Bone is a living tissue and it needs blood supply to survive. Avascular necrosis avn is a disease where there is cellular death of bone component due to interruption of the blood supply. Avascular necrosis of femoral head after gammanailing for unstable intertrochanteric fractures. Aseptic necrosis of the femoral head nacf is an important cause of morbidity in young patients with sickle cell disease. Avascular necrosis of the capital femoral epiphysis. Ficat and arlet classification of avascular necrosis of femoral head dr daniel j bell and assoc prof frank gaillard et al. It is defined as, death of the femoral head following partial or complete obliteration of its blood supply. But certain bones in our body have precarious unidirectional blood supply like head of femur, scaphoid, and talus.
Avascular necrosis, blood supply femoral head everything you need to know dr. The ficat and arlet classification uses a combination of plain radiographs, mri, and clinical features to stage avascular necrosis of the femoral head. Feb 04, 2019 avascular necrosis of the femoral head anfh is a degenerative condition which causes the upper ends of the thigh bones femurs to break down due to a disrupted blood supply and poor bone repair. Quick help to memorize the boundaries of the femoral triangle. Como bien senalan algunos articulos, como coxalgia cronica. It can lead to pain and limping, hip collapse, and cause the legs to be of unequal length. Leo massari et al have analysed the effects of stimulation with pulsed electromagnetic fields pemfs on the treatment of avascular necrosis of the femoral head. Avascular necrosis of the femoral head is a frequent condition with an insidious pre. The bilateral joint spaces shows mild narrowing with femoral articular surface irregularity.
Avascular necrosis, death of bone tissue caused by a lack of blood supply to the affected area. Avascular necrosis free download as powerpoint presentation. The proximal femoral nail pfn for pertrochanteric femur fractures in elderly patients. Unlike xrays, an mri can detect changes in the bone marrow and can show avascular necrosis in its earliest stages before the joint space has begun to fragment or collapse and often before any xray changes are detectable. One of the most common places for osteonecrosis to occur is in the hip. This article covers the anatomy of the femur, its bony elements, and the muscle attachments. Avascular necrosis of the hip occurs when blood flow to the top portion of the thigh bone femur is interrupted. To explore a new method for the therapy of avascular necrosis of the femoral head. Avascular necrosis of the femoral head physioworks. Dec 17, 2014 avascular necrosis of the femoral head anfh is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Avascular necrosis is the most common orthopedic complication. This article reports a case of bilateral avascular necrosis of the proximal tibia associated with longterm steroid usage. Essentially, the femoral head or ball of your hip joint receives less and less blood supply. Avascular necrosis of the femoral head is a frequent condition with an insidious presentation.
Avascular necrosis of head of femur pubmed central pmc. Both hypothesized that the effect of pemf stimulation may be to protect the articular cartilage from the catabolic effect of inflammation and subchondral bonemarrow edema. Avascular necrosis of femoral head physiotherapy treatment. Avascular necrosis usually affects people between 30 and 50 years of age. When it occurs in children at the femoral head, it is known as leggcalveperthes syndrome.
Avascular necrosis of hip avn hip linkedin slideshare. Avascular necrosis most commonly affects the epiphyses ends of the femur thigh bone. Osteonecrosis, or avascular necrosis, is a condition that occurs when blood flow to an area of bone is restricted. A patients guide to avascular necrosis of femoral head. Read avascular necrosis of the femoral head following trochanteric fractures in adults. Avascular necrosis of the femoral head anfh is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. K consultant orthopaedic surgeon, trauma, arthroscopy, arthroplasty surgeon apollo hospitals, hyderabad consultant orthopaedic surgeon at. Avascular necrosis avn of the femoral head is a clinical entity that generates due to the reduction or interruption of blood flow to the femoral head, leading to bone necrosis, loss of medullary bone trabeculae and subchondral collapse, causing deformity with secondary joint destruction 5,6. Case report a 29 yearold man with a monthcourse of pain in the right heel, without trauma, and with a personal history including. Avascular necrosis treatment in some cases, persistent hip pain may be caused by avascular necrosis, or osteonecrosis of the femoral head. Nontraumatic anfh continues to be a significant challenge to orthopedic surgeons.
There is a well defined expansile lesion with sclerotic borders and narrow zone of transition noted in the left proximal femoral diaphysis. Osteonecrosis of the femoral head is not a specific diagnostic entity, but rather the final common pathway of a series of derangements that produce a decrease in blood flow, leading to cellular death within the femoral head. A 42yearold woman patient first presented in june 1 993. Nontraumatic avascular necrosis of the femoral head. The recombinant plasmid pcdrbfgf was mixed with collagen and was implanted in the necrotic femoral head. Familial avascular necrosis of the femoral head genetic and. Patients usually experience pain and coldness as a result.
Avascular necrosis is a condition that results when blood flow to the head of the thigh bone is reduced or stopped, resulting in the death of cells in the bone tissue. Avascular necrosis or osteonecrosis is a condition affecting the upper part of the leg specifically the femoral head. Avascular necrosis of femoral head can cause hip joint pain. Dec 21, 20 avascular necrosis of the femoral head 1. The place of intertrochanteric osteotomy in the treatment of idiopathic necrosis of the head of the femur. The place of intertrochanteric osteotomy in the treatment. Avascular necrosis avn of the femoral head is a pathological process that results from interruption of the blood supply to the bone. Ficat and arlet classification of avascular necrosis of. Pdf avascular necrosis avn is a disease where there is cellular death of bone component due to interruption of the blood supply. If there is damage to one of the blood supply, bone may depend on the accessory blood supply for the survival.
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