17:55,9,Jul,2006 | (804/0/0) | Original

femoral avascular necrosis

Hello: The hospital is the hospital treatment of femoral head necrosis, in the North under the guidance of the quantum holistic medicine, using the "three make a living" treatment of femoral head necrosis, that is, qi, blood, kidney, promoting blood circulation Tongluo of femoral head necrosis from the disease, etiology, pathology, dialectical, psychological refinement of the five multi-dimensional aspects of diagnosis, according to North quantum holistic medicine "Three on the" principle of treatment, the overall balance of treatment, local repair treatment, lesions targeted therapy requirements, the internal environment through the intervention of drugs, equipment and medicines against therapeutic targets in vitro, invasive surgical treatment, the traditional manual therapy, sports rehabilitation, psychological counseling and treatment aspects of the comprehensive use of the optimal development of individualized treatment program, obtain the best therapeutic effect. This therapy has won the State Science and Technology in 2007, "China Industry Innovation Award for high-tech" pharmaceutical prize, more than twenty years by tens of thousands of clinical practice, the total efficiency of more than 90% of patients on the efficacy of satisfaction rate of 97.1%, early clinical cure can be achieved without pain, no hip dysfunction, with normal standards of walking the same distance limitations; in clinical cure in patients with advanced osteonecrosis standard is walking short distances without pain, life completely take care of themselves, to engage in the effect of general labor in the conservative treatment of femoral head necrosis disease has reached a higher level, you can look at in detail.
femoral avascular necrosis

Pathogenesis of femoral head necrosis caused by many reasons, and can be divided into invasive and non-invasive two broad categories, such as traumatic femoral neck fracture, hip dislocation, hip trauma, either directly or indirectly damage the femoral head blood flow , resulting in avascular necrosis; non-invasive induced by many factors, and most disease and its pathogenesis is uncertain, there's even the cause is not clear, said the idiopathic avascular necrosis of femur. Common triggers are: a large number of corticosteroids, chronic alcoholism, kidney transplantation, chronic liver disease, diving disease, sickle cell anemia, pancreatitis, hyperlipidemia, gout, radiation sickness, atherosclerosis and other vascular stenosis disorders, collagen diseases, etc. As for some real cases of idiopathic pathogenesis is not fully understood. Check under the inguinal ligament disease early tenderness, hip adduction, outreach pain, "4" test was positive; to late the activities are limited by the parties, Thomas and positive signs, severe limb shortening, and the emergence of subluxation sign. According to dual-X ray should be 150
to 200 hip internal rotation around the place, and the abduction of the hip flexor 900 breaststroke (Lauenstein) and lateral films, can be observed from two angles necrosis size and location. X-ray symptoms of the beginning of no change, 6 to 8 months after the bone thinning and density appeared uneven, after cystic subchondral zone in transition and crescent sign, subchondral femoral head bone density increased in area, and its low-density area around the visible point sheet; disease aggravated, there subchondral weight-bearing area fragmentation, collapse, post all or part of the regional uneven hardening, severe collapse, flat irregular femoral head, joint space narrowing, subluxation was , Shenton line is not continuous. CT, MRI can be early detection of lesions, and necrosis observed in various parts of the fault, but the cost is expensive and not specific, for additional inspection after the X ray. 1 auxiliary examination, isotope scanning and γ scintillation camera 2, the bone marrow cavity pressure measurement and angiography 3, medullary core biopsy (Core biopsy) diagnosis is based on 1. May have neck fractures, hip dislocation or trauma, decompression sickness, long-term use of cortical history of alcoholism and other hormones. 