Hong Kong Journal of Orthopaedic Research最新文献

{"title":"Forefoot infection by Staphylococcus lugdunensis following a stonefish sting: A case report","authors":"M. Grassi, D. Brioschi, E. Placenza, M. Larghi, A. Manzotti","doi":"10.37515/ortho.8231.4301","DOIUrl":"https://doi.org/10.37515/ortho.8231.4301","url":null,"abstract":"Several orthopedic injuries caused by marine creatures envenomation have been reported in recent years all around the world, occurring mainly during water sports practice. We reported a case of an Italian tourist who developed an acute forefoot infection by Staphylococcus lugdunensis following a penetrating wound at the plantar region of the fourth toe, caused by a Stonefish, during a session of snorkeling in Indonesia. Diagnosis by microbiological methods, soft tissue and bone biopsy, surgical debridement and administration of antimicrobials led to a successful treatment of this potentially severe infection in this case. From this experience, we suggest to consider this bacterium in the differential diagnosis of bone infection following stonefish envenomation in tropical areas.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127992299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periprosthetic joint infections: a 20 years retrospective epidemiological study in a single european accademic hospital","authors":"A. Manzotti, M. Grassi, Marco Mattia Larghi, Francesca Moioli, D. Brioschi","doi":"10.37515/ortho.8231.4303","DOIUrl":"https://doi.org/10.37515/ortho.8231.4303","url":null,"abstract":"Introduction: Periprosthetic Joint infections (PJIs) still represent one of the most challenging complications in orthopaedic reconstructive surgery. The aim of our work is to present a retrospective observational analysis with 20 years of follow up of PJIs referred to a single center equipped with a regional referral infectious diseases department. Materials and methods: 368 case of deep PJIs following a primary or revision hip and knee arthroplasty procedure referred to our center between January 1996 and December 2016 were included in the study. Criteria of inclusion in the study was a primary PJI entirely managed in our hospital. We collected demographic data, risk factors, microbiology (identification pathogenic agent), previous surgical treatments, type of implant, diagnostic criteria of infection, type of infection and medical or surgical treatments performed in our institution Results: A total of 200 (54,3%) infection occurs in hip arthroplasty and 168 (45,7%) in knee arthroplasty. Mean age was 64,7 years. The majority were late infections (58,8%). Respectively polymicrobial infections was identified in 83 (22,6%) cases and in 54 (14,7%) patients no isolation was possible. S. Aureus was the most frequently identified pathogen. The major risk factors were hypertension in 254 (69,1%), cardiovascular diseases in 167 (45,7%), obesity in 97 (26,5%) and diabetes mellitus in 92 (25%). Discussion: Epidemiological analysis of PJI in our hospital which collects data relating to the last 20 years, has permitted to obtain a summary of our scenario. Ideal PJI management should include an accurate patient history considering carefully risk factors, patients conditions, and previous surgical procedures ideally in a multispecialist enviroment.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130510503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The electrocardiogram (ECG) made easy for orthopaedic surgeons","authors":"Wafaa S. Soliman, Esraa M. Ahmed, Eslam M. Ansary, Sarah M. Hussien, A. Khalifa","doi":"10.37515/ortho.8231.4206","DOIUrl":"https://doi.org/10.37515/ortho.8231.4206","url":null,"abstract":"Evaluation and interpretation of an electrocardiogram (ECG) is not formally included in the surgical residencies teaching curriculum, at least in our area. In this review, we aimed to discuss some of the basic ECG principles that could enable an orthoapedic surgeon to perform an initial assessment of an ECG trace paper and report on the ECG appearance of some common postoperative cardiovascular complications. Some reports have been published about surgeons' capability in dealing with an ECG trace paper. Since a subset of patients going under different surgical procedures being old and fragile with more susceptibility to postoperative cardiovascular complications, even in the absence of a history of cardiovascular comorbidity. Having the necessary knowledge regarding ECG assessment, a surgeon could suspect or diagnose these complications. In this review, we explained the basic concepts of cardiac electrophysiology, the typical components of an ECG trace paper, and a systematic approach to interpreting. We provided some of the commonly encountered postoperative cardiovascular complications and their appearance in the ECG trace paper. As we believe that orthoapedic surgeons should master basic ECG interpretation skills, this review will serve as an opportunity and a guide to understanding the essential components and concepts of an ECG trace paper.