navicular osteochondrosis
Introduction
Introduction to scaphoid osteochondrosis The scaphoid osteochondrosis, also known as aseptic necrosis of the scaphoid, refers to the hardening, flattening and fragmentation of the scaphoid bone during growth and development. Children often 4 to 8 years old, more boys than girls. The scaphoid is a keystone on the longitudinal arch of the foot. It is subjected to great stress and is prone to ischemic necrosis. However, Caffey found that 30% of boys and 20% of girls had irregular scaphoid ossification centers. Someone chose 100 foot X-ray films without choice. 37% of the scaphoids were developed from multiple ossification centers. Indeed, some children may have irregular scaphoid fractures when filming for other reasons. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: nonunion, traumatic arthritis
Cause
Cause of scaphoid osteochondrosis
Gender factor (75%):
The scaphoid is a keystone on the longitudinal arch of the foot. It is subjected to great stress and is prone to ischemic necrosis. However, Caffey found that 30% of boys and 20% of girls had irregular scaphoid ossification centers. Someone chose 100 foot X-ray films without choice. 37% of the scaphoids were developed from multiple ossification centers. Indeed, some children may have irregular scaphoid fractures when filming for other reasons.
Developmental factors (25%):
In addition, the X-ray film of the contralateral asymptomatic foot of the child may also have similar performance to the symptomatic side. From the clinical point of view, the symptoms of the disease begin to be rapid, and the medical history is often only 1 to 2 days, but its X The performance of the line can be formed in a short period of time. It cannot be imagined that it can be long-term and asymptomatic after osteonecrosis. Therefore, many scholars believe that this disease is a normal growth variation.
Prevention
Prevention of scaphoid osteochondrosis
In the treatment of certain diseases, especially some painful diseases, try not to use or less hormonal drugs. Because the relevant diseases must be applied with hormones, it is necessary to master the principle of short-term and appropriate amount, and cooperate with vasodilators, vitamin D, calcium, etc., do not listen to the doctor's advice and abuse hormone drugs.
Complication
Foot skeletal osteochondrosis complications Complications, nonunion, traumatic arthritis
The complications of this disease are less common, the most common cause is disease. Careful observation shows that the patient often walks on the lateral edge of the foot. In severe cases, the scaphoid may be irregularly fragmented, and the patient may also have osteonecrosis.
Complications that may occur during treatment include the following:
1 bone is not connected;
2 scaphoid ischemia and necrosis;
3 traumatic arthritis;
4 The arch is collapsed.
As we all know, the arch of the foot plays a vital role in adapting the function of the foot. The arch of the foot has elasticity, which can cushion the shock generated by the body during walking and protect the blood vessels of the foot from oppression. Therefore, the focus of foot trauma treatment It is to maintain the stability of the arch, and the scaphoid is at the top of the medial longitudinal arch. The surrounding area is mostly joint and the blood supply is poor. This is one of the causes of complications in the treatment of this disease.
Symptom
Symptoms of scaphoid osteochondrosis Common symptoms Foot swelling, tenderness, joint swelling, toe flexion, foot pain
The main clinical manifestations of this disease are pain. Patients often complain of pain in the back of the foot. They are aggravated after weight bearing. They also have pain at night, and gradually appear limp. There is mild swelling and tenderness above the scaphoid. It also hurts when compressing the longitudinal arch.
Examine
Examination of scaphoid osteochondrosis
The most commonly used auxiliary examination method for this disease is X-ray examination:
X-ray performance: the density of the scaphoid is deepened and flattened, which can only be 1/2 to 1/4 thick of the normal scaphoid. It can be fragmented later, and the gap between adjacent joints is widened. The bones returned to normal.
In some cases where conventional X-ray examination is not clear and there are suspected symptoms, CT examination should be performed to obtain a clearer image and help in diagnosis.
Diagnosis
Diagnosis and differentiation of scaphoid osteochondrosis
The disease needs to be differentiated from the scaphoid fracture, and X-ray examination can be identified.
The scaphoid bone is involved in the composition of the medial longitudinal arch of the foot. Its shape and joint structure are essential conditions for the arch arch to play a buffering stabilizing effect. Clinically, there are many avulsion or well-positioned fractures, which are comminuted for the fracture. In the case of unstable fractures with displacement or dislocation, the normal position cannot be maintained after the manipulation is completed. Surgical treatment is required. The operation is often performed by Kirschner wire or screw fixation. However, in actual surgery, the fracture is comminuted and cannot be firmly fixed. Postoperative fractures are prone to "squeezing" out of the joints, bulging on the back of the foot, reducing the anteroposterior diameter of the scaphoid bone, prone to joint pain, and ischemic necrosis of the fracture block.
