Neurovascular component of the dystrophic process and the development of osteonecrosis in Perthes disease

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Abstract

In 60 patients with reactive synovitis and Perthes disease the thermographic evaluation of neurovascular interconnection was performed. The importance of neurodynamic tissue regulation disturbances of the hip region including microvasculature in pathogenesis of preradiologic lesions transition into the decompensation phase with osteonecrosis development was shown. It was noted that important moment in osteonecrosis development was the achievement of threshold level of neurodynamic vascular regulation disturbances with the involvement of enormous number of neurons from the adjusted segments and loosing of hamper mechanism. Prevention of volume spreading of tissue and neurodystrophic reaction at preradiologic phase is of essential significance for the prevention of process of transition into osteonecrosis phase.

About the authors

A. I. Krupatkin

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

O. A. Malakhov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

A. V. Ivanov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

References

Supplementary files

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1. JATS XML
2. Rice. 1. The degree of change in thermographic parameters (in %) in the pre-radiological stage of Perthes disease, which later progressed to stage I of aseptic osteonecrosis. Isolines are similar indicators for reactive synovitis that did not progress to stage I of Perthes disease. The dark columns are the anterior projection of the thigh, the light columns are the posterior projection. * p<0.05 (otherwise p>0.05).

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3. Rice. 2. The degree of change in thermographic parameters (in%) after conservative treatment of reactive synovitis that did not progress to stage I of Perthes disease. Isoline - similar indicators before treatment. The rest of the designations are the same as in Fig. one.

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4. Rice. 3. Key links in the pathogenesis of neurodystrophic syndrome in Perthes disease. A - sensitive spinal ganglion, B - sympathetic ganglion, C - vascular network of the femoral head, D - striated muscles of the thigh and hip joint; I - pathological afferent influences against the background of dysplasia of tissues and vessels of the hip joint during growth and / or possible microtraumas; II - violations of interneuronal interconnections of spinal centers with the involvement of neighboring neurons; III - disorders of the efferent neurovascular-tissue relationships of the hip joint against the background of hypoplasia of the vessels of the femoral head.

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