Q. What is the treatment of old scaphoid bone facture with avn?

Doctor Answer is medically reviewed by SecondMedic medical review team.

Answered by Secondmedic Expert

The treatment of an old scaphoid bone fracture with avascular necrosis (AVN) depends on the degree of bone loss, the presence or absence of symptoms, and the patient's overall health. In cases of mild AVN, where there is no pain or limited mobility, a conservative approach with exercise and activity modification may be adequate. However, if there is significant pain or decreased mobility then surgical intervention may be necessary.

Surgery for scaphoid fractures typically involves arthroscopy to establish an accurate diagnosis and understand the extent of damage caused by AVN. Then debridement can be performed to remove any remaining non-viable tissue before stabilizing any remaining viable tissue in place using pins. The pins are then secured in place via a plate or screws which provide stability until healing occurs.

Another surgical option that can help preserve range-of-motion while also aiding healing is called proximal row carpectomy (PRC). This procedure involves removing one row of bones from the wrist joint so as to create extra space for movement without placing additional strain on nearby tendons or ligaments that could further damage them due to increased pressure and friction during movement. As a result, PRC offers improved range-of-motion compared to regular pinning techniques as well as improved long term outcomes due to less risk of tendon/ligament damage resulting in further injury down the line.

Finally, reconstruction surgery is sometimes used when all other options have been explored but still no satisfactory outcome has been achieved due atrophic nonunion (i.e., when bone cannot heal naturally). During reconstructive surgery additional bone grafts are placed into areas where they are needed most; either externally taken from another part of your body such as your knee cap/shinbone area tapings)or internally taking advantage stored fossilized bones available at cadavers banks among others sources prior treated by gamma sterilization for safety purposes). These grafts will provide much needed support for rebuilding strength/stability in order to reestablish alignment within damaged joints allowing full recovery from old scaphold fractures with AVN..

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Q. Hello Doctor, from past 3 weeks I have too much dandruff problem and it cause hair loss will you suggest any best solution for this?

Doctor Answer is medically reviewed by SecondMedic medical review team.

Answered by Secondmedic Expert

Dealing with excessive dandruff leading to hair loss can be frustrating, but there are effective ways to address this issue. Here's what you can do:

1. Switch to a Gentle Shampoo: Opt for shampoos specifically designed for dandruff, containing ingredients like ketoconazole, zinc pyrithione, coal tar, or selenium sulfide. Use these shampoos regularly to reduce dandruff buildup.

2. Scalp Massage: Gently massage your scalp while shampooing to help remove flakes and improve blood circulation, which can promote healthier hair growth.

3. Avoid Hot Water: Wash your hair with lukewarm water instead of hot water, as hot water can dry out your scalp and worsen dandruff.

4. Balanced Diet: Ensure you're eating a balanced diet rich in vitamins and minerals essential for healthy hair and scalp, such as omega-3 fatty acids, zinc, and B vitamins.

5. Manage Stress: Stress can exacerbate dandruff problems. Practice stress-relief techniques like meditation, yoga, or regular exercise to help manage stress levels.

6. Apple Cider Vinegar Rinse: Consider using diluted apple cider vinegar as a rinse after shampooing. It can help restore the scalp's pH balance and reduce dandruff.

7. Consult a Dermatologist: If the issue persists despite trying home remedies or over-the-counter solutions, seek advice from a dermatologist. They can provide a personalized treatment plan tailored to your specific scalp condition.

Remember, consistency is key when dealing with dandruff. Give these remedies some time to work, as immediate results might not always occur. It's essential to find what works best for your scalp, so don't get discouraged if you don't see immediate improvements.

Taking care of your scalp health not only addresses dandruff but also aids in reducing hair loss associated with this issue. Feel free to incorporate these tips into your routine and observe how your scalp responds. If the problem persists or worsens, seeking professional guidance is always recommended.

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