In the human body, a huge number of bones. Especially a lot of them in such moving parts of the body, such as the feet and wrists. Dozens of bones connected by tendons help to perform work that is inaccessible to animals, except perhaps for monkeys. The complex system of hands and feet, although it has a large amount of connective tissue, is prone to various injuries and diseases. The most common is a fracture. The concept is associated with bone fracture and possible displacement. In the hands and feet, as already mentioned, a large number of these organs, which do not differ in size, so it takes a lot of time to treat them. The scaphoid is most susceptible to disease and injury.
Foot
Leg bones are represented in huge numbers. Some of them are united by the common name of the foot. The scaphoid belongs to this group. It is located between the ram, cuboid and intermediate sphenoid bones. It is this place of the foot, excluding the toes, that is most often prone to fractures.
The bones of the foot, the anatomy of which is represented by three sections, are quite numerous: tarsus, metatarsus and toes. Metatarsal bones of the foot contain scaphoid in their rows. It is located near the inside of the foot. On its edge there is a tuberosity of the scaphoid directed downward. In medicine, this feature is used to determine the arch that the foot has. X-rays help to understand the composition of this part of the body.
Brush
The scaphoid is also located in the cyst. It refers to the small bones of the wrist. It is she who is most prone to fracture, as it is located on the edge of the palm. Interestingly, the person who broke this bone does not feel much pain and can only feel a bruise, albeit a strong one. Therefore, it is quite dangerous. If you do not consult a doctor, there can be serious consequences. For example, the scaphoid may not grow together correctly.
The wrist consists of 8 bones. They form 2 rows, in each of which there are 4, located between the metacarpal bones and the forearm. The scaphoid is easy to feel due to its location. It is located between the tendons of the long extensor of the thumb and the long abductor muscle.
Foot bone disease
In addition to the fracture, the scaphoid of the leg is susceptible to other injuries and diseases. For example, Kellerra’s disease. Osteochondropathy may be a messenger of this disease. It affects all the bones of the foot. Gradually destroys tissue. During illness, a small amount of blood enters the bones, which means that there is not enough oxygen and nutrients. Therefore, cells that do not receive a sufficient amount of this gas and other necessary components, gradually die. However, this happens, in the case of Keller's disease, without infection.
Causes of Keller's Disease
Keller's disease cannot occur by itself. For her, there are several reasons that somehow interfere with the passage of blood to the bones. Most often, these are foot injuries, for example, a severe bruise or fracture. Also, those who wear uncomfortable small shoes are susceptible to this disease. Arthrosis and arthritis are diseases that also lead to Keller's disease. In addition to the above reasons, congenital deformities of the bones of the foot can also lead to deterioration. Flatfoot is one of the main defects. But the reasons that directly affect the onset of the disease have not been found even today.
Forms
Leg bones are subject to two varieties of Keller's disease. It all depends on which part of the foot does not receive enough nutrients and oxygen.
When the navicular bone is damaged , the disease is called Keller’s disease 1. If blood does not reach the heads of the third and second metatarsal bones, which leads to their change, then this is called Keller’s disease 2.
In addition, there are several stages:
- Necrosis.
- Compression fracture.
- Fragmentation.
- Bone restoration.
At the first stage, bone beams die, which serve as the structural elements of the bone. Next, the formation of new parts of the bone tissue, which often break due to poor strength. Then the bone beams dissolve. And the last stage is fully consistent with the name.
Keller's disease treatment
It is necessary to treat the bones of the foot. Their anatomy is extremely complex, so they are not easy to cure. In Keller's disease 1, it is most often a scaphoid fracture. It can be taken for a bruise, and the disease is extremely difficult to detect. If only by chance, the sick person does not consult a doctor. After a course of treatment occurs. A bone with the same name is also located in the brush, but this will be called Iracera’s disease, although the principle of treatment will be the same.
Conservative therapy is one of the most effective treatments. A plaster cast is also applied. It is not recommended to move the leg itself, since such a small and non-standard in shape bone is difficult to fix. After removing the cast, in order to preserve the result, you need to walk on crutches or a cane for some time, special insoles are sewn for children. Medicines can accelerate the growth. Thermal procedures help a lot.
Unacceptable
After removing the plaster, you can not engage in a dispute. The foot needs constant peace. There is also the possibility of abnormal fusion and the formation of a false joint, which is difficult to cure. It will take an operation. Therefore, the process of rehabilitation must be treated with maximum attention. In addition, you can take only those drugs that the doctor prescribed, otherwise you can only make the leg worse. The advice of a doctor should not be neglected, since each person has his own characteristics of the body. Some bones are fragile from birth, so they should pay special attention to the treatment of this disease.
Bone fracture on the arm
As already mentioned, the scaphoid of the arm and foot is more at risk of fracture than others. This is due to the fact that on the foot and on the hand, the bone is located in places with which injuries most often occur. If we turn to statistics, then in the case of a wrist fracture in 61–88%, it is the scaphoid that suffers.
Causes of fracture
But why does this bone fracture occur? As practice shows, many are injured, falling into their arms. In this case, the load almost completely rests on the bone. Fractures themselves also differ: intraarticular and extraarticular.
