Treatment of aseptic necrosis is highly inefficient. Conservative treatment using multiple methods of physiotherapy is essentially symptomatic and, best case leads only to temporary and non-persistent decrease in pain in the wrist joint. The most significant is immobilization of the wrist joint, but its effectiveness, even in those cases where it lasts up to 2 months, very quickly turns out to be invalid, when the patient returns to work. Long-term treatment, long transfers to facilitate the work to which we are so happy to have recourse, is simply an attempt to delay the time of recognition of patient disabilities and needy in terms of disability.
There are many ways of surgical treatment of aseptic necrosis of the lunate bone, but also an active surgical intervention does not lead to desired results. Removing diseased lunate bone like a foreign body, Subhon-dralnoe excision it in appropriate cases, partial resection, cortical thickness incisions of the affected bone or piercing it in many places in order to stimulate regeneration, the formation of lunate-beam fusion, excochleation lunate bone with Sealing cavities - far not a complete list of operations used for aseptic necrosis. Wide dissemination of these operations is hampered not only by their complexity, but the fact that an overwhelming majority of cases end in an extremely heavy ankylosing osteoarthritis of the wrist joint and thus, even if the patient gets rid of the pain, wrist function is lost.
Based on the importance of "negative option" for the formation of aseptic necrosis, Persson suggested that in severe cases with sharply expressed "negative option" to produce radial shortening or lengthening of the ulna in order to change the existing relations of articular sites. Persson said that out of 19 operated by this method in 14 patients with good results.
Pessimistic assessment of outcomes in patients with aseptic necrosis of the lunate bone is based on a sufficient number of indisputable facts. Of 209 examinees were only 7 (3.3%) were able, after long-term care to remain in its ongoing work. The remaining 202 have lost their skills and were considered disabled in need of continued employment for work that does not require any intense and significant amount of hand movements (radiocarpal joint, fingers).
Real prevention of disease Kienbock very difficult. Brush, as is known, is the "gateway of vibration, but the number of workers with vibrating tools has been steadily increasing in line with the needs of the economy. Only improved antivibration devices will reduce the many effects of vibration, including necrosis of the lunate bone disease. In no less prevention must include full and mechanization and automation of many tense for hand work. It is very possible that a significant role can be played by a professional selection, taking into account the structural features of the articular sites radius and ulna bones, preventing a number of works, primarily associated with vibration, those with "negative option" for the wrist joint. Peculiarities of aseptic necrosis of the lunate bone, the trend of the disease to progress and make it virtually irreversible physician conducting the examination of disability, to take into account these circumstances and did not expect that treatment and temporary employment to facilitate the work will help the patient return to his profession. Summation microtraumas will have its destructive effect on the lunate bone and after a few years after onset, and by the time the repair will come a sharp change in bone formation deforming osteoarthrosis of the wrist joint with a significant restriction of the brush. Establishing the diagnosis of aseptic necrosis of lunate bone means recognizing patient disability. Need for such a strong conclusion due primarily to and features of the disease, and the fact that the vast majority of the patients is the profession of heavy physical labor. Employment of such patients is often challenging, since it is necessary to take into account that they are counter-work requiring support, shock or pressure on the wrist extensors and flexion. Many patients also have to constantly wear a splint or bandage fixing the beam-carpal joint.
There are many ways of surgical treatment of aseptic necrosis of the lunate bone, but also an active surgical intervention does not lead to desired results. Removing diseased lunate bone like a foreign body, Subhon-dralnoe excision it in appropriate cases, partial resection, cortical thickness incisions of the affected bone or piercing it in many places in order to stimulate regeneration, the formation of lunate-beam fusion, excochleation lunate bone with Sealing cavities - far not a complete list of operations used for aseptic necrosis. Wide dissemination of these operations is hampered not only by their complexity, but the fact that an overwhelming majority of cases end in an extremely heavy ankylosing osteoarthritis of the wrist joint and thus, even if the patient gets rid of the pain, wrist function is lost.
Based on the importance of "negative option" for the formation of aseptic necrosis, Persson suggested that in severe cases with sharply expressed "negative option" to produce radial shortening or lengthening of the ulna in order to change the existing relations of articular sites. Persson said that out of 19 operated by this method in 14 patients with good results.
Pessimistic assessment of outcomes in patients with aseptic necrosis of the lunate bone is based on a sufficient number of indisputable facts. Of 209 examinees were only 7 (3.3%) were able, after long-term care to remain in its ongoing work. The remaining 202 have lost their skills and were considered disabled in need of continued employment for work that does not require any intense and significant amount of hand movements (radiocarpal joint, fingers).
Real prevention of disease Kienbock very difficult. Brush, as is known, is the "gateway of vibration, but the number of workers with vibrating tools has been steadily increasing in line with the needs of the economy. Only improved antivibration devices will reduce the many effects of vibration, including necrosis of the lunate bone disease. In no less prevention must include full and mechanization and automation of many tense for hand work. It is very possible that a significant role can be played by a professional selection, taking into account the structural features of the articular sites radius and ulna bones, preventing a number of works, primarily associated with vibration, those with "negative option" for the wrist joint. Peculiarities of aseptic necrosis of the lunate bone, the trend of the disease to progress and make it virtually irreversible physician conducting the examination of disability, to take into account these circumstances and did not expect that treatment and temporary employment to facilitate the work will help the patient return to his profession. Summation microtraumas will have its destructive effect on the lunate bone and after a few years after onset, and by the time the repair will come a sharp change in bone formation deforming osteoarthrosis of the wrist joint with a significant restriction of the brush. Establishing the diagnosis of aseptic necrosis of lunate bone means recognizing patient disability. Need for such a strong conclusion due primarily to and features of the disease, and the fact that the vast majority of the patients is the profession of heavy physical labor. Employment of such patients is often challenging, since it is necessary to take into account that they are counter-work requiring support, shock or pressure on the wrist extensors and flexion. Many patients also have to constantly wear a splint or bandage fixing the beam-carpal joint.
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