Humeral head necrosis

( Osteonecrosis )


humeral head necrosis, osteonecrosis. x-ray

X-ray of a humeral head necrosis
Here you can read:
What is a humeral head necrosis ?
Signs and symptoms of a humeral head necrosis ?
How does a humeral head necrosis develop ?
How to treat a humeral head necrosis ?
What is a humeral head necrosis ?
Ina humeral head necrosis of the shoulder the bone of the humeral head becomes necrotic, which means that it is dead.


Signs and symptoms of a humeral head necrosis ?
Nearly all patients with a humeral head necrosis are suffering from shoulder pain. As the necrosis progresses shoulder pain becomes more intensive. The patient feels his pain in the shoulder or sometimes it is radiating into the upper arm. Pain at night occurs quite frequently and due to relieving posture the shoulder might get stiff. In an advanced stage, when the bony surface of the “ball” is broken, a cracking in the shoulder joint can be felt and pain can be very intensive, even at night.


How does a humeral head necrosis develop ?
Until today, we don´t know the exact mechanism how a humeral head necrosis develops. These necrosis are called idiopathic or primary. If blood vessels are torn / ruptured due to a shoulder trauma, the situation is clear. But this is an exception. Most of the necrosis are idiopathic / primary humeral head necrosis. Some factors like alcohol abuse, corticosteroid long time or high dose medication, metabolic disorders and so on, are associated with a humeral head necrosis.
The latest theory assumes that there might be a disorder of the blood clotting in patients with humeral head necrosis.
How to treat a humeral head necrosis ?
If a humeral head necrosis is recognized in an early stage it can be decompressed. That means, placing a drill hole in a minimal invasive procedure, high pressure inside the bone is eliminated, so that the bone can heal.
In an advanced stage of the disease, when bony structures are destroyed the implantation of a shoulder prosthesis is the method of choice. Quite often younger patients are affected by such a humeral head necrosis. Shoulder prostheses have a survival rate of about 10 to 15 years. Whenever possible special shoulder prostheses are used in these patients, that can be implanted in a minimal invasive procedure and changed more easily, when loosening starts after one to two decades.
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