Richard Haynes PTA/CPT - 9/12/2008

Question
Nine months after my son fractured the elbow of his femur he was diagnosed
with avascular necrosis - the MRI indicated that 80% of the head of the femur
is affected but the cartilage has not yet collapsed.  He is on crutches in wait
and see mode as his orthopedist thinks he may heal naturally.  That would be
great, but nowhere have I read about AVN reversing naturally - should I be
patient and give it a few months, or start searching aggressively for further
treatment?

Answer
Hi and thanks for the question.  I would look for another opinion as well. I have not heard of AV improving in other words 80% of the bone is no longer getting a blood supply and the bone will slowly die and crumble under pressure. I would if you haven't already ask the orthopedic why does he think it will improve? maybe your sons age? Or is it not a full blown case of AV and that the blood supply may re-rote itself and nourish the bone again? Only your orthopedic knows as he has seen the X-rays.

Again I would speak with another doctor as well if there is one available.
If your son was older I am sure a possible hip replacement where the head of the femur was replaced would be in order.

Richard Haynes
www.totaljointfitness.com
Punta Gorda, Florida.