2. Of the hip or knee pain, and gradually intensified, limp. 3. Adductor muscle tenderness, limited mobility of hip joints, particularly outreach and internal rotation staggering. Thigh muscle atrophy may have. 4.X-ray findings: The early outline of the normal femoral head, but in lateral phase on the side of discreet area in the femoral head before subchondral bone in the joints, showing a density of 1 ~ 2mm wide arc to reduce the zona pellucida, constitute " crescent sign. " The signs are of great value. Appears discreet area increased subchondral bone density, which can be seen around the point, plates to reduce the area density and cystic changes. Finally, different degrees of subchondral bone was broken, flat, collapse, flat femoral head changes, cave-like subluxation. Visible changes of osteoarthritis. 5. Isotope bone scan or ECT prompt radiation defect zone in the femoral head. Clinical stage 0: asymptomatic hip, X-ray film no exception, but the opposite has been the onset of symptoms and diagnosis, and bilateral involvement were 85% more than they help, said this silence of the hip (silent hip ), the actual time for the isotope scan, the measured pressure or bone marrow core biopsy, has proved to be changed at this time is a good time to decompression therapy. I: hip joints pain, may, after trauma or exertion, were progressive, heavy night, internal rotation, abduction slightly limited. X-ray film shows some areas sparse, pressure, performance of biopsy were positive. The treatment of decompression is good. Phase II: clinical signs continue to increase, X-ray showed increased bone mineral density and cystic changes, there arc light subchondral bone zone, said crescent-shaped sign (Crescent sign), but the shape of the femoral head is still normal. III: Disease hip pain barriers to mobility, all activities have been significantly limited, X-ray film due to femoral head collapse and overlap the edge of, or have lost their round, hardened area clear. Although easy to set diagnosis, treatment already difficult. IV: the course is to late femoral head deformation, joint space narrowing, acetabular sclerosis, obvious symptoms of osteoarthritis. Treatment principles 1. Non-surgical therapy: suitable for children or adults are early lesions, the scope is less. 2. Strictly avoid weight-bearing limb: one side may crutches with ischial support, walking with a walker; bilateral involvement at the same time, should stay in bed or a wheelchair; such as hip pain, could also lower limb traction bed can often relieve symptoms. This treatment can be with physical therapy, but the duration is longer, usually takes 6 to 24 months or more. Treatment should be regularly taken X-ray examination, to be discreet lesions completely healed. 3. Quadriceps active functional exercise to avoid muscle atrophy. 4. With the blood Quyu, Bushenzhuanggu the herbal treatment. 5 \. Removal of pathogenic factors, such as stopping hormone therapy, the treatment of diseases such as alcohol or radiotherapy treatment of avascular necrosis should be based on etiology, age, lesion, single or double hip hip involvement, etc. for the corresponding treatment, the aims to stop disease continue to develop and improve the femoral head blood supply, promoting necrosis of repair, the maximum retained risk of hip function. Has been developed for severe osteoarthritis, age and larger, viable artificial hip replacement. 1. Conservative treatment of adult femoral head necrosis, II of the disease, a smaller range, can stay in bed, to avoid weight-bearing limb or traction. Such as bilateral lesions should stay in bed or wheelchair car, lose weight. Blood circulation and oral vasodilators, such as Puhuang, Sichuan dome, safflower, Daqingye and so on. Hyderabad Western Qin (Hydergine), coronary heart level (Clofibrate) and other similar effects with Salvia films. Hyperbaric oxygen therapy has a certain effect. X-ray film should be regularly observed disease progress, if any, progress, should be diverted to surgery. 2. Surgical treatment (1) femoral head core decompression technique (2) with a vascular pedicle flap and muscle pedicle graft and vascular bundle implantation (3) the rotation osteotomy of the greater trochanter (4) of the obturator nerve surgery (5) total hip arthroplasty: femoral head destruction in advanced weight, can not be retained, should be total hip replacement (7) The hip joint and soft tissue lysis (8) drilling and bone graft the femoral head (9 ) with femoral neck decompression and external iliac circumflex iliac vascular pedicle flaps grafting; (10) trochanteric rotation osteotomy; (11 hemiarthroplasty (12), total hip replacement surgery; 13) hip arthrodesis (8) obturator neurectomy. Therapeutic approach yi gruel: Coix seed papaya 10g 30g 60g