Keller's disease is a dystrophic pathology of the bones of the foot, which, if progressive, leads to aseptic necrosis. Since the disease is based on dystrophic changes in bone tissue, it falls into the group of osteochondropathies. In most cases, the pathology is diagnosed in patients of the pediatric age group and adolescents. Treatment of Keller's disease in Israel is carried out by highly qualified orthopedic specialists through a comprehensive program that includes modern methods. It is noted that as a result of undergoing a full course of therapy, more than 95% of patients experience a resolution of clinical symptoms, ensuring conditions for normal bone growth, which allows for a positive prognosis.
In medical centers in Israel, great attention is paid to the prompt and accurate diagnosis necessary for determining the future treatment strategy. Rapid diagnosis and initiation of therapy are essential to prevent disease progression, which leads to pathological changes in bone tissue, manifesting as significant foot deformity. Performing procedures on high-tech equipment allows for accurate diagnosis and determination of the characteristics of the developed changes, which is required for selecting effective treatment methods. Patient and family feedback emphasizes the effectiveness and reasonable cost of therapy, the comfortable conditions for its implementation, and the competence and friendliness of the medical staff.
Treatment Methods for the Disease
The disease was first described over a hundred years ago, and it was one of the forms of pathology later named Keller's disease I, manifesting as the development of aseptic necrosis of the navicular bone. After some time, Keller's disease II was identified, in which the heads of the metatarsal bones are affected by necrosis. If the first type of the disease is most often diagnosed in boys aged 3-7 years, the second usually develops in adolescent girls.
As with other types of osteochondropathy, the exact causes of Keller's disease are unknown. Researchers believe that the most likely stimulating factor is a disruption of local blood circulation, leading to insufficient trophism of bone tissue. Circulatory disorders may be caused by the presence of flat feet, wearing tight shoes, injuries, or metabolic disorders.
Clinical symptoms of the disease include pain that worsens with physical activity, swelling of the affected part of the foot, and limping. Usually, the structure of the bone tissue is restored within a maximum of two years due to reparative processes occurring in the tissues. However, the absence of adequate therapy leads to complications such as limited mobility of the nearby joint, bone deformities, and flat feet.
The therapeutic course begins with the application of conservative methods, and if the effectiveness of medication and physiotherapy is weak, surgical intervention is indicated.
Conservative Therapy
The comprehensive scheme for outpatient conservative treatment includes various methods.
- Medication therapy — to alleviate symptoms and stimulate bone tissue repair, analgesics, anti-inflammatory, and anti-edema medications are indicated. To normalize disrupted metabolism, medications containing calcium and phosphorus, B vitamins, and vitamin E are used.
- Immobilization of the affected foot — upon diagnosis of Keller's disease I, the patient's foot is immobilized using a plaster cast that ensures the correct position of the foot and prevents excessive loads. The cast is applied for 1-1.5 months. In the case of Keller's disease II, the patient's leg is immobilized with a plaster boot for approximately 1 month.
- Limitation of physical activity — since the plaster cast maximally limits the load on the patient's leg, after its removal, walking is restricted, and running and sports activities are prohibited. The child is fitted with insoles with arch supports, the use of which normalizes blood circulation and significantly reduces pressure on the bone, promoting its faster recovery. Wearing orthopedic shoes that do not constrict the foot is also important.
- Physiotherapy procedures — are prescribed after the plaster cast is removed and include electrophoresis, magnetotherapy, UHF, mud therapy, therapeutic massage, and magnetotherapy.
Surgical Treatment
If conservative treatment is ineffective, manifesting as further progression of the pathology and the development of an inflammatory process in the joint, surgical intervention is indicated. The patient undergoes revascularizing osteoperforation, which involves creating small channels in the affected bone tissue through which blood vessels begin to grow. Activation of local blood circulation contributes to enhanced trophism, resulting in symptom relief and requiring less time for recovery.
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Diagnostic Methods for the Pathology
When clinical symptoms develop in a patient, a correct diagnosis can be made as a result of a superficial examination. However, the most informative diagnostic method is foot X-ray. In clinics in Israel, a comprehensive examination of the patient and the development of a treatment program takes no more than three days.
During the initial consultation, conducted immediately after the patient arrives at the clinic, the leading pediatric orthopedic surgeon reviews the medical history and results of previous examinations. After discussing with the patient's parents, he clarifies the nature of the symptoms and prescribes necessary examinations.
On this day, the specified types of diagnostic procedures are performed. If Keller's disease is suspected, diagnosis is based on X-ray results.
- Keller's disease I — the X-ray shows densifications and deformations of the navicular bone, changes indicating the development of osteoporosis. In advanced stages of the pathology, the bone is defragmented, and fragments that formed due to its decay caused by the necrotic process are identified.
- Keller's disease II — X-ray images display pathological changes in the head of the metatarsal bone, depending on the severity of the disease process, areas of the head are variably densified and deformed, with osteoporosis, fractures, and defragmentation noted.
The results of the study are submitted for review by a medical council consisting of a pediatric orthopedic surgeon and narrow-profile specialists. After analyzing the obtained information, the doctors collectively establish the final diagnosis and develop a therapy scheme.
How Much Does Treatment of the Pathology Cost
The cost of therapy, which is invariably of interest to medical tourists, is finally determined only after selecting effective treatment procedures. Undergoing treatment in Israel allows the patient to save about 30% of the funds spent in Western European countries and is approximately 50% cheaper than therapy in the USA.
Advantages of Treatment in Israel
- High level of qualification and extensive experience of pediatric orthopedic specialists.
- Equipping clinics with modern medical equipment.
- Inclusion of the latest effective methods in the treatment scheme.
- Prompt and accurate diagnosis.
- Reasonable prices.
It should be remembered that delayed therapy poses serious risks of bone defects in the foot for your child, excluding a normal active life. By promptly contacting an Israeli clinic, you will restore your child's health, who will soon forget about the disease.