Martin Oliva Xavier, Viladot Voegeli Antonio
Department of Anatomy, University of Barcelona, Barcelona, Spain.
Tres Torres Hospital, Barcelona, Spain.
EFORT Open Rev. 2020 Oct 26;5(10):684-690. doi: 10.1302/2058-5241.5.200007. eCollection 2020 Oct.
Aseptic necrosis may be defined as a group of diseases that have bone necrosis as a common denominator. They usually appear in the epiphyses and in the carpal and tarsal bones. They generally appear during a growth period and principally at those skeletal points subjected to particular stress.In Müller-Weiss disease in the advanced stages, talonavicular-cuneiform arthrodesis, with or without back foot correction, is the best surgical option.In Freiberg-Kohler disease, treatment can be conservative and we can maintain the head of the metatarsal by performing a joint debridement of the metatarsophalangeal joint with removal of loose bodies. The lateral upper and lower faces of the distal extremity of the metatarsal are resected, preserving the joint cartilage that in its centre portion is always healthy. The osteophyte border that may be present in the phalanx is resected.Most frequently, avascular necrosis (AVN) of the talus is a sequel to talar fractures, with the possibility that the AVN increases with the severity of the trauma and the damage associated with the already precarious blood supply of the talus.The surgical treatment used for sesamoid AVN is partial excision of the affected bone. Cite this article: 2020;5:684-690. DOI: 10.1302/2058-5241.5.200007.
无菌性坏死可定义为一组以骨坏死为共同特征的疾病。它们通常出现在骨骺以及腕骨和跗骨中。它们一般在生长发育期出现，主要发生在承受特定应力的骨骼部位。在晚期的米勒 - 魏斯病中，距舟 - 楔骨融合术，无论是否进行后足矫正，都是最佳的手术选择。在弗赖贝格 - 科勒病中，治疗可以是保守的，通过对跖趾关节进行清创并清除游离体来保留跖骨头。切除跖骨远端肢体的外侧上、下表面，保留中央部分始终健康的关节软骨。切除可能存在于趾骨的骨赘边缘。距骨缺血性坏死（AVN）最常见的是距骨骨折的后遗症，且AVN可能会随着创伤的严重程度以及与距骨本就不稳定的血供相关的损伤而增加。用于籽骨AVN的手术治疗是对受影响的骨头进行部分切除。引用本文：2020;5:684 - 690。DOI: 10.1302/2058 - 5241.5.200007。
