achieving union, but persistent pain led to further interventions. By 2011, lab tests showed increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and the lesion had recurred, necessitating resection and a free vascularized fibular graft. In 2013, after irrigation and debridement, the Masquelet technique was utilized. Four years post-surgery, the patient reports no pain or symptoms.

Conclusion: On the basis of this case, we suggest that in extreme cases of chronic GSO, when bone resection remains the chosen treatment option, and we have a significant bone defect, a Masquelet technique is a valid and possible method.