Is immobilization treatment for pediatric femoral head necrosis sufficient?

According to different stages, different prescriptions are used. In the early stage, it is advisable to invigorate blood and relieve pain, and the prescription is to use peach four things Tonga Chuan, papaya, and mulberry parasitism; or blood-invigorating pain-relieving soup, Heying pain-relieving soup, etc. In the middle stage, it is advisable to activate the meridians, benefit qi and blood, strengthen muscles and bones, Fang Yong Bazhen Tonga Chuan interrupted, broken bones, papaya, hyssop, Wujiapi, pain, add frankincense and myrrh.

In the later stage, it is advisable to nourish qi and nourish blood, strengthen muscles and bones. Fang Yong's ten perfect tonic Tonga salvia, Sichuan interrupted, broken bones.

In the non-weight-bearing state of the affected limb, actively engage in the contraction function of the buttock muscles and quadriceps muscles to adjust the ventilator, cover the local blood circulation, and promote.

Surgery can also be used for non-surgical ineffectiveness**, and the commonly used surgical methods can be divided into two categories:

1. Good blood supply to the femoral head, such as phantom resection, drilling or fenestration decompression, vascular hip bone grafting, vascular capsule implantation, etc.

2. Improve molars tolerance and change the weight-bearing parts of the femoral head, such as proximal femoral varus rotation osteotomy, acetabular capping, hip osteotomy, etc. Choose a specific ** regimen according to your condition.

Hello,**femoral head necrosis, do not treat it casually, be sure to find a professional hospital for it**, so as not to delay the condition and cause incalculable consequences. You can go to Qianhai as soon as possible, it is a regular tertiary hospital, and the general small hospital has necrosis of the femoral head, and the technology and conditions are not up to standard, and the disease will not be controlled.

Avascular necrosis of the femoral head in children is a common orthopedic disease in the process of growth and development of children, the clinical onset is more complex, clinical research believes that it is related to trauma, poor development of acetabulum, physique genetics, endocrine and other factors, in order for the baby to grow well, parents and friends must understand the avascular necrosis of the femoral head, so as to better disease.

Necrosis of the femoral head in children may be a congenital developmental problem. It could also be due to other reasons. X-rays may be taken to determine the extent and possible cause of necrosis of the femoral head.

For the necrosis of the femoral head in children, most drugs can be conservative first to promote angiogenesis in the necrotic area of the femoral head, improve microcirculation, and theoretically can fundamentally ** necrosis of the femoral head.

Symptomatic manifestations of necrosis of the femoral head in children:

1. Pain caused by necrosis of the femoral head in children: it is initially manifested as hip or knee pain after activity, which is relieved after rest and aggravated after exertion. The pain is often mild or dull.

Pain is often in the groin, inner thighs, and inner knees. Hip pain worsens in the middle stage, and knee pain remains. Later, the pain gradually resolves or disappears completely.

2. Dysfunction caused by necrosis of the femoral head in children: At the beginning, all aspects of the affected hip can be slightly restricted, especially with obvious internal rotation, followed by abduction, and pain can be induced when the hip joint is forced to move.

3. Tenderness caused by necrosis of the femoral head in children: deep tenderness is mostly located in the front of the hip joint. Examination may reveal mild wasting of the muscles around the hip joint, spasms and even shortening of the affected limb.

4. Claudication caused by necrosis of the femoral head in children: At the beginning, in order to relieve pain, the child takes shortening the weight-bearing interval of the affected limb with less maintenance, that is, presents a painful claudication gait. When a functional hip varus deformity is present, due to dysfunction of the hip abductor muscles, there is a marked Küdrenberg claudication, that is, when walking, the tendon side pelvis rises and falls, and the trunk swings from side to side.

In the case of bilateral lesions, the pelvis rises and falls alternately when walking, and the trunk also swings from side to side at the same time. And it is a "duck step".

Femoral head necrosis, also known as aseptic necrosis of the femoral head, or avascular necrosis of the femoral head, is a lesion caused by local blood vascularization of the femoral head caused by a variety of reasons, resulting in further ischemia, necrosis, trabecular fracture, and collapse of the femoral head. There are two aspects. One is non-surgical**.

That is, the combination of traditional Chinese and Western medicine, internal administration of traditional Chinese medicine, external plasters, functional exercises, physiotherapy, etc., the effect is better, and it is easy to be accepted by patients; The second is surgery**. Including surgical drilling, fenestration and decompression, bone grafting, replacement of artificial femoral head, etc., the effect is not ideal, and most patients are unwilling to accept it.

1.Non-surgical**.

Since the disease is still unknown and is a self-limiting disease, the principle should be to prevent the compression and deformation of the femoral head, maintain the tolerance of the acetabulum to the femoral head, maintain a certain range of motion of the hip joint, and facilitate the bioshaping of the femoral head for 1 year.

Methods: (1) Initial bed rest, abduction and percutaneous traction of the affected limb were conducive to the resolution of synovial inflammation and the relief of muscle spasm and pain.

