Avascular Necrosis of the Knee

Avascular Necrosis

Avascular Necrosis is a disease that develops from the temporary or permanent loss of the blood provided to the bones. Bone tissue needs blood otherwise it will die causing the bone to breakdown. This can occur from trauma, non-traumatic or even pressure within the bone. Other names for Avascular necrosis include ischemic bone necrosis, osteonecrosis and aseptic necrosis.

There are also other sites for avascular necrosis to occur such as the femur, shoulder, upper arm bone and ankles. The disease may impact just one bone, multiple bones at the same time or multiple bones at separate times

Normally after an injury, a bone can heal itself by breaking down and restoring itself along with the old bone that gets drawn in and is exchanged with new bone, however if this doesn't take place and the bone is losing blood circulation then Avascular Necrosis presents itself.

At the beginning of this disease, a patient may not have any indication that they have Avascular Necrosis but as it advances the patients encounter joint pain. The pain first starts in the joint when weight is placed on the joint and then it continues on even in a relaxed state. The pain begins slowly and steadily increases to severe. The severity of this pain can restrict a persons range of motion.

After an orthopaedic doctor has completing a physical exam and has assessed the patients history, they can determined what tests are needed to diagnose the patient as having Avascular Necrosis. X-rays can help decide if more test need to be performed to evaluate if further test are required for their diagnosis. Other diagnostic tests include MRI, CT, Bone Scan, Biopsy and Functional Evaluation of Bone.

To choose the most suitable treatment, the doctor takes into consideration the patients age, at what stage the disease is in, where the affected bone is located and its size, and what is the primary cause of Avascular Necrosis. Conservative treatment such as corticosteroid is usually given to patients first, however, these hardly ever give permanent improvement. So, more than likely the patient will have to have surgery.

Boxer's fracture

Boxer's Fracture
A boxer's fracture is break in the bones in the knuckle region of the hand. The knuckle is the head of the metacarpal bone and the break is just below it at the neck of the metacarpal bone. The most frequent metacarpal bone to fracture when striking a fixed object is the small finger known as the fifth metacarpal. This fracture can also occur in the fourth metacarpal but some doctors include the second and third metacarpal in the explanation of a boxer's fracture.
Common symptoms of a boxer's fracture are tenderness or pain in a particular location in one of the metacarpal bones on the hand near the knuckle. The hand may appear deformed, bruise or enlarge throughout the location that is injured. If the fracture has a cut, it may be a more serious break and should be checked out as soon as possible.
Any hand injury that has symptoms or signs demonstrating a fracture should be assessed by a doctor. If you are unable to see a doctor right away, you should go to the emergency department at a hospital. The doctor will deem whether an x-ray is necessary after an examination. Before you are able to see a doctor, there are steps you can do to take care if the injury. To reduce swelling and pain, apply a cold pack or something cold to the area that is injured and elevate the broken hand to minimize the swelling. If the injured hand is cut, you run the risk of infection so it is important to wash the hand with soapy water and then conceal it promptly with a sterile bandage to decrease the chance of infection. Keep the injured hand restrained to keep from damaging nearby blood vessels, ligaments, tendons, muscles and nerves.
Once the injured hand is diagnosed with a boxer's fracture, the doctor will determine how to treat the hand and how to take care of it once you go home. If the fracture does not require surgery, a cast or splint is used to keep the hand stable. Usually with any broken bone, a person will have pain so it is important to receive some form of pain management. Pain relievers and anti-inflammatory medicine provide great alleviation. It is important to make sure that the broken bone is rehabilitating properly so it is best to look into acquiring an orthopedic specialist.