lunate

Head of humerus

femoral condyles

Scaphoid

femoral head

talus

Movement restricted Local tenderness

capitulum

+ stiffness

Bone death w/o structural change

High risk sites

repair n early structural failure Stage 1

Clinical Features

Pain - usual! felt near joint

trauma Stage 2 major structural failure Stage 3 Stage 4 articular destruction

Pathology

Avascular necrosis
Definition

Type of bone necrosis ARTERY damage d/t bone ischemia

VENOUS ow slows

Treatment
Stage 1&2 Stage 3

Imaging
MRI Radionuclide scan can see early changes

Xray

Inc bone density

prevent bone collapse weight relief splint

Avascular part: Dec activity bone has collapse Stage 4

subarticular fracture

reactive bone formation

surgical decompression of the bone realignment osteotomy treatment: same with OA transfer stress to other area relieve pain prevent further damage

d/t marrow ischemia n edema

bone deformation