Management and treatment of osteonecrosis in divers and caisson workers.
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; :195-199
Advice, management and treatment of osteonecrosis arising in divers and caisson workers were discussed. There does not appear to be any indication that a man with radiographically demonstrable bone lesions in a site that does not promote other symptoms will suffer additional bone damage, either in the form of new lesions or the worsening of existing ones, if he continues to work under hyperbaric conditions. It is suggested that he should be excluded from unusual exposures, such a may occur in experimental diving, but continuing with his regular work should be up to the individual. When the lesion is in an area such as the head of a femur or humerus, where symptoms may arise, the individual should probably be advised against continuing diving or tunnel work. If the pain is already present, the patient will not likely argue to remain on the job. When painful conditions exist but the radiographs are normal, use of tomography or xeroradiography should be considered. Some physicians also suggest venography, biopsy, or radioactive scanning techniques. Treatment may consist of resting the injury. As this can mean complete bed rest for a prolonged period such treatment can not be undertaken lightly. If surgery is the alternative to be used, the procedure to be adopted must be considered, including the possibility of partial or total replacement of damaged bones and joints.
Caisson-disease; Decompression-sickness; Bone-disorders; Skeletal-system-disorders; Hypobarism; Pressure-chambers; Construction-workers
Dysbarism-related osteonecrosis: proceedings of a symposium on dysbaric osteonecrosis