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Malaysian Orthopaedic Journal

N Mansor, A H Abdul-Rashid, S Ibrahim
No abstract text is available yet for this article.
July 2018: Malaysian Orthopaedic Journal
A Saw
Cadaveric dissection is an integral component of medical education. There had been concerns about negative impact on medical students exposed to deceased donors before their clinical years, but most studies reported overall positive outcome following this form of teaching. Due to reducing number of body donations in most parts of the world, many institutions are adopting alternative models especially for the teaching of gross anatomy. A new body donation programme that incorporate humanistic values in the procurement process was initiated by Tsu Chi University of Taiwan in 1996...
July 2018: Malaysian Orthopaedic Journal
S K Nema, G Behera, M Poduval
We present an unusual case of five months old neglected anterior dislocation of the right elbow joint in a 19-year old man. The patient had been initially treated by a traditional bone setter, but the elbow remained unreduced. He presented to us with pain, deformity and limited range of motion of his right elbow joint. Radiographs revealed an unreduced anterior dislocation of the right elbow joint. We describe the problems encountered during open reduction and rehabilitation and result one year after the operation with the patient having a stable elbow and a functional range of motion...
July 2018: Malaysian Orthopaedic Journal
A Munjal
Dislocation of meniscal bearing insert is a rare but well-recognised complication in meniscal bearing unicompartmental knee arthroplasty (UKA). On the other hand, fracture of meniscal bearing insert of phase III Oxford UKA has only been reported once in the current literature. The authors report a case of fracture and posterior dislocation of one of the fragments of the meniscal bearing insert in a mobile bearing medial UKA. The fracture was only diagnosed during the revision surgery. The posteriorly dislodged fragment was subsequently retrieved through the same skin incision and a new polyethylene insert of the same size was implanted...
July 2018: Malaysian Orthopaedic Journal
A Rajeev
The incidence of insufficiency fractures is approximately 1% in rheumatoid arthritis patients. The predisposing factors are chronic inflammation, skeletal deformities, biomechanical stresses and osteoporosis. The medications used in the treatment of rheumatoid arthritis such as Glucocorticosteroids and Methotrexate also contribute to the development of osteoporosis and insufficiency fractures. A 68-year old lady who was suffering from rheumatoid arthritis and on long term Methotrexate was seen in the outpatient clinic with recurrent episodes of heel pain...
July 2018: Malaysian Orthopaedic Journal
R Sanjeevan, S Prabu, A Azizul, Y Abdul-Halim
Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc...
July 2018: Malaysian Orthopaedic Journal
P S Joshi
Multiple rice body formation is a rare presentation of chronic sub-acromial bursitis secondary to extensive underlying rheumatoid arthritis, sero-negative inflammatory arthritis or tuberculous joints. Although there is usually an accompanying inflammatory arthropathy, it can occur in the absence of any underlying systemic disorder. We report a case of five years old neglected rice body deposition in shoulder in a 54-years old lady diagnosed to be having rheumatoid arthritis. After initial investigations, arthroscopic removal of rice bodies with bursa excision relieved the symptoms...
July 2018: Malaysian Orthopaedic Journal
G Bulut, I Colak, G Mik, Z Kilic, Z Tasdemir
An 18-year old male patient, with a history of paragliding accident, sustaining a coronal shear fracture of the body of the talus, an anterior process fracture of the calcaneus extending to the calcaneocuboid joint and a nondisplaced navicular body fracture at the right foot and a displaced fracture of the navicular body accompanied with posteromedial process fracture of the talus at the left side was referred to our emergency clinic. For the right foot, the coronal plane fracture of the talar body was anatomically reduced and fixed with screws...
July 2018: Malaysian Orthopaedic Journal
G T Pundkare, S S Deshpande
Introduction: Though complex injuries like CarpoMetacarpal (CMC) Joint dislocations represent only 1% of all hand injuries, they have disabling impact on the functional status of patient. There are no reports in the literature classifying disabling complex injuries like CMC joint dislocations presumably because of low incidence. We propose a new classification through retrospective analysis of patients, along with literature search. Materials and Methods: A new classification system has been proposed and designed at our clinical unit and applied to eight patients with CMC joint dislocations...
July 2018: Malaysian Orthopaedic Journal
J Gunasagaran, R J Rasid, S Mappiare, C Devarajooh, T S Ahmad
Introduction: Microsurgery is a subspecialised field which requires high technical skill. Laboratory training offers good opportunity for novice surgeons to learn and repetitively practise their skills prior to hands-on clinical practice. Commonly, the training programme consists of models in a stepwise increase in fidelity: from latex sheet to anaesthetised rat. We introduce microgrids model as a daily warm up procedure in a 5-day basic microsurgery course. The purpose of this study is to evaluate the correlation between microgrids colouring under magnification with microsuturing proficiency among novice surgeons...
July 2018: Malaysian Orthopaedic Journal
K C Kapil-Mani, A Niroula
Introduction: The optimal surgical treatment for acromioclavicular joint (ACJ) injuries remains controversial. The modified Weaver-Dunn (WD) procedure is one of the frequently used techniques. Recently when it was compared with anatomical autogenous tendon graft reconstruction procedures, the results were inferior. However, these anatomical procedures are technically more demanding with small margin of error and they have tendency for postoperative pain because of extra donor site incision. Materials and Methods: Forty patients with type IV to VI ACJ dislocations were treated by modified WD procedure using non-absorbable synthetic suture passed through the base of coracoid process for augmentation of transferred coraco-acromial (CA) ligament...
