Kienbock disease is avascular necrosis of the lunate bone in the wrist that results from impaired blood flow. It progresses through stages of increased lunate density, fragmentation, collapse of the lunate, and degenerative changes in surrounding wrist bones. Treatment aims to unload the lunate bone, improve vascularity, and stabilize the carpus, depending on the stage of disease. Early stages may be treated with immobilization, but later stages often require surgical interventions like osteotomies, revascularization procedures, fusions, or joint replacements to relieve pain and preserve function.
Elbow joint is a complex multiarticular joint. Its stability is provided by multiple factors , however unstable elbow is not uncommon .
"Types of elbow instability, how to suspect , diagnose and how to treat" .
All these will be discussed at the lecture which will be presented by Dr. Ahmed Saleh (assistant Lecturer at Mansoura University Hospitals.
Distal Humeral Fractures – How to Fix Them, with Correlation with EvidenceAshMoaveni
This presentation accompanied a talk given by Melbourne based Orthopaedic Surgeon Mr Ash Moaveni, FRACS, on distal humeral fractures.
http://www.melbourneshoulder.com.au
Slides include information on
- Fracture classification
- Epidemiology of Supracondylar Fractures
- Injury Evaluation
- Non-Operative Management
- Elbow Hemiarthroplasty: Indications, case example and literature
- Total Elbow Replacement: Case example and literature
- Open Reduction Internal Fixation: How to fix them, Expectations, Setup, Exposure
- Olecranon Osteotomy literature
- Technical Pearls for Internal Fixation
- Plate Positioning
- Complications
- Summary
i present this lovely topic at Notional Guard Hospital in Al-Ahsa in the Orthopedic department.
hope you enjoy
Fahad Al Hulaibi
Orthopedic Resident
NGH-A
Elbow joint is a complex multiarticular joint. Its stability is provided by multiple factors , however unstable elbow is not uncommon .
"Types of elbow instability, how to suspect , diagnose and how to treat" .
All these will be discussed at the lecture which will be presented by Dr. Ahmed Saleh (assistant Lecturer at Mansoura University Hospitals.
Distal Humeral Fractures – How to Fix Them, with Correlation with EvidenceAshMoaveni
This presentation accompanied a talk given by Melbourne based Orthopaedic Surgeon Mr Ash Moaveni, FRACS, on distal humeral fractures.
http://www.melbourneshoulder.com.au
Slides include information on
- Fracture classification
- Epidemiology of Supracondylar Fractures
- Injury Evaluation
- Non-Operative Management
- Elbow Hemiarthroplasty: Indications, case example and literature
- Total Elbow Replacement: Case example and literature
- Open Reduction Internal Fixation: How to fix them, Expectations, Setup, Exposure
- Olecranon Osteotomy literature
- Technical Pearls for Internal Fixation
- Plate Positioning
- Complications
- Summary
i present this lovely topic at Notional Guard Hospital in Al-Ahsa in the Orthopedic department.
hope you enjoy
Fahad Al Hulaibi
Orthopedic Resident
NGH-A
Η Άσηπτη Νέκρωση του Μηνοειδούς: Τι δεν μάθαμε σε 100 χρόνια- Kienbock's dise...Nikos Darlis
State fo the art on Kienbock's disease (avascular necrosis of the lunate). One handred years after its first description, it remains a source for controversies. What is new and what is outdated? Where do we go next?
Presentation at MATSOL, May 8, 2014 in Framingham, Massachusetts.
Abstract:
As a result of the RETELL Initiative, English Language Learners and their teachers are receiving much needed and deserved attention and resources in Massachusetts. We as advocates of ELLs and professionals in the field of TESOL must be proactive in ensuring that these efforts are both successful and ongoing. This presentation details ways that teacher education programs, teachers, and districts can help initiate, renew, and sustain the efforts started through the RETELL initiative. First, we discuss ways to encourage infusion of ESOL related content into the general curriculum. Next, we offer methods of providing continuing leadership and support for content-area faculty members in infusion techniques. Lastly, provide a framework for generating professional development opportunities for teacher educators to learn more about building their candidates' ESOL knowledge base. Attendees will leave this presentation with ideas on how to motivate dialogue and foster collaboration with content area faculty in order to better prepare teacher candidates to serve our ELLs in the commonwealth.
