24. Aseptic bone necrosis (except Perthes disease) скачать в хорошем качестве

24. Aseptic bone necrosis (except Perthes disease)

24. Aseptic bone necrosis (except Perthes disease) Aseptic bone necrosis (AN) results from a vascular disorder supply. Causes include metabolic disorders, trauma, sick cell anemia, and iatrogenic damage (e.g., corticoid application, dialysis). Examples of AN: • Aseptic Necrosis of the Humerus Head (M. Haas): X-ray may show a crescent sign (line of clarification under the subchondral bone). Advanced stages require surgical treatment (hemiarthroplasty, alloplasty). • Morbus Panner: Aseptic necrosis of the head of the humerus in the elbow area ("throwing elbow") in boys aged 6–10 years. • Morbus Kienböck (os lunatum): The most common AN in the wrist area due to limited collateral vascular supply, treated conservatively or surgically (revascularization procedures). • Morbus Köhler I (os naviculare): Typically affects boys aged 3–8 years; treatment is conservative (plaster bandage, foot arch support). • Morbus Köhler II (Freiberg-Köhler): Affects the head of the 2nd metatarsal bone (MTT) in females aged 10–18 years. Chronic cases leading to arthritic changes may require surgical wedge resection of the MTT head. • Morbus Osgood-Schlatter: Overload disease affecting the proximal tibial apophysis, involving partial avulsion and subsequent AN. • Morbus Haglund-Sever: Apophysitis of the calcaneus, treated conservatively.