Osteochondropathy tuberosity of the calcaneus — the signs and treatment of this disease
Osteochondropathy of the hill and Apophis calcaneus
Osteochondropathy of the hill and Apophis calcaneus was first described in 1907 by Haglund. The disease mainly occurs in girls aged 12-15 years. The pathological process affects one or both limbs.
The disease is characterized by the appearance of aseptic necrosis of the cancellous bone sections, which are under the influence of increased mechanical loading.
Most osteochondropathy the calcaneus occurs in children. Usually the disease is benign and does not affect the function of joints and General condition of the person.
Quite often, the disease goes away without treatment, as evidence of the disease are only deforming arthrosis.
The pathogenesis of the disease
The pathogenesis of the disease has not been fully elucidated. I believe that osteochondropathy of the calcaneus is a consequence of local disorders of blood circulation leading to reduction of the supply of the adjacent tissue, which is the starting point for the development of the disease.
There are five stages of disease development:
- aseptic necrosis (necrosis);
- fracture and partial fragmentation;
- resorption of dead bone tissue;
- reparation (recovery);
- inflammation or deforming osteoarthritis, in the absence of treatment.
The causes of pathology
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The researchers suggest that such pathogenic factors as microtrauma, increased stress (running, jumping), the tension of the tendons of the muscles attached to the tuberosity of the calcaneus, endocrine, vascular and atroficheskie factors cause osteochondropathy calcaneus.
A characteristic feature of the disease is that the pain in the region of the tuberosity of the calcaneus occurs only when the load or when pressure is applied, pain at rest absent.
This characteristic allows to distinguish this illness from bursitis, periostitis, osteomyelitis, tuberculosis of the bones, malignant tumors.
Over the hill of the calcaneus occurs swelling without redness or any other signs of inflammation.
For patients with osteochondropathy calcaneus are typical walking with a transfer support on the forefoot, walking with support on the heel becomes impossible due to the unbearable nature of the pain.
Most of the patients noted the appearance of atrophy of the skin, moderate edema of the soft tissues, increased sensitivity of the skin on the plantar surface of the foot in the heel bone. Quite often, atrophy of the calf muscles.
X-ray examination detects the presence of defeat Apophis heel bone, resulting in loosening of the bone structure and cortical substances under apofiza.
For pathology the characteristic feature is the presence of shadows, dead portion of bone, shifted, as the roughness of the contour of the bone surface is more pronounced than normal on the healthy leg.
What treatments are available?
Conservative treatment in this pathology is not always effective. But still, it’s better to start with him.
In acute pain syndrome prescribe rest, immobilization carry out plaster cast. For anesthesia of the soft tissue in the heels cut away the novocaine.
Carry out physiotherapeutic procedures: electrophoresis of novocaine with analginum, microwave therapy, ozocerite applications, compresses, baths.
Prescribed drugs such as pirogenal, brufen, vitamins of group B.
With the ineffectiveness of conservative treatment resort to surgical intersection of the tibial and saphenous nerves with branches extending to the heel.
This allows the patient to get rid of the unbearable pain, as well as gives the opportunity to load the tuberosity of the heel bone when walking without fear.
Unfortunately, the operation entails a loss in the heel area not only pain but also skin sensitivity.
In the case of timely and correct treatment of structure and form heel bone is fully restored.
If not detected early, the disease or use of irrational treatment, enlargement, and deformation of the tuberosity of the calcaneus will remain forever, which will lead to difficulty wearing conventional shoes. This problem can be solved by wearing special orthopedic shoes.
Video: Surgical correction of the deformity stop
As a result of many diseases of the feet may be damaged stop. The video shoot of surgical intervention to relieve the patient from disease.