Review on Case Hemisection of the Spinal Cord (Brown Sequard Syndrome)
This case is a trigger in Neuroscience Module in Medical Faculty University of Indonesia
Lecture given to the West of Scotland Pain Group on Wednesday 28th November 2012 by Emma Mair, Specialist Physiotherapist in Pain Management about Complex Regional Pain Syndrome (CRPS) and its treatment with Graded Motor Imagery (GMI).
Different types of fractures (radius & ulna). Open and close fractures. Monteggia & Galeazzi fractures. Classification system for fractures. Fasciotomy.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. INDRODUCTION
KIENBOCK DISEAS is an isolated disorder of
lunate resulting from vascular compromise to the
bone
Avascular necrosis/osteomalacia of lunate
Dr Robert Kienbock –1910
He described step wise progression disease from
isolated proximal lunate involvement ,to
fragmentation and collapse of lunate evolving to
radiocarpal involvement with degenerative changes
3. AETIOLOGY
Exact aetiology ?
But it is likely multifactorial
1. Anatomical factors
2. Interrupted vascularity
3. Traumatic insults to lunate -repeated
microtrauma
4. ANATOMICAL
1.Ulnar negative varience
2. Three types of lunte morphalogies
type 1 lunate has proximal apex
type 2 and 3 more rectagular
Type 1 seen in wrist with negative ulnar varience
Type 1 –higher rate
3.Lower radial inclination
All this anatomical factors seems to be results in un
equal load distribution through the radiocarpal joint.
5. Normal ulnar variance
80% of load goes to the radius
Positive ulnar variance
in +2.5mm of ulnar variance 60% of load goes to radius while 40%
goes though ulna
leads to ulnar sided wrist pain from increased impact stress on the
lunate and triquetrum
associated conditions include
ulnar impaction syndrome
SLD
TFCC tears
lunotriquetral ligament tears
Negative ulnar variance
in -2.5mm of ulnar variance, 95% of load goes through radius and 5%
of load goes through ulna
associated with Kienbock's disease
6.
7.
8.
9.
10. INTERRUPTED VASCULARITY
Vascularity to lunate is variable
3 major patterns of vascularity described
Y pattern
I pattern
X pattern
In I pattern there is a single vessel supplying the
lunate ,which may increase risk of ostenecrosis.
11.
12.
13.
14. In addition AVN of lunate has been linked to
vascular insult caused by fracture,ligamentous
collapse,primary circulatory collapse,systemic
diseases and venous congestion.
15.
16. Although there is no single definitive cause of
kienbock disease ,a complex interplay of vascular
and anatomic variation ,combined with varying
degrees of microtrauma and insults contribute to its
development.
17. CLINICAL PRESENTATION
Commonly affect men 20 to 40 years
Symptoms can vary depending upon the stage at
initial presentation
Pain localised to the radiolunate facet- pain is
classically insidious in onset
Decreased wrist motion
Swelling and decreased grip strength
18. Tenderness over the dorsal lunate and radiolunate
facet
An effussion or bogginess overlying the radiocarpal
join
Movements especially dorsiflexion is limited
Average grip strength may decrease upto 50% of
contralateral side
In extreme case clenching of hand fails to show the
normal prominence of 3rd metacarpal—
FINSTERS’S SIGN
Percussion over head of 3rd mc -tenderness
19. RADIOGRAPHIC IMAGING
X Ray wrist PA and lateral view
Negative in early in disease process
Progressively shows increased lunate density
Fragmentation
Collapse
Proximal migration of capitate
widening of proximal carpal raw
scaphoid rotation
degeneratine changes in radio carpal bone
21. MRI SCAN
MRI SCAN can detect early stages of disease with
increased signal uptake.
In patients with perilunate dislocation or ulnar
impaction syndrome changes within the lunate may
appears similar to the AVN ,however these changes
are often focal and non progresive
22. CT SCAN
CT scan characterise the lunate necrosis and
trabecular destruction once collapse has occurred.
27. STAGE I
Non specific intermittent wrist pain and synovitis
,which may mimic a wrist sprain.
Plain x ray films are either normal or shows small
linear compression fracture through lunate.
There is no collapse ,sclerosis or increased
radiodensity of the lunate
Mri shows decreased signal uptake
28. STAGE II
Characterised by increased swelling ,varying
degree of stiffness and progressive pain
X ray shows lunate sclerosis with or without
compression fracture lines
No evidence of collapse , lunate height is
maintained
The remainder of the carpus remains without
degenerative changes
29.
