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Malaysian Orthopaedic Journal

K S Dhillon
We are all aware that there has been a dramatic increase in the number of anterior cruciate ligament (ACL) reconstructions that are carried out here in Malaysia as well as around the world. The numbers of ACL injuries have undoubtedly increased over the years with greater participation of young adults in sporting activities. However it is not certain whether the increase in the numbers of reconstructions can be accounted for by the increasing numbers of ACL injuries. Without doubt commercial interests as well the influence of the biomedical companies have a role to play...
November 2014: Malaysian Orthopaedic Journal
Wyw Tham, Smc Sng, Y M Lum, Y H Chee
This paper describes the life of Sir Robert Jones, from his humble beginnings as an apprentice of Thomas Smith, to his many contributions to the orthopaedic specialty. Robert Jones' passion and interest in the subject led to its advancement from a specialty that dealt mainly with crippling diseases in children, to that of treating and rehabilitating disabled adults. He revolutionized the practice by integrating the use of plain radiography, and by developing many new surgical and procedural techniques. He largely improved the specialty by publishing many textbooks and papers, and trained many orthopaedic surgeons from within England and internationally...
November 2014: Malaysian Orthopaedic Journal
I M Anuar-Ramdhan, I M Azahari, M Med Orth
The diaphyseal tibia fracture is best treated with intramedullary nail but in some cases where the nail is not applicable, plate fixation will be the next option of fixation. The extensile anterior approach is normally used for conventional compression plate fixation in tibia shaft fractures. The extensive surgical dissection may devitalizes the bony fragments and interfere with the fracture union as well as soft tissue healing. Minimally Invasive Plate Osteosynthesis (MIPO) provides good preservation of blood supply and fracture hematoma at the fracture site thus promotes biological bone healing...
November 2014: Malaysian Orthopaedic Journal
C Dechosilpa, P Mulpruek, P Woratanarat, P Thiabratana
Idiopathic Chondrolysis of the Hip (ICH) is a rare condition, occurring mostly in black female adolescence. It is characterized by the rapidly progressive destruction of articular cartilage in the hip joint resulting in premature degeneration and subsequent joint arthrosis. We report three cases of ICH: a 13-year old boy presented with left knee pain, an 11-year old girl with right hip pain and a 12-year old girl with right thigh pain. All of them had the same characteristic radiographic findings. The initial treatment was started conservatively...
November 2014: Malaysian Orthopaedic Journal
C K Chiu, Cyw Chan, M K Kwan
A method of transpedicular bone grafting using contrast impregnated bone to improve the visualization of bone graft on the image intensifier is reported. A - 36-year old man who had sustained traumatic burst fracture of T12 vertebra, with Load-Sharing Classification (LSC) score of 8, was treated with posterior short segment fusion from T11 to L1 with transpedicular bone graft of T12 vertebra. We were able to correct the kyphotic end plate angle (EPA) from 19º to 1.4º. Anterior bone graft augmentation was achieved with contrast enhaced transpedicular bone grafts...
November 2014: Malaysian Orthopaedic Journal
A R Muhammad-Lutfi, M R Zaraihah, I M Anuar-Ramdhan
Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients' knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 'yes' or 'no' questions on foot care knowledge and practice. Score of 1 was given for each 'yes' answer...
November 2014: Malaysian Orthopaedic Journal
Mrcs T Zin-Naing
The aims of spinal tuberculosis treatment are to eradicate the disease, to prevent the development of paraplegia and kyphotic deformity, to manage the existing deformity and neurological deficit, to allow early ambulation and to return the patient back to daily life. Methods for the treatment of tuberculosis of vertebra are still controversial. Conservative treatment includes medical therapy as well as external supports and surgery is indicated for deformity of spine, severe pain, or neurological compromise conditions...
November 2014: Malaysian Orthopaedic Journal
R Magetsari PhD, P Dewo PhD, B K Saputro Md, Z Lanodiyu Md
S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistant compared to the planktonic form. This study was carried out to determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 times using a mixture of cinnamon oil and chitosan 3% and 2% respectively with serial concentration of cinnamon from 0...
November 2014: Malaysian Orthopaedic Journal
R Magetsari, P Dewo, A S Nugroho, Z Lanodiyu
The incidence of Deep Vein Thrombosis (DVT) is high in orthopaedic cases, associated with morbidity and mortality. This study was done to evaluate the incidence of DVT and factors that contributed to DVT in elderly patients with proximal femur fracture who underwent surgery. Patients 60 years of age and older with proximal femur fracture who underwent surgery were enrolled into this study. Daily observation of the clinical signs of DVT was done post operatively until the subjects were discharged from the hospital...
November 2014: Malaysian Orthopaedic Journal
A Anizar-Faizi, A Hisam, K P Sudhagar, M Moganadass, C Suresh
The aim of this study was to assess the outcome of surgical treatment in displaced acetabular fractures in our local facilities. Previous studies reveal good outcome via open reduction method with achievement of congruent joint. We note that studies in this respect have not been conducted in our region. We retrospectively analyzed thirty patients with acetabular fractures who underwent open reduction and internal fixation. The data collection was performed over a 4-year period, from 2008 to 2011. The results showed 20 out of 30 patients (66...