sugar 2 spoons of rice will yi m, papaya, cleaned, poured into a small pot, add rice and two bowls of cold water, soak a moment, then low heat slowly stew yi MI Ren Su Lan, add sugar, a little stew can, the daily consumption, informal content. There expelling wind and dampness, relaxing tendons and pain of the power applies to joint severe, adverse events such as wet as the disadvantages of avascular necrosis. Qi snake soup: Astragalus 60g, snake 1000g, Dipsacus 10g, ginger 15g, cooked pork, 30g, cooking wine, pepper, salt, the amount of light blue. Chopping off the head and tail first snake, stripped of visceral washed, cut into pieces; Astragalus, continued off with cold water to wash away impurities from dust, then the net cold water immersion for 1 hour. Heat wok, pour lard 30g, boil and pour it into snake oil stir fry, cooked into the cooking wine, and then the snake into the casserole, add ginger, light blue and salt, stew over low heat 1 hour, add pepper powder, onion ginger can choose to go. Table consumption. Have liver or kidney, benefit qi and blood, dispelling rheumatism of power, for osteonecrosis of the joints pain. Qi Tian Qi Red chicken: fat hen 1, medlar 15g, Panax 10g, lean meat 100g, cabbage heart 250g, flour 150g, rice wine, light blue of the 30g, ginger, monosodium glutamate, pepper, salt and the right amount. Net hair back first hybrid chicken slaughter, remove viscera, chopping off the claws, rinse; Lycium Wash; Panax divided into two, one into powder, a cage steam until soft, cut into thin slices; pork Zhancheng Velvet; cabbage washed with hot boiling water after the cut pieces; flour and water to reconcile, knead the dough dumplings; onions, ginger wash, spring onion cut into fine, the rest cut into sections, ginger cut into large, pieces pounded ginger. Chicken first into the boiling pot will boil for a short, remove, rinse with cold water, drain, and then wolfberry, notoginseng, ginger, onion stuffed chicken abdomen, within the chicken into the Tang Ciwan; put broth, Add pepper, rice wine, then sprinkle the chicken breast on notoginseng powder, with wet tissue paper seal sized, with Wu Huo cage steam about 2 hours. After 1 hour on the cage of chicken, pork and dried can be salt, pepper, rice wine, ginger and a little water, stir into the stuffing, add cabbage and mix well. Pulling the dough into 20 small sub-agent, after skin rolling, put the meat, pack into small dumplings. When the chicken until cooked, and the other into the water pot, boiling, add dumplings, pot cooked. Meanwhile remove the chicken, unfold the paper, and adjust seasoning MSG, the soup, dumplings can be poured into a bowl. Table consumption. There Bugan kidney, blood stasis, swelling and pain of the power for avascular necrosis. Beware of femoral neck fracture avascular necrosis of the femoral head blood supply, the lack of a rich collateral circulation, as was femoral neck fracture displacement, vascular injury, often caused by avascular necrosis. In general, the femoral neck fracture and avascular necrosis of the following factors: (1) children and the prime of life higher than the old rate of femoral head necrosis, because the neck area of children and young adults generally hard and difficult bone fractures , femoral neck fracture caused by violence will be larger, more serious degree of fracture displacement, and therefore more serious damage to the blood supply it. (2) treatment of femoral neck fracture with time delay, the incidence of avascular necrosis also increased. Necrosis rate of early surgery, necrosis was lower than delayed operation. Even cases of necrosis of early surgery is also a partial necrosis, necrosis of the time is late; and delayed surgery, often complete, necrotic, and necrosis appeared earlier. (3) The closer the femoral head fracture line, the necrosis rate is also higher. After the top of the outside through the femoral neck fracture lines were oblique and necrosis rate is highest. (4) the original displacement serious neck fracture, suggesting that the femoral head more seriously broken blood vessels, a higher incidence of femoral head necrosis. (5) reset the bad, such as over-adduction, flexion or valgus shift rotation and separation of such practices, can increase the necrosis, and separation due to rotation can not tighten the blood vessels rupture, or rupture. (6) Most scholars believe that should be closed reduction, the use of multi-pin or screw pin fixation fracture. Some advocates of open reduction and nailing three-Ji. Alignment is good, good healing can reduce head necrosis femoral head necrosis does not mean it does not. Prescription treatment 1, Taohongsiwutang: 21 grams Rehmannia, Angelica 12 grams, 12 grams of white peony, Chuanxiong 9 grams, 6 grams of peach kernel, safflower 3 grams. Addition and subtraction with the disease according to the disease. 