Disease Keller

April 18, 2013

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Disease Keller   - A disease that affects the bones of the foot. Generally, it is diagnosed in adolescence and childhood. The development of this disease is expressed osteochondropathy   - A gradual process of destruction of bone tissue and its subsequent recovery. For the first time the disease is described by the radiologist Keller   in Germany, it happened at the beginning of the last century.

If a person develops Keller's disease In the body is a violation of the flow of blood to the bones of the foot. As a result, the foot is not the right amount of oxygen supplied and a number of nutrients needed for normal functioning of the tissues. The process of the withering away of bone tissue, which in medicine is called aseptic necrosis . Tissue death foot disease Keller   It takes place without the participation of infectious processes. Among the variety of human ailments bone osteochondropathy make up about 3%.

Causes

The disease manifests itself as a consequence of a number of causes that lead to a deterioration of the blood circulation in the foot. First of all, it is a variety of a foot injury, the constant wearing of tight and uncomfortable shoes of the wrong size. Keller's disease can occur in people suffering arthritis . arthrosis As well as some of the diseases associated with endocrine and hormonal disorders. Another important factor in this case is a genetic predisposition to the development of this disease. Acquired or congenital defects of the foot (usually flatfoot ) Can also lead to the manifestation of the disease. An important factor is also a violation of the metabolic processes in the human body. However, experts note that the final of the precise reasons osteochondropathy not known until now.

The forms of the disease

The doctors who diagnose disease Keller define two types of the disease, depending on what is bone loss occurs.

If a person is determined   Keller's disease 1 It is a question of the defeat of the navicular bone of the foot. This bone is located at the inner edge of the foot. Disease Keller 2   pathological changes seen in the heads of the second and third metatarsal bones of the foot. These bones are connected to the joint surfaces with phalanges. Disease Keller 2 degrees more frequent in adolescents.

In addition, identifying symptoms that occur osteochondropathy, doctors divide the disease into several stages. In stage necrosis   patient death occurs bony beams, which are the building blocks of bones. Such changes are pronounced, they can even see in the photo. In stage compression fracture   the formation of new bone elements, but now they do not yet have sufficient strength. During this period, bone beams often can not withstand strong loads. As a consequence of fractures occur, and the beam can be wedged in each other. Followed by Stage fragmentation At which osteoclasts (cells that break down bone), contribute to the resorption of bone trabeculae. The final stage of the disease - Is the process of reconstructing the shape and bone structure. The answer to the question of how to treat the disease depends on what stage of the disease is the case at the moment. Therefore, treatment of the disease Keller can begin only after careful professional diagnosis.

Symptoms

The disease I Keller   in the majority of cases are diagnosed in boys of preschool children aged 3 to 7 years. Initially, the child observes signs of soreness and swelling at the back of the inner edge of the foot. Because pain is marked permanently hobble the child who is trying to build in the process of walking to the opposite, the outer part of the foot. Typically, the disease affects only one stack. It lasts about a year, after which the pain is being phased out.

Keller's Disease II   most often diagnosed in adolescents .  It was first described by Freiberg trauma from the US, but Keller has studied this type of illness in more detail, and gave a description .  This form of the disease is often bilateral .  Usually, the beginning of the disease remains undetected .  Initially, the head region II or III metatarsals develop pain .  They immediately appear in cases where a strain on the forefoot, and then the patient feels pain at rest .  Gradually noted the appearance of lameness, the patient can not walk in shoes with thin soles, it is very difficult to walk barefoot, especially if the surface is uneven .  Where developing the disease process - in the dorsum of the foot - manifested swelling .  One finger, which is located near the head of the affected bone becomes shorter, limited movement in the joint .  All of these symptoms are present in the patient for about two years, after which the pain begins to subside gradually .  However, if during this period there have been changes in the joint, the pain may soon emerge again .  Sometimes familial cases diagnosed lesions stop .  Most often, the disease is localized at the head of II or III metatarsal bones, but the defeat of several bones is rare .

