U.S. Air Force experience in hypobaric osteonecrosis.
Allen TH; Davis JC; Hodgson CJ
Dysbarism-related osteonecrosis: proceedings of a symposium on dysbaric osteonecrosis. Beckman EL, Elliott DH, eds. Cincinnati, OH: U.S. Department of Health, Education, and Welfare, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHEW (NIOSH) Publication No. 75-153, 1974 Jan; :17-20
Cases of hypobaric osteonecrosis were cited which had occurred following military flight. Additionally, a review was made of an earlier study of 623 U.S. Air Force (SIC-9711) altitude chamber men. X-ray studies in 1958 of these 623 men revealed no lesions that might be attributable to pressure changes. A followup study in 1966 secured x-rays for 164 of these same individuals. One immature lesion had been found in the earlier study which by now had become a mature intramedullary infarct. This man had a history of six attacks of bends. In the 1966 study one additional case of aseptic bone necrosis was found in a man who had five episodes of bends. It could not be determined whether this lesion had been present at the earlier x-ray as well. Only 44 of the 164 respondents to the 1966 followup had no history of decompression sickness (DCS). While the authors cite some deficiencies in these studies, they place the incidence of hypobaric osteonecrosis among men abruptly exposed to simulated high altitudes at 2.2 percent, at most. They further suggest that after treating such reactions by means of oxygen breathing at 2.8 atmospheres, the patients should be clinically observed in subsequent years to prevent development of hypobaric osteonecrosis.
Pilots; Pressure-chambers; Military-personnel; Decompression-sickness; Osteogenesis; Hypobarism; Bone-structure; Bone-disorders; Caisson-disease
Beckman EL; Elliott DH
Dysbarism-related osteonecrosis: proceedings of a symposium on dysbaric osteonecrosis