30. STAGE IIIA
Is defined by continued sclerosis and collapse of
lunate
Carpal height and intercarpal alignment is
preserved
No scaphoid rotation
Xray -lunate appears widened in AP view as a
result of the coronal plane collapse
Scapholunate angle is preserved at -10 to
10degree
31. STAGE IIIB
Collapse of lunate and charecteristic changes of
serrounding capitate and scaphoid
Capitate migrate proximally and carpal height
become diminished
Scaphoid flexes ,rotates resulting in DISI pattern of
instability
32.
33. STAGE IV
Progressive carpal collapse leading to radiocarpal
and midcarpal degenerative changes
Xray joint space narrowing ,subchondral sclerosis
,degenerative cysts and osteophyte formation
Symptoms have typically progressed to stiffness
,constant pain and swelling
34.
35.
36. Classification Based on MRI pattern
Schmitt and Lanz
N- Normal signal
A- Marrow edema with viable and intact bony
trabeculae
B- Early marrow necrosis with fibro-vascular
reparative tissue
C- Necrotic bone marrow with collapse
37. TREATMENT
Based on the stage at presentation
Unload the lunate
Revascularise the lunate
Treat carpal instability and collapse with salvage
procedure
38.
39. STAGE I
Conservative treatment with 3 months
immobilisation is typically recommended for stage 1
desease
The patient should continue to be monitored and if
symptoms or radiographs progress consider
surgical management
40. STAGE II OR III WITH NEGATIVE ULNAR
VARIENCE
Goal in this stage is generally centered towards
unloading of lunte in an attempt to reduce
intracarpal stress and allow revascularisation
Joint leveling procedures –
Radial shortening osteotomies
Ulnar lengthening procedures
Radial osteotomy is prefered over ulnar due to less
complication
41. STAGE II AND IIIA ULNAR NEUTRAL OR
POSITIVE VARIANCE
Revascularisation
Osteotomies
Cor decompression
42. REVASCULARISATION
Principle – Transplantation of an arteriovenous
pedicle into normal and avascular bone results in
new bone formation
Direct revascularisation allows the potential for
salvage of the lunate and possible reversal of
destruction of lunate through neoangiogenesis
43. Sources –distal radius pedicle graft with pronater
teres
Vascularised pisiform graft
Fourth and fifth extensor compartment artery graft
I,II or III dorasal metacarpal artery ransfer
44. OSTEOTOMIES
Goal of this procedure to unload the lunate in an
attempt to decrease stress across radiolunate joint
to allow revascularisation and prevention of disease
progression
Capitate shortening osteotomies with or without
capitohamate fusion
Radial closed wedge osteotomy—shift pressure
from lunate by decreasing radioulnar inclination
45.
46. COR DECOMPRESSION
Metaphyseal decompression of radius and ulna
Decompression involve curettage of distal radius
/ulna through small cortical window
Healing is due to local vascular response
47.
48. STAGE IIIB
Goal in this stage
Stabilisation of carpus
Prevent further collapse
Decrease the load across radiolunate joint
Proximal row carpectomy
Scaphotrapeziotrapezoid arthrodesis
Scaphocapitate arthrodesis
Grafting ,arthroplasty and interposition
49. PRC
Is procedure that excises the scaphoid ,lunate and
triquetrium transfering load from the capitate
directly to the lunate facet of the distal radius
50. STT AND SC ARTHRODESIS
Is to correct fixed and rotated scaphoid and
stabilise midcarpal joint ,prevent further collapse
52. STAGE IV
Salvage procedures performed
PRC If mild degeneration
WRIST ARTHRODESIS
WRIST ARTHROPLASTY
WRIST DENERVATION
53.
54. SUMMARY
Kienbock disease is defined by AVN of lunate,with a
predictable pattern of lunate collapse ,carpal
changes , and degenaration resulting from an
apparent combination of vascular,anatomical and
traumatic insults.
55. Goal of treatment is pain relief,motion preservation
,strength maintenance and function
There is no one procedure that consistently and
reliably achieves this outcome
56. Goal of treatment is pain relief,motion preservation
,strength maintenance and function
There is no one procedure that consistently and
reliably achieves this outcome