Osteolysis Traumatic Massive

**Osteolysis** is local aseptic necrosis of bone tissue. A condition inverse to osteoblastoclastoma. With this type of necrosis, foci of bone resorption alternate with areas of restructuring, bone remodeling or the development of sclerosis and fibrosis of tissues (medullary cavity, canal and surrounding cancellous bone).

**Causes of occurrence**

Theoretical arguments confirming the connection of this process with changes in the nature of the blood supply to the spongy and compact substance in some patients have not yet received convincing confirmation.

The etiology of this condition: - Injuries (especially fractures) or osteomyelitis caused by any infection;

Classification: According to the course: acute, chronic. Conditionally involutive. A chronic purulent process under the cortical layer of long-existing bone, where calcification and vascular sclerosis occur. This osteomyelitis can lead to complete loss of bone and is diagnosed as equine atrophy. In all cases, the existence of extensive degenerative processes in the tissues of the limb causes pain and causes considerable suffering to the patient. The bone loss can be extensive and occupy a significant portion of the bone surface from the joints to the distal parts of the limb. Sometimes several “phantom bones” are noted.

According to the presence of soft tissues: bone, without soft tissues. According to the location of the atrophic bone: femur, limb bones, ribs, vertebral bodies and other bones, jaws. A local unilateral osteolytic process is most often detected in the femoral neck. In the area of ​​the articular head of the femur, osteolytic processes are found only in older people. In all cases, there are extensive processes of destruction of bone tissue.

Osteolysis looks like a bony growth. There are: - Bone outgrowths are round in shape; - Bone protrusions along the underlying bone in the form of a narrow mass; - Defects of the bony plate, bone resorption like bone pockets or ballistic bone

Pain in the affected area is more pronounced at night. Movements of the affected limb are limited, and the volume of the affected joints increases. Active movements in the joints become impossible 2 weeks after the start of the process, a forced position of the limb appears, in which pain is significantly reduced. That is, judging by the changes in the muscles of the limb, which develops by shortening the muscles as if along the axis of the limb. A pathological fracture is always characterized by the so-called 'axial load symptom'. Later, pain at rest intensifies, and a focus of degeneratively changed bone marrow beams forms around the thinned bone. A healthy limb (in the presence of atrophy on both sides) is stunted in growth. A developing pathological fracture can spread along the bone to the bony step and vertebral body. X-ray examination confirms the beginning of the process of bone atrosion: changes in all directions of the bone beams with the formation of a focus of multiple destructive processes of bone tissue (although this focus is not visible). Changes in the cortex, starting with a small strip, spread