Idiopathic avascular necrosis of the scaphoid is a rare condition. A review of the literature shows a variety of conditions labelled as spontaneous avascular necrosis or Preiser's disease. In this paper we report on a study of eight patients with idiopathic avascular necrosis affecting only the proximal pole of the scaphoid. Seven of these patients had positive ulnar variance. The possible aeti...

I read with interest the Clinical Vista Brief about bilateral hip avascular necrosis. I note that the corticosteroid injection was given 8 months before the condition was diagnosed, but the patient had complained of hip pain for 13 months. Cortisone injections (particularly bursa and tendon sheath infiltrations) are extremely common treatments in primary care, but avascular necrosis is rarely s...

Avascular necrosis of the scaphoid following a fracture in children is rare and there is no established treatment protocol in the literature. We present two boys with nonunion and avascular necrosis of the scaphoid treated by simple immobilisation. Both cases healed with painless wrists and full movements. Our cases confirm that an ununited scaphoid fracture in children may heal with conservati...

Numerous cases of osteonecrosis associated with steroid therapy have been reported and most of these had received large doses for prolonged periods. Avascular necrosis of bone occurring after short term steroid treatment is, however, rare. Many underlying causes have been suggested as being associated with this condition. Gregg et al believe that cases may have avascular necrosis of bone with c...

Avascular necrosis after fracture of the talus is well recognized, but is very rare in children. We report a case of avascular necrosis of the talus simulating juvenile idiopathic arthritis. The diagnosis was confirmed by open biopsy, and non-operative treatment was performed. The patient was asymptomatic with full range of motion postoperatively for two years. We hypothesize that avascular nec...

Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the...

Untreated 3- and 4-part fractures of the proximal humerus have a poor functional outcome. Open operation increases the risk of avascular necrosis and percutaneous reduction and fixation may be preferable. We report 27 patients, 9 with 3-part and 18 with 4-part fractures, treated by percutaneous reduction and screw fixation. Thirteen of the 4-part fractures were of the valgus type with no signif...

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