Anatomical relation and carpal instability
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This document discusses anatomical measurements related to carpal instability. It defines radial height, radial inclination, ulnar variance, capitolunate angle, scapholunate angle, carpal height ratio, and palmar tilt. It also defines dynamic stability as maintaining normal alignment at rest but collapsing under load, and static instability as abnormal alignment visible on static radiographs. Carpal instability can occur between individual bones or between rows of bones in the wrist.
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TribologyDr Sharanprasad Hongal
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Tribology is the science of interacting surfaces in relative motion, including friction, lubrication, and wear. It studies how surfaces in contact interact and move over each other. Key aspects include the different types of friction (solid, fluid, mixed), lubrication processes like hydrodynamic and boundary lubrication, and wear modes like abrasive, adhesive, and fatigue wear. Synovial fluid in the joints provides lubrication through processes like boundary lubrication, where lubricants like lubricin form protective monolayers on cartilage surfaces to prevent direct contact and reduce friction and wear.Ankylosing spondylitis
Ankylosing spondylitisDr Sharanprasad Hongal
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Ankylosing spondylitis is a form of arthritis that primarily affects the spine and sacroiliac joints, causing fusion of the spine over time. It typically develops in young adults aged 18-30 and is more common in men. Genetics play a role, as 90% of patients have the HLA-B27 gene. Symptoms include chronic lower back pain and stiffness that worsens with inactivity. Diagnosis involves blood tests, x-rays showing spinal changes, and assessment of limited range of motion. Treatment focuses on reducing inflammation and pain through NSAIDs, DMARDs, biologics that target tumor necrosis factor-alpha, and occasionally surgery for deformities.Vitamin d
Vitamin dDr Sharanprasad Hongal
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This document discusses vitamin D, calcium, parathyroid hormone, and calcitonin. It covers their roles in calcium regulation and bone health. Vitamin D is a fat-soluble vitamin that is synthesized in the skin from cholesterol or ingested from plants and animals. It is metabolized in the liver and kidneys to its active form calcitriol, which increases calcium absorption from the intestine and bone resorption. Parathyroid hormone increases serum calcium levels by promoting bone resorption and renal calcium reabsorption. Calcitonin has the opposite effect of parathyroid hormone by inhibiting bone resorption and promoting calcium deposition in bone. Together these elements work to maintain adequate calcium levels in the bloodspondylo listhesis
spondylo listhesisDr Sharanprasad Hongal
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This document discusses spondylolisthesis, defined as anterior or posterior displacement of one vertebral body over another. It can be caused by trauma, degenerative changes, or congenital/pathological defects. The document describes the 5-part Wiltse classification of spondylolisthesis etiology, including dysplastic, isthmic/spondylolytic, degenerative, traumatic, and pathologic types. Isthmic spondylolisthesis is most common and occurs from microfractures or defects in the pars interarticularis. Degenerative spondylolisthesis results from facet joint degeneration. Diagnosis involves tenderness and neurological signs. Treatment options include conservative care, surgical fixation,Lisfranc injury
Lisfranc injuryDr Sharanprasad Hongal
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This document provides information on Lisfranc injuries, which involve fractures or dislocations of the tarsometatarsal joint complex of the midfoot. It describes the anatomy of the Lisfranc joint, classification of injuries, evaluation, treatment options, postoperative care, outcomes, and complications. Lisfranc injuries can range from mild sprains to severely displaced fractures and dislocations and are often difficult to diagnose due to swelling obscuring physical exam findings. Treatment may involve closed reduction and casting for non-displaced or mildly displaced injuries, while more severe injuries typically require open reduction and internal fixation with screws.Dvt prophalaxis
Dvt prophalaxisDr Sharanprasad Hongal
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This document discusses the treatment and prophylaxis of deep vein thrombosis (DVT). The primary objectives are to prevent pulmonary embolism, reduce morbidity, and minimize risk of postphlebitic syndrome. Treatment includes anticoagulation with heparin or low molecular weight heparin followed by warfarin for 3-6 months. Prophylaxis is indicated for patients with major surgery or prolonged immobility and can include mechanical methods like compression stockings or pharmacological methods like low molecular weight heparin injections. Specific regimens are outlined for total knee/hip arthroplasty and fractures.Seronegative spondyloarthropathy
Seronegative spondyloarthropathyDr Sharanprasad Hongal
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This document summarizes seronegative spondyloarthropathies, which are inflammatory arthritic conditions similar to but distinct from rheumatoid arthritis (RA). They are characterized by the absence of rheumatoid factor and rheumatoid nodules, and the presence of inflammatory peripheral arthritis and radiological evidence of sacroilitis or spondylitis. They can also be associated with gastrointestinal, ocular, genital, or cutaneous abnormalities. Major types include ankylosing spondylitis, juvenile spondylitis, Reiter's disease, psoriatic arthritis, and arthritis associated with inflammatory bowel disease. Identification of the HLA-B27 antigen can help differentiate these from RA. Clinical features,Non union
Non unionDr Sharanprasad Hongal
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This document discusses nonunion fractures, including definitions, causes, classification, evaluation, and management. Some key points:
- Nonunion occurs when a fracture fails to heal in the expected time and is unlikely to heal without further intervention. Delayed union is when healing is delayed but still possible with treatment.