Diagnostics

Keller's disease is diagnosed based on the detected changes in the bones that have been affected. They allow you to define the X-rays. Type of illness is determined depending on where specifically develop the processes of destruction or restoration of bone tissue. Very often the disease Keller I is determined by chance, when the X-ray examination carried out on another occasion.

Treatment

With Keller's illness I   osteochondropathy affected navicular bone. In the development of this type of disease is a fracture of the navicular bone. Treatment of the disease usually occurs after an accidental diagnosis when the doctor identifies a closed fracture of the foot. On X-rays in this type of disease can be clearly seen as broken navicular bone of the foot. Note that if the affected navicular bone of the hand, then we are talking about disease Ireysera And not the disease Keller.

Usually,   Keller's disease 1 treated with conservative therapy. If during the diagnosis was a fracture of the navicular bone revealed the brush, the treatment is carried out using a plaster cast. With the defeat of his foot is necessary to ensure its unloading and subsequent immobilization. Whoa, that hurts, it is necessary to keep in a state of immobility. In most cases the plaster on the foot or hand (wrist with lesions) overlaps for four weeks. After removing the plaster baby that has previously occurred aseptic necrosis It must be limited in mobility. Sometimes the patient is shown walking with a cane or walking with crutches. After removing the plaster baby advisable to wear special insoles, which are made to order. If the soles are made correctly, their use makes it possible to reduce the pressure that falls on the scaphoid. Therefore, the child does not suffer from severe pain and nutrition of tissues recovering faster. A very important point in the process - a child wearing orthopedic shoes properly selected, which allows you to keep the correct shape of the foot.

You do not need during the recovery period to jump, run to the bones in the foot are not a crack. In addition, if after breaking bones fuse not immediately, then later it may form a false joint. In this state it changes the structure and the shape of the opposing bone fragments. Sometimes it requires surgery, so the period of recovery of Keller's disease should be treated with special care.

To the bone was restored quickly, patients received drugs that improve blood circulation and metabolism in the body. Patients received supplementation, activates metabolic Calcium   and Phosphorus   in the body. May be appointed B vitamins .   E As well as complex vitamins, which contain calcium in bioavailable form. Sometimes, the doctor prescribes a course of electrophoresis with calcium chloride, analgesics, nicotinic acid. In addition, a good effect is observed during heat treatments, the use of hardware physiotherapy techniques.

Surgical treatment is practiced relatively rare. However, when there was a lot of pain, and the effect of conservative treatment is not observed, the possibility of revascularization osteoperforation. When this operation is done in the scaphoid small channels in which relatively quickly sprout new blood vessels. This can significantly improve the nutrition of the bones, which recovers more active. As a consequence, I cured the disease Keller faster.

With proper treatment approach and timely application of all these methods of recovering the child, and disorders of the foot after the disease were observed. But if the disease is not treated, it happens very often due to lack of diagnosis, often form the navicular bone is broken and the child develops flat.

Treatment   Keller's disease 2   is, first of all, to restrict the movements. This is achieved through the imposition of plaster bandage on the foot. This bandage should be worn for 3-4 weeks, and after its removal to avoid too heavy load. Furthermore, appointed physiotherapy, massage the muscles of the foot and lower leg. Effective in this case as a special physiotherapy. It is also practiced by wearing orthopedic shoes, periodic foot bath. It is important to consider that in the absence of treatment of the illness can last about three years, and, besides, can disrupt the function of the joint.

Keller complications of the disease in the absence of adequate treatment can be deformations of the musculoskeletal system . osteoarthritis . flatfoot . joint contracture.

Prevention

To ensure a correct approach to the prevention of, and prevent the development of Keller's disease   both forms, parents need to first of all make sure that children always wear only comfortable and appropriate shoes size. It is also important to reduce the mechanical load on the feet. To ensure the fulfillment of this condition, there should be no serious physical exertion at the pre-school children. Upon receipt of any foot injury must be sure to consult the doctor and take their assigned study. It is also important to pay attention to the presence of foot deformities and be sure to consult with a specialist about it.