What Is Aseptic Necrosis?

The first degree: a small fracture line of the moon.

Aseptic necrosis of the crescent bone

Kienbck's disease is rare, 54.5% is related to trauma, and after the blood supply is impaired, there are different degrees of moon-shaped osteonecrosis, which mostly occur at the age of 14-17 years, and often on one side . Stahl divides it into 5 stages (Figure 1).

Western Medicine Name

Aseptic necrosis of the crescent bone

English name

Kienbck s disease

Affiliated Department

Surgery-Orthopedics

Disease site

Wrist

The main symptoms

Stiff wrist, pain

Contagious

Non-contagious

Whether to enter health insurance

Yes

Staging and Staging of Lunar Bone Aseptic Necrosis

The first degree: a small fracture line of the moon.

Degree : Decalcification occurred on the palm of the fracture line, and the fracture line became wider.

Grade III: Osteosclerosis appears on the back of the fracture line.

The fourth degree: the scope of sclerosis on both sides of the fracture line expanded, the moon bone collapsed, and there were secondary fractures.

Grade : Traumatic arthritis of the radial wrist articular surface. ^[1]

Clinical manifestations of aseptic necrosis of crescent bone

The wrist is stiff and has limited movement, especially when the extension is restricted. Pain, which can be released to the forearm, showing persistent pain. Pain usually occurs 2 to 6 months before diagnosis. Grip strength is only 47.4% to 52.0% of normal. A few cases show symptoms of carpal tunnel syndrome.

X-rays may be negative in the early stage, and the bone density may be increased in the future, or there may be spots. The lesions continued to collapse and collapsed. ^[1]

Overview of Aseptic Necrosis of Lunar Bone

Figure 1 A. Extended ulna; B. Shortened radius

Early non-surgical treatment was mainly used for physiotherapy and plaster fixation. Stahl reported that the curative effect was 80% satisfactory. In the early days of aseptic necrosis of the crescent bone, ulnar lengthening and radius shortening are advocated (Figure 1 A. Extending the ulna; B. shortening the radius) to reduce the pressure on the moon and achieve treatment purposes; in advanced cases, it can be done according to the situation Lunar replacement, local fusion of the carpal bone (Figure 2A. Fusion boat, large and small polygons stabilize the crescent bone; B. Fusion of the head and hook bones, reducing pressure on the moon bone; C. Shortening the fusion of the skull and lumbar bone with the hook) 3. Near-line carpal resection and joint fusion. Sometimes only lunar excision is performed, and satisfactory results can be obtained. ^[1]

Figure 2 Local fusion of carpal bones ^[1]