July 2018: Malaysian Orthopaedic Journal
I S Komang-Agung, O Sindrawati, P S William
Introduction: The only treatment for grade IV knee osteoarthritis is total knee arthroplasty (TKA) irrespective of the age of the patient. Most of the grade IV OA patient are elderly and most likely to have some comorbidities. Age and comorbidities are the major reasons for patient's reluctance to undergo TKA. A clinical pathway with standard length of stay (LOS) could justify the patient's hesitation for TKA. The aim of this study was to determine the factors, including age and comorbidity, that affect the LOS of patients treated with TKA...
July 2018: Malaysian Orthopaedic Journal
V L Narayanan, N Balasubramanian
Introduction: Proximal humerus fracture fixation using plate osteosynthesis depends on the quality of the bone, design of the fixation devices and intra-operative soft tissue dissection. This study evaluates the functional outcome of minimally invasive percutaneous plate osteosynthesis using locking compression plate in proximal humerus fracture treatment. Materials and Methods: The study was conducted on 30 patients with complex proximal humerus fractures treated by minimally invasive percutaneous plate osteosynthesis using locking compression plate (PHILOS)...
July 2018: Malaysian Orthopaedic Journal
K Shalabh, S Ajai, K Vineet, A Sabir
Introduction: Non-operative management has successfully been practised for long in diaphyseal fractures of both bones of the leg. This study attempts to establish an acceptability criteria for plaster cast in order to predict future loss of reduction and its adequacy. Materials and Methods: A total of forty subjects were included as per inclusion-exclusion criteria. Gap and cast indices were calculated in the immediate post reduction phase and at third week follow-up visit. Results: The mean values of gap and cast indices in the immediate post-reduction phase were 0...
July 2018: Malaysian Orthopaedic Journal
C Ghazala, N Choudhry, A Rajeev
Introduction: Metacarpal fractures are frequent injuries in the young male working population and the majority are treated non-operatively. There is a growing trend to surgically treat these fractures, with the aim of reducing the deformity and shortening the rehabilitation period. The aim of this retrospective case series is to report on our experience and clinical outcomes of using percutaneous flexible locking nails for the management of displaced metacarpal fractures. This study is a retrospective review of 66 fractures that were managed at our centre over a 7-year period...
July 2018: Malaysian Orthopaedic Journal
M I Yusof, A F Azizan, M S Abdullah
Introduction: This study is to evaluate the reliability, sensitivity and specificity of nerve root sedimentation sign (NRS) in our populations. The NRS is a radiological sign to diagnose lumbar spinal stenosis (LSS). It is claimed to be reliable with high sensitivity and specificity. Materials and Methods: A total of 82 MRI images from 43 patients in Group A (LSS) and 39 patients in Group B (non LSS) were analysed and compared for the presence of the NRS sign. Two assessors were used to evaluate intra and inter-assessor reliability of this sign based on 56 (33 patients, Group A and 23 patients, Group B)...
July 2018: Malaysian Orthopaedic Journal
N A Ferdaus-Kamudin, N H Mohamed-Haflah
Calcinosis cutis is a rare presentation and not many cases have been reported especially of idiopathic type. We are reporting a case of idiopathic calcinosis cutis of lower limbs in a 33-year old female who presented to our clinic for multiple painless swellings over her lower limbs for the past six months, without any history of trauma or infection. We have decided to observe her condition on regular follow-up and conservative management.
March 2018: Malaysian Orthopaedic Journal
G M Sharma, A R Bhardwaj, N R Relwani, S Dubey
Filariasis continues to be one of the endemic problems worldwide with 40% of the cases in India. We report a case of lymphatic filariasis in a 32-year old female who presented with a non-tender swelling over left upper arm. Blood sample showed no eosinophilia while the FNAC was diagnostic of W. bancrofti. Patient responded well with oral diethylcarbamazine. High index of suspicion of filariasis is indicated when dealing with a swelling of unknown cause especially in filariasis endemic areas.
March 2018: Malaysian Orthopaedic Journal
M Y Bajuri, H W Boon
Bilateral clavicle fractures are not frequently seen. To treat these injuries surgically or non-surgically is still a debatable issue. Implant option for surgical management is also in doubt. We would like to share our experience in treating a patient with bilateral clavicle fracture surgically. He had excellent outcomes in terms of function and radiology. Surgical option for bilateral clavicle fractures promises excellent outcome in terms of early rehabilitation and return in function.
March 2018: Malaysian Orthopaedic Journal
A R Vosoughi, M A Erfani
Peroneal tendon dislocation in association with medial malleolus fracture is a very rare traumatic injury to the ankle. A 19-year old male patient was referred after injury sustained in a motorcycle accident with car, with concomitant traumatic peroneal tendon dislocation and medial malleolus fracture. The possible mechanism of this unusual injury could have been sudden external rotation force to the pronated foot in full dorsiflexed position of the ankle. Diagnosis of peroneal tendon subluxation or dislocation should be carefully evaluated in patients with single medial malleolus fracture...
March 2018: Malaysian Orthopaedic Journal
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