Exposed Tibia: Exceptional Mode of Revelation of Tuberculous Osteomyelitis

Isolated bone localization of osteoarticular tuberculosis is uncommon and their diagnosis is sometimes difficult explaining the delay in management. The authors report a new case of tuberculous osteomyelitis diagnosed late following a pathological fracture with exposure of the tibia in a 6-year-old child. The child initially presented with 8 months of insidious onset pain evolving into a pathologic fracture of the tibia with exposure of the tibial shaft. Standard radiography showed a diffuse osteolytic lesion of the tibial shaft associated with intraosseous abscess images. A biopsy was taken intraoperatively and confirmed the diagnosis of tuberculous osteomyelitis. The evolution of the wound was favorable after surgical debridement and total diaphysectomy followed by antitubercular chemotherapy. Unfortunately, the patient was subsequently lost, preventing the realization of a reconstructive surgery for a better functional recovery of his lower limb.