Symptoms
The scaphoid is very often injured. But after the fracture, she practically does not hurt. Most simply do not notice the inconvenience, thinking that this is just a bruise. However, you should consult a doctor as soon as possible. The scaphoid is poorly treatable, and if you do not have time to grow together, but there may be irreparable consequences. Unfortunately, not everyone goes to the hospital. Most often, a fracture is detected randomly. There are some symptoms that can help you recognize the trauma:
- Pain in the scaphoid.
- Discomfort when moving the joints of the hand.
- A rather painful extension of the radius.
- Puffiness of the affected area.
Diagnostics
As with a fracture of the bone on the wrist, the foot suffers greatly in trauma to the scaphoid on the foot. An x-ray helps detect the cause of the pain. Initially, a 3D projection is carried out on the apparatus, for which they study zones in three projections. At the final stage, a fracture (fracture) of the scaphoid is clearly visible. All this is carried out due to the fact that the scaphoid is extremely difficult to treat, it is surrounded by other organs. To correctly and accurately apply a plaster cast, a 3D projection is simply necessary.
There are subtleties. For example, fingers should be clenched. If the fracture is not immediately visible with x-ray, but by all indications it is, then the victim wears a plaster cast for about 2 weeks, then his hand is re-checked. The thing is that resorption occurs during this period and the crack will be clearly visible, if, of course, is present at all. Actions help establish a diagnosis and prescribe treatment.
Bone treatment
The scaphoid on the wrist is often broken, which is extremely difficult to detect. To detect a fracture, one has to resort to 3D projection. But fracture treatment is much longer and more difficult. Bone consolidation is purely due to the endosteal callus, which forms extremely slowly and requires a large amount of nutrients (blood). Perhaps displacement of the distal fragment. All of the above leads to the formation of a false joint, and thereby complicates an already difficult treatment.
1 way. Fresh injury treatment
The easiest way to grow the scaphoid of the hand is to apply a plaster cast. The most common, it is used in 90–95% of cases. The imposition occurs from the heads of the metacarpal bones up to the elbow joint, while the capture of the little finger under the armband is considered mandatory. The brush remains motionless, but for the convenience of the victim its position has the appearance of a slight extension. Immobolization of the hand lasts about 11 weeks. If the fracture occurred with a tubercle, then it is only 4 weeks. After removing the plaster cast, an x-ray is mandatory, which will show whether the accretion has occurred correctly. If a gap is detected, then the plaster cast is applied again, but already for 1-2 months, with the control of fusion occurring every month. After treatment, a recovery course occurs.
Cons of conservative treatment include:
- Blend time
- Continuous monitoring of doctors.
Other methods. Treatment for long-standing injuries
If the fracture is detected only after 3 months, then it is considered long-standing. By this time, the false joint has time to grow. This complicates the treatment. With the help of an X-ray, the fracture site is found, and the presence of cystic cavities and diastases between the fragments is also determined. In this case, the application of a plaster cast cannot help. One of the many methods used, the most famous:
- Bone grafting with a cortical graft.
- Bone grafting by Matti-Russe.
Bone grafting with a cortical graft
The method was invented back in 1928. It is used with non-fused fractures and pseudoarthrosis of the scaphoid. Rear-beam access is used for anesthesia during surgery. Without damage, without touching the radial nerve, access to the carpal joint occurs. Dissecting its capsule helps detect a false joint. After the operation, a plaster cast is applied in the same manner as described above. It takes about 14 days to go with it. Then the stitches are removed and a circular dressing is already used. The role of the bone plate is often performed by a spongy graft.
Bone grafting by Matti-Russe
One of the most effective operations. But it’s quite simple. For her, the field is bled, but thereby the blood supply practically does not deteriorate. The scaphoid is stabilized with the help of knitting needles. The graft is jammed into the bone. The preliminary placement of the spokes does not allow the debris to mix. Immobolization takes about 10 weeks. The removal of the needles occurs only after 8 weeks.
Fracture of the foot
As already mentioned, the tarsal bones are most prone to various kinds of injuries. Most often, a fracture occurs after a heavy object falls on the foot. Sometimes not one bone suffers, but several, as they are located in close proximity to each other and are small in size. As with the scaphoid of the wrist, do not be late with treatment. However, the foot is much easier to treat. Directly, the scaphoid fracture occurs either due to the fall of an object with a large weight, or due to compression between others. The bones of the foot are quite diverse, their anatomy has dozens of species.
Symptoms
Detecting a scaphoid fracture is much easier than brushing. With an injury of this kind, it is almost impossible to move normally, constant pain is felt. In addition, the circular motion of the foot reveals the fracture completely, the bone makes itself felt. But almost always an injury of the scaphoid is combined with injuries of other bones of the foot and, in particular, of the tarsus.
Foot bone treatment
To know the size and location of the crack, it is enough to make an x-ray in 2 projections, and not in 3, as was the case with the navicular bone of the hand. If displacement has not occurred, then a conventional plaster cast is applied. But if it happened, reposition is done. In the most severe cases, open reduction is performed. A plaster cast is applied on average for 4 weeks.
In conclusion, it can be said that the scaphoid more than other bones of the wrist and foot is prone to injury. For its treatment, it takes a long time, often you have to resort to operations. However, bone splicing on the foot is much faster and easier. It is quite difficult to detect a fracture on the cyst, and most often this happens by accident. The scaphoid of the foot in case of a crack is very painful.