As an independent disease first identified osteochondropathy G.Akskhauzen German doctor in 1923. He found that when osteochondropathy hip happening aseptic necrosis (necrosis and disintegration of bone tissue without the bacterial flora) of the femoral head.
Osteochondropathy - a number of diseases of bone and articular apparatus, occurring mainly in childhood and adolescence, which occur as a series of successive stages and manifest aseptic necrosis of most of loaded areas of the skeleton, their destruction and subsequent restoration.
The essence of the disease is poor circulation in the local bone, which is a violation of its nutrition and necrosis (aseptic necrosis). All osteochondropathy can be divided into four groups:
- osteochondropathy epiphysis (end) of the tubular bones - humerus, metacarpals (on the hand), phalanxes of fingers, the femoral head, heads II and III metatarsal (on foot);
- osteochondropathy short spongy bones - vertebrae, lunate and scaphoid bones of the hand, the navicular bone of the foot;
- osteochondropathy apophyses (projections on the bone), or apofozity - Youth apofozit vertebrae, pelvic bones apofozit, tibia, patella, the calcaneus, V metatarsal bone (on the foot);
- wedge-shaped partial necrosis of the articular ends of bones (osteochondrosis dissecans) - the head of the humerus, distal epiphysis of the humerus, the body of the talus (on foot).
Among the orthopedic diseases osteochondropathy constitute about 2, 5 - 3%. Thus for aseptic necrosis of the hip joint accounts for 34% of the knee - 8, 5%, elbow - 14, 9% of the wrist joint and carpal - 42, 6%.
Causes osteochondropathy still unclear. It is believed that the importance of injury, infection, congenital structural features of the tissue, hormonal disorders
Hormonal disorders - oversupply and a lack of equally dangerous
, Metabolic disorders
Metabolism: The basis of life of all living things
and so on. Most researchers believe the main cause of chronic or acute trauma in conjunction with blood circulation.
How does osteochondropathy
During Osteochondropathy usually long-term (2-3 years or more). There are three phases of the flow of aseptic necrosis: the phase of necrosis (bone necrosis), fragmentation phase (bone disintegration into separate fragments), and the outcome of, or recovery phase of bone.
In the first phase, the patient complains of fatigue, vague pain. There are small joint dysfunction, mild local pain, lameness (with the defeat of the lower limbs). Then comes the compression (broken by squeezing) necrotic bone, the pain intensifies, the patient sparing the affected limb. By the end of the second phase of the pain may disappear, but the function of the limb is not restored. In the third phase there is the process of restoring bone or the development of deforming arthrosis (growths inside the joint connective tissue in violation of its functions) with the resumption of pain.
The children in the period of growth of aseptic necrosis can lead to premature closure of the growth zone of the bone (ie the cessation of its growth).
A crucial role in the diagnosis of x-ray plays. Radiological findings in the development of osteochondropathy five distinct phases or stages:
- Stage I - the subchondral necrosis, it is not a picture you can not see;
- Stage II - compression fracture;
- Stage III - the stage of resorption of bone fragments;
- Stage IV - the stage of gradual recovery of the bone;
- Stage V - complete restoration of bone structure, or changes in the type of joint arthrosis.
The intervals between the next X-ray examination depend on the stage of the disease and are on average from one to several months in stage II, from 6 months to a year and sometimes more in the later stages.
Treatment osteochondropathy in children due to the high regenerative capacity in growth should be conservative, with the unloading of the affected limb (bed rest or walking on crutches) and the use of physiotherapy. If osteochondropathy in children and adults over the deformation of the joint end, in some cases, surgical treatment is shown.
The prognosis for life in osteochondropathy favorable, and in respect of restoration of function of limbs determined by timely treatment. Cures rare. Because of late begun or irrational treatment of the full restoration of form and function of the limb bones often occurs - are the consequences in the form of osteoarthritis
Osteoarthritis - when the joint loses its function