- Causes of nonunion include poor vascularity, instability, infection, and patient factors like smoking or diabetes. Types of nonunion include hypertrophic, atrophic, necrotic, and defect.
- Evaluation involves standard radiographs and stress views. Treatment includes non-operative options like bracing or stimulation, or operative options like plating, nailing, bone grafting, and correctionIntra articular steroid injection/aspiration
Intra articular steroid injection/aspirationDr Sharanprasad Hongal
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This document provides instructions for performing intra-articular injections and aspirations in the shoulder and knee. For the shoulder, it describes both posterior and anterior approaches for the glenohumeral joint and subacromial space. For the knee, it outlines superolateral, superomedial, inferolateral, and inferomedial injection sites, noting the superolateral approach is most accurate. Detailed steps are provided for preparing the skin, inserting the needle at the specified angles, aspirating fluid, injecting steroid, and applying a bandage.Hip biomechanics
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2. The hip is both mobile and stable due to its strong bones, muscles, ligaments and the depth of the acetabulum.
3. Forces acting across the hip joint include body weight, abductor muscle forces, and a joint reaction force that maintains equilibrium. The joint reaction force increases during activities like walking and running that place greater demands on the hip.Recently uploaded (20)
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Anatomical relation and carpal instability
- 1. ANATOMICAL RELATION AND CARPAL INSTABILITY DR SHARAN HONGAL
- 2. ANATOMY
- 4. Radial height: the distance between two parallel lines drawn perpendicular to the long axis of the radial shaft one from the tip of the radial styloid and the other from the ulnar corner of the lunate fossa. Average = 12 mm.
- 6. Radial inclination: the angle between two linesone drawn perpendicular to the long axis of the radius at the ulnar corner of the lunate fossa and the other between that point in the lunate fossa and the tip of the radial styloid. Average = 23属.
- 8. Ulnar variance: a measurement of the relative lengths of radius and ulna at the wrist. The distance between two parallel lines drawn perpendicular to the long axis of the radius at the distal articular surface of the ulna and the ulnar corner of the sigmoid notch of the radius. 60% of the population are ulnar neutral.
- 10. Capitolunate angle : A straight line drawn down third metacarpal shaft , capitate , lunate and shaft of radius with wrist in neutral position on lateral radiograph which is 0 degree
- 12. Scapholunate angle : The scapholunate angle is the angle between the long axis of the scaphoid and the mid axis of the lunate . 30 to 70 degree
- 14. Carpal height ratio : carpal height of proximal and distal carpal is 0.53 degree
- 16. Palmar tilt : The volar tilt, or palmar/volar inclination, is an angle between a line drawn perpendicular to the long axis of the radius and a tangential line drawn along the radial articular surface.
- 18. DEFINITIONS Dynamic stability : maintains normal alignment at rest but will collapse under applied load
- 19. Static instability : abnormal intercarpal alignment on static radiograph
- 20. Carpal instability : instability occurs between the individual bones. In the same row
- 22. Carpal instability : instability occurs between the row of bones
- 23. THANK YOU