2) Reduce the amount of activity, and in some cases can be immobilized with an abduction and internal rotation cast.

3) Abduction and internal rotation walking bracket fixation.

2.Surgery**.

The principle is to increase the tolerance of the acetabulum to the femoral head, restore the concentric circles of the cephala, so that the necrotic femoral head can be run in the acetabulum, bio-shaping, and provide more physiological conditions for repair. Therefore, complex and invasive surgery is not appropriate. It should be made clear that there are complications associated with surgery** and that the natural history of the disease will not be shortened.

Surgical method: Different methods can be selected according to the degree of lesions, deformity characteristics and the experience of the surgeon.

1) To improve the inclusion of the femoral head and restore the concentric circles of the head of the head, there are alter iliac osteotomy and proximal femoral varus osteotomy.

2) Chiari pelvic osteotomy is beneficial for pain relief.

3) Acetabular plasty can be used for megahip with femur enlargement.

4) Descending trochanteric surgery can improve claudication due to weak buttock abduction.

Femoral head necrosis is a common orthopedic disease in children, and the blood circulation of the femoral head is blocked, that is, the arterial hypoperfusion and venous return are blocked, resulting in increased intraosseous pressure. If you don't get timely and regular **, you will miss the best ** opportunity, and further deteriorate to necrosis of the femoral head, coupled with weight bearing (such as walking, climbing stairs, carrying things, etc.) causing the femoral head to collapse, forming osteoarthritis, and the final result is that the patient is disabled. The peak age of incidence is around 30-60 years old.

At present, the incidence of avascular necrosis of the femoral head due to hormone abuse and excessive alcohol consumption is on a linear upward trend. However, the initial stage of femoral head necrosis is not terrible, and the "five-link synchronous integration" can achieve the goal of complete ** by relaxing the muscles and veins, improving microcirculation, accelerating blood circulation, maintaining and restoring the activity function of the hip joint, and preventing early muscle atrophy.

Generally, there are two types of necrosis of the femoral head in medicine, traditional Chinese medicine conservative and Western medicine.

Surgery ** necrosis of the femoral head.

However, for pediatric patients with femoral head necrosis, surgery** is clearly not advisable. Because the body of a child patient is still in the development period and there is a lot of room for physical development, after the joint replacement is selected, the prosthesis will be replaced twice as the patient grows and develops, until the patient reaches adulthood.

In addition, surgery** has the disadvantages of being expensive and has a wide range of limitations, which makes it difficult for patients to accept it. In addition, patients with other contraindications to surgery and young and elderly patients are not suitable for surgery**.

In contrast, the conservative approach is relatively safe. However, Professor Meng He mentioned that although conservative femoral head necrosis in children has advantages over surgery, it is completely impossible to achieve femoral head necrosis in children with oral drugs alone, for the following reasons:

1.The active ingredient of traditional Chinese medicine reaches the first part through blood circulation, and the necrosis of the femoral head is precisely caused by the obstruction of blood circulation. Therefore, the active ingredient of the drug cannot act on the affected area through the blood circulation.

2.The process of traditional Chinese medicine pays attention to the overall comprehensive conditioning, and it often has a slow onset and a long course of treatment, which cannot catch up with the development of bone cell necrosis in the femoral head.

3.Oral Chinese medicine, after intestinal absorption, reaches the lesion area of the femoral head, and often loses most of its medicinal power. Traditional Chinese medicine cannot quickly solve the problem of tissue adhesion caused by necrosis of the femoral head, so it cannot quickly solve the dysfunction of the limbs.

Therefore, Professor Meng He proposed that in order to effectively achieve necrosis of the femoral head in children, the combination of Chinese and Western is the key!

Hello. Prevention of necrosis of the femoral head in children.

1. Pay attention to whether the child has unexplained gait abnormality, and must go to the hospital for examination if this condition occurs;

2. Whether the child suffers from hip synovitis, if so, it must be thoroughly carried out to prevent recurrence, because hip synovitis may turn into avascular necrosis of the femoral head;

3. In the first process, the function of the affected limb should be protected, the further development and deterioration of bone necrosis should be prevented, and the occurrence of deformity of the affected limb should be avoided. In the early stage, multi-faceted preventive treatment can be carried out, such as comprehensive prevention and treatment with external use of traditional Chinese medicine, massage, medicinal diet and other methods;

4. Always remind children to pay attention to safety everywhere and reduce damage. When the injury is completed, it is necessary to pay close attention to the various changes in the child, no matter what the disease, to achieve early diagnosis and early **. If necrosis of the femoral head has been diagnosed, it should be done early and thoroughly** and should be reviewed regularly;

5. Prevent necrosis of the femoral head in children, improve vigilance, and reduce the chance of injury in children.

Hope it helps.

It is recommended that there is no need for surgery to be the best medicine for femoral head necrosis, compound interrupted bone pills, which is a drug developed by the famous old Chinese medicine doctor Luo Youming after decades of clinical verification, and has a good effect on fractures and femoral head necrosis, and is now produced by Beijing Zhibai Herbal Medicine Co., Ltd.