November 2014: Malaysian Orthopaedic Journal
N Aizah, Y Su, Cwm Shaifulnizam, Ma MRos
ABSTRACT: Extruded bone is a rare complication of high energy open fractures, and there is only a handful of literature on reimplantation of the extruded segment. No clear guidelines exist regarding timing of reimplantation, stabilization of extruded bone segments, and also bone disinfection and sterilization techniques. Previous reports describe sterilization using thermal or chemical methods. We present a case of successful reimplantation of an extruded metaphyseal segment of femur after gamma sterilization in a fourteen- year old boy...
July 2014: Malaysian Orthopaedic Journal
M F Michelle Chan, K O Ong, S S Leon Foo, S Selvarajan
UNLABELLED: Pathological lesions in and around a joint can arise from underlying dermis, subcutis, deep muscle, bone or synovium. Clinical presentation can include joint pain, joint swelling, palpable masses and mechanical restriction. Whilst giant cell tumour of tendon sheath, pigmented villonodular synovitis, synovial chondromatosis, lipoma arborescens, juxta articular myxomas and inflammatory arthritis are the better-known conditions of the joint. Intra-articular nodular fasciitis, on the other hand, is less well recognized both clinically and radiologically...
July 2014: Malaysian Orthopaedic Journal
Hz Chan, Cl Ooi, My Lim, Eks Ong, O Zulkiflee
ABSTRACT: Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders(1). Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with direct arthroscopic distal clavicle excision and subacromial decompression in single setting...
July 2014: Malaysian Orthopaedic Journal
Cyl Choong, Hz Chan, A Azuhairy, M Anwar Hau, O Zulkiflee
ABSTRACT: Conventional chondrosarcomas rarely metastasize and it is extremely unusual to see multicentric- behaviour in malignant cartilage tumour. We report a 40 year old lady with presentation of two non-contiguous metachronous foci of low to intermediate grade of chondrosarcoma over left pelvic bone and right scalp respectively in the absence of pulmonary or visceral metastasis. KEY WORDS: vacuum assisted closure, infection, instrumentation, spine.
July 2014: Malaysian Orthopaedic Journal
C Saturveithan, A Arieff, G Premganesh, N Sivapathasundaram
ABSTRACT: A one year old boy was admitted with left shoulder pain with reduced range of motion of five days' duration associated. Inflammatory markers were raised and radiograph of the left shoulder revealed widening of the metaphysis of the proximal humerus. Empirically, he was started on intravenous C-penicillin and cloxacillin after initial joint aspiration yielded only synovial fluid with negative culture. Subsequent MRI revealed acute osteomyelitis of the proximal left humerus with concurrent septic arthritis of the shoulder joint...
July 2014: Malaysian Orthopaedic Journal
Cw Chang, Hz Chan, Sw Lim, Eh Khoo, O Zulkiflee
ABSTRACT: Postoperative wound infection in an instrumented spine patient is often disastrous. Management includes implant removal leading to spine instability. Negative pressure wound therapy (NPWT) applied to the spine surgical wound is one of the wound care technique with successful results. We report a case of a man who sustained Chance fracture of Lumbar 1 (L1) vertebra treated with long segment posterior instrumentation, who unfortunately developed Extended-spectrum beta-lactamase (ESBL) positive E...
July 2014: Malaysian Orthopaedic Journal
Rajat Jangir, Diwakar Misra
ABSTRACT: Scapulothoracic dissociation is a rare injury involving separation of scapula from the thorax along with the upper extremity. Majority of the patients have concomitant neurovascular injury and the prognosis is uniformly poor in such cases. We present a case of scapulothoracic dissociation with comminuted fracture of scapula and acromioclavicular joint disruption without neurovascular deficit. There were associated avulsion fractures of the spinous processes of vertebrae (T3-T5)...
July 2014: Malaysian Orthopaedic Journal
P Choudhari, Anand Ajmera
ABSTRACT: HASH(0x4b6d3d8) BACKGROUND: Hemagioma arising in the knee is a rare cause of knee swelling. The diagnosis frequently is delayed for long. METHODS: We are presenting the case report of a 12 year old male child who had a swelling on anteromedial knee which remained undiagnosed for more than 1 year. Patient had all baseline blood investigations and plain radiograph of knee which were normal. He also had got his knee aspirated which yielded only blood...
July 2014: Malaysian Orthopaedic Journal
Mh Ariffin, Selvyn Lloyd, Sa Rhani, Kamalnizat, A Baharudin
ABSTRACT: The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with postradiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder...
July 2014: Malaysian Orthopaedic Journal
Bb Tan, R Shanmugam, R Gunalan, Yp Chua, G Hossain, A Saw
ABSTRACT: Taylor's spatial frame (TSF) and Ilizarov external fixators (IEF) are two circular external fixator commonly used to address complex deformity and fractures. There is currently no data available comparing the biomechanical properties of these two external fixators. This study looks into the mechanical characteristics of each system. TSF rings with 6 oblique struts, 4 tube connectors, 4 threaded rods, and 6 threaded rods were compared to a standard IEF rings with 4 threaded rods...
July 2014: Malaysian Orthopaedic Journal
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