The lunar bone is located in the upper row of bones in the wrist. It is located between the trihedral and scaphoid connective tissue. This bone is subjected to a fairly strong mechanical impact. That is why often she suffers from necrosis. Fractures and dislocations of this bone are rare.
Causes of Fractures
As a rule, the cause of a fracture of such a bone is indirect trauma. Least of all - direct. Fractures come in several forms. Distinguish longitudinal, fragmentation, transverse, detachable.
Fracture symptoms
A fracture of the lunar bone resembles problems with the wrist joint. The first thing to watch out for is problems with the movement of the wrist. When you try to reject the brush, the patient will feel severe pain. On palpation, it intensifies and gives to other bones.
It is impossible to bend a hand into a fist due to the fact that a pain symptom occurs again. To confirm the diagnosis, you need to take an x-ray.
Fracture treatment
With a fracture, conservative treatment is usually used. In this case, it is necessary to put gypsum on the arm. Duration: up to 2 months. After removing the dressing, movements in the wrist joint and wrist joint will need to be developed. The doctor will prescribe physical therapy and UHF.
In the event that a fracture of the lunar bone is accompanied by nonunion or splinters, then you need to contact a surgeon. He will perform arthrodesis, arthroplasty or endoprosthetics. Which procedure will be carried out depends entirely on the severity of the problem.
Dislocations
Often a fracture is accompanied by a dislocation. In men 20-40 years old, a perilunar type of problem occurs. At risk are those who engage in heavy physical labor.
The peculiarity of dislocation of the lunar bone is that most often around it bones are in the wrong position, and she alone is in the correct position. The perilunar problem described above is often accompanied by a scaphoid fracture. The treatment will be quite difficult and lengthy.
How does a dislocation occur? As a rule, it occurs with indirect exposure. For example, when a person falls on the palm of his hand, the bones are very bent, and then shifted to the dorsal side. Due to the fact that the lunar bone is rather tightly connected with the radial bone, it remains in place or is shifted towards the radial carpal ligament.
Symptoms of Dislocation
Of the characteristic external symptoms, it should be noted that the wrist of the victim is thickened, the fingers are bent. A strong pain effect may occur due to the fact that the nerves are strongly compressed.
In order to make a diagnosis, it is important to collect the correct medical history. In addition, you need an x-ray in a lateral projection.
Dislocation treatment
To bring the brush and lunate bone in order, you need to reposition. The capitate bone should be pulled a long distance. Due to this, the described bone is set using pressure. This method takes place only if the injury occurred a few hours ago. In the event that several days have already passed, then reposition will not be so effective.
If the patient turned to the doctor only a few weeks later, then this method is useless. In this case, an operation is performed that allows you to surgically insert the bone into place. If the injury occurred more than 12 weeks ago, more sophisticated methods are used.
In the event that the dislocation could not be corrected, then the patient will have a picture of a long-standing problem. This leads to the fact that the wrist is swollen, moving fingers and a brush is painful enough. In this case, only the operation will help.
Bone necrosis
At the moment, five stages of lunar bone necrosis are known. Unfortunately, not in all cases it turns out to clearly distinguish between them.
- In the first stage, the bone substance begins to decay. However, cartilage remains normal. At this stage, the lunar connective tissue already becomes almost non-functional. If a strong physical impact is exerted on her, a fracture will occur.
- The second phase is characterized by the fact that a fracture of the compression form occurs. Dense bone mass begins to form.
- In the third stage, the compressed bone begins to dissolve. At the same time, cartilage becomes little functional, as their integrity is violated.
- The fourth phase is characterized by the fact that tissue susceptible to necrosis is absorbed. A new bone tissue appears, while the bones and cartilage turn into a spongy formation. Cysts may appear. The shape of the lunar bone of the wrist changes, and all processes that occurred during this stage and earlier are already considered irreversible.
- The last - fifth - stage is characterized by the fact that osteoarthrosis of the wrist joint is formed. It is impossible to stop its formation.
It is important to consult a doctor at least at the first or second stage, so that it is possible to stop necrosis with minimal consequences.
Symptoms of necrosis
Most often, lunar bone necrosis develops quite quickly. In this case, symptoms and functional problems are noticeable almost immediately. However, there are those people whose problem develops slowly. To make a diagnosis and approve it, it is important to take an x-ray.
This problem is characteristic of people who are engaged in physical work. Most often, installers and stampers turn to the doctor. Symptoms in them are divided into permanent and temporary. 60% of all patients have swelling at the site of the described bone. A similar manifestation can also occur in patients in whom the problem arose both a few months ago and more than 3-4 years ago. Palpation causes severe pain.
Necrosis treatment
To bring the lunar bone back to normal, conservative and surgical treatment can be used. The first type of therapy is often effective only in eliminating symptoms and reducing pain. Many doctors immobilize the wrist joint. However, even with the fact that this method is effective, its results are reduced to zero when returning to work. Therefore, it is important to consult a surgeon in time. Although, even the operation does not always lead to the desired result.
The whole problem is not even that surgical intervention requires a lot of experience and certain skills. Often, due to surgery, the patient develops osteoarthrosis, and the function of the wrist joint is still reduced to zero. In the early stages of the problem, surgery can lead to a positive result.
Postoperative Recovery
If the patient had necrosis, which is also called osteochondropathy of the lunar bone, then after the operation it is important to follow certain rules. They will help restore the brush:
- It is necessary to go to medical gymnastics, perform physiotherapeutic procedures using phonoresis, ultrasound.
- In some cases, the doctor advises you to relax in the sanatorium.
- Without fail, drugs that anesthetize and improve blood circulation will be prescribed.
Summary
The lunar bone has a special location, so it is difficult to injure it. However, if such a thing happened, it will be quite difficult to recover. In this case, necrosis is considered the most severe pathology. It is impossible to get rid of it in most cases. Help the patient only at the earliest stage. However, the likelihood of a complete cure is still minimal.