2, Liu Wei Di Huang Tang: 24 grams Rehmannia, cornus, dried yam, each with 12 grams Alismataceae, tree peony bark, Poria 9 grams each. 3 Zuoguiwan: Big Rehmannia 24 grams, 12 grams of yam, wolfberry fruit 12 grams, 12 grams cornus, Cyathula 9 grams, 12 grams Dodder, Lujiaojiao 12 grams, 12 grams of turtle shell. Addition and subtraction with the disease according to the disease. Osteonecrosis of femoral head necrosis of the hip joint in the hip is very large, the femoral head necrosis in patients with severe hip flexion, abduction, squatting function will be limited, that is, thigh lift it up, he could not bend over, bent knees, wearing socks; legs separated out; Dundao location can not squat. Resulting in hip joint can not restore these features, seriously affecting the quality of life of patients so that patients can not engage in the work of labor, life is very painful, inconvenient. However, the femoral head necrosis in patients with early collapse of femoral head shape has not yet appeared flat, there is no proliferation of the outer edge of the acetabulum, the femoral head in the activities without any restrictions, so patients with early osteonecrosis of femoral head does not appear in the late necrosis of hip joint dysfunction. Hip joint dysfunction caused by three reasons. The first reason is congenital acetabular dysplasia. Performance of acetabular femoral head is too small can not accommodate them properly, then the event part of acetabular labrum bone necrosis, parts of acetabular labrum to bone cell necrosis and sclerosis in the atrophy of the femoral head can not withstand the acetabulum and femoral subluxation or bone necrosis occurs. Then the femoral head is not in the original position due to the femoral head outwards, upward mobility, walking the more pain the more severe hip dysfunction are more serious. This causes the hip joint dysfunction, sexual life can not be restored. The second reason is due to necrosis of the femoral head cartilage. Necrosis of femoral head cartilage, the surface rough, when in the hip joint synovial membrane will be very likely to cause damage, injury appears synovial synovitis of the hip joint, the acetabulum for a long time by inflammatory stimuli, there will be hip part of the proliferation of acetabular labrum physiological changes, when parts of acetabular labrum to a certain degree of proliferation, the formation of the inclusion of the femoral head is too large, it will affect the scope of activities of the femoral head, resulting in hip joint dysfunction. This causes the hip joint dysfunction, sexual life can not be restored. The third reason is that flat femoral head necrosis caused by hip. Collapse of the femoral head in the process of gradual recovery, occur within the femoral head necrosis of bone cells are absorbed by the formation of new bone cells changing state, with patients walking control unreasonable, under the pressure of the gravity deformation of the femoral head, resulting in shares respect to the deformation of the development of hypertrophy of the bone, forming t
he so-called flat hips. Flat hip range of activities seriously affecting the femoral head, resulting in hip joint dysfunction. This causes the hip joint dysfunction, sexual life can not be restored.
Trauma / disease in patients with more Lee, male, femoral head necrosis,
Lee patients, male, 38 years old, Jilin Province who, in February 2009 double hip discomfort, was intermittent acid, inflation does not, the inside of a double hip groin Lee were not significant, male, femoral head necrosis, femoral Qu a neck fracture, bilateral avascular necrosis treatment of patients Jiangmou contrast, treatment of avascular necrosis of the left femoral head necrosis (â…£ period) how to treat avascular necrosis (â…£ of) treatment How effective were Mr. Han, femoral neck fracture caused by femoral head necrosis in patients before and after treatment compared Zhang, bilateral femoral head collapse, fragmentation, bilateral avascular bad Kwak, male 32 years old, right femoral head necrosis
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