Bone spurs

heel spur photobone Spurs, awl - shaped growths of bone tissue on the surface of the bones. Bone spurs are more common in the field of calcaneal (heel spurs) due to chronic or acute injury, platypodia and etc heel spurs from several millimeters up to 1,5 cm In the apex spurs, with prolonged its existence, often formed mucous bag that can develop inflammatory changes.
The main symptom of bone spurs are a pain; when heel spare patients acquire peculiar gait - come only on the forefoot and fingers. The diagnosis is confirmed by x-ray - defined hooked bone growth on the bottom or back surface of the heel bone.
Treatment in mild cases conservative (removal plantar surface callous skin, sheathing the shoes insole with the notch in the field of bone spurs, physiotherapeutic procedures - iontophoresis with iodine, novocaine; some therapeutic effect gives the injection of 1 % solution novokaina or alcohol with novocaine in the region spurs). Used x-ray treatments, affected inflammatory phenomena in the surrounding spur soft tissues subside and pain decrease. Long-existing and not respond to medical treatment Bone spurs removed promptly. Cm. also Exostosis.

Bone spurs, awl - shaped growths of bone tissue on the surface of the bones. Bone spurs are found most often on the heel bone, especially they are often observed on the middle ledge plantar heel bone spur, why and emerged a figure of speech "spur". Less bone spurs are marked on the back bone of the heel bone and the epiphyses of other bones, for example on an elbow bone, where they should be named osteophytes or exostosis.
Etiology bone spurs unclear. According to the majority of the authors, the reason for them is acute or chronic injury, such as excessive loads. According to Ebbinghaus (Ebbinghaus), heel bone spurs - a congenital condition; they can grow under the influence of mechanical stress. L. E. Caves connects the bone spurs to an elderly, M. I. of Kaslik - with disorders of the statics (flat) and infection (in history of these patients had gonorrhoea, acute rheumatism, influenza, angina, brucellosis).
Patologicheskoi research of bone spurs in some cases detects inflammation.
In covering the bone spurs soft tissues often formed mucous bag. Dimensions spur from 3-4 10-12 mm; edge spurs directed to the skin directly or in the form of bent upwards beak.
The clinical picture of bone spurs are observed more often in men than in women, are in different age (from 16 to 70 years), in some cases, remain invisible to patients and found randomly on x-rays. The main symptom of bone spurs - pain; when spore heel bone patients acquire peculiar gait, stepping mainly on the fingers. When bilateral lesions gait becomes the moving, the patient raises little foot and uses primarily the front points of support. Pain caused by bone sporah some authors explain inflammation bags lying on spore; Goman believes that in the development of pain plays a significant role neuritis passing through the bag nervous twigs; A. K. Janowski believes that the pain might be connected with the flat foot, at which the top spurs are directed vertically, the pressure on the soft tissues; according to C. R. Braitsev, pain caused by inflammation of the periosteum and possibly inflammation of the lining of the bag.
The main role in the diagnosis of bone spurs plays an x-ray examination. To differentiate bone spurs have chronic arthritis and osteomyelitis this area, as well as with gout, and plays a decisive role radiography.
Treatment of bone spurs in the lungs cases, conservative, in the most severe operational. When the flat foot first of all must be carried out correction of the foot. In some cases helps wearing shoes with special rubber cushion in the form of a ring to heel and physiotherapy.
Surgical treatment should be to remove spurs with the surrounding periosteum and mucous bag with the plane, possibly extensive resection of the bone around spurs. To improve access for bone sporah plantar process of the heel bone is recommended arched an incision on the back edge of the heel with the detached attached to the hill of the plantar aponeurosis and muscles. When non-radical surgery possible relapse. Relapses can grow large bone mass than before surgery.
Sometimes it is possible to achieve a temporary analgesic effect injections of alcohol with novocaine in places of the greatest pain.
X-ray diagnostics and radiotherapy. Radiographically heel spurs are revealed in the form of bone growths on the plantar surface of the heel bone, as well as on its back surface of the hill in the place of the tendon (Fig). These growths merge with sklerozirovanie surface layer of the bone. The form of their different: thorn, beaked, and sometimes in the form of a flat rough growth, adjacent to the surface of the bone its broad base. Clinical manifestations due to changes in the surrounding spur soft tissues (bursitis, fibrosity), direct reflection on radiographs are not.
A beneficial therapeutic effect comes from the use of radiotherapy. To irradiate should depending on the clinical need plantar surface of the heel bone field 4x6 or 6x8 cm or back surface of one or two lateral margins size 3x6-8 cm (region Achilles tendon). Conditions: 180-200 kV, 5-10-15 mA, filter 0.5 mm Cu+1 mm Al, skin-focal length 30 cm Single dose 50-75-100 R. a Total of up to 400-600 R one field day with an interval between sessions in 2-3 days. When bilateral lesions Pets irradiation two fields a day on different limbs.
Therapeutic effect occurs after 3 to 4 weeks after the end of the course.
In the absence of improvements and in the recurrence of pain designate a refresher course by the same method.
Not recommended x-ray treatments to children in the period of formation of bone skeleton.
Cm. also Exostosis.