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114155639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical challenges in chronic zone 2 flexor tendon reconstruction and analysis of function in toddler: A rare case Report","authors":"Parag B. Lad, Sanket Tanpure, T. Nagda","doi":"10.37515/ortho.8231.4203","DOIUrl":"https://doi.org/10.37515/ortho.8231.4203","url":null,"abstract":"Introduction: Flexor tendon injury in zone 2 is challenging to treat, when child was presented late. As flexor tendon are smaller in size, the repair or reconstruction technique along with rehabilitation becomes very challenging. We report a technical challenge in chronic zone 2 flexor tendon reconstruction in toddler presented two month post accidental glass cut injury. Case presentation: An 18-month-old male toddler presented with inability to flex left little finger after twomonths post accidental glass cut injury proximal to proximal interphalangeal (PIP) joint in zone two of left index finger. The passive range of motion (RoM) of DIP was zero degree to 60 degrees and PIP joint RoM was zero to 95 degrees. Child was unable to do active flexion of PIP and DIP joint movement. The parents of child were counselled for exploration and staged reconstruction of flexor digitorum profundus (FDP) tendon using either flexor superficialis (FDS) slip or palmaris longus. One slip of FDS graft was harvested and utilised to reconstruct FDP. At two years follow up, the injured index finger was normal in cosmesis and function. The active DIP joint movement was 50 degrees with complete healing of surgical site. Conclusion: Zone two flexor tendon injury in toddlers needs thorough clinical judgement and assessment by ultrasonography to locate the cut ends of tendons. Reconstruction of pulley, FDP reconstruction using FDS slip and supervised rehabilitation is recommended surgical option to achieve excellent function.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114770585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Proteinases in Osteoarthritis: A Brief Review of New Potent Cartilage Metabolism Therapeutic Target","authors":"C. Dharmayuda, A. A. N. Subawa, K. S. Kawiyana, Febyan","doi":"10.37515/ortho.8231.4204","DOIUrl":"https://doi.org/10.37515/ortho.8231.4204","url":null,"abstract":"Osteoarthritis (OA) is the most frequent form of degenerative joint disease that becomes a major source of disability worldwide. The loss of articular cartilage is the central etiology of osteoarthritis. Cartilage is solely composed of one cell type, the chondrocytes, which are surrounded by a large volume of extracellular matrix (ECM). Extracellular matrix components consist of two main macromolecules, namely collagen and aggrecan. The degradation of these molecules plays a significant role in OA pathological process, although degradation of less abundant molecules composing the matrix organization is also likely to contribute to disease progression. Several proteinases, including matrix metalloproteinase 13 (MMP-13) and A Disintegrin And Metalloproteinase with Thrombospondin Motifs (ADAMTS) -4 and -5, are known to involve in the matrix degradation of cartilage structure. A comprehensive understanding of the various factors and pathways involved in the regulation of MMP-13, ADAMTS-4, and ADAMTS-5 is essential in regard to osteoarthritis management, as they have great potential in future therapies.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129110680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Lower Extremity Amputations due to Diabetes Mellitus Complications","authors":"P. Devkota, Shiraz Ahmad","doi":"10.37515/ortho.8231.4202","DOIUrl":"https://doi.org/10.37515/ortho.8231.4202","url":null,"abstract":"Background: Lower limbs ulcers and wounds, Charcot foot with the presence of peripheral neuropathy or peripheral vascular disease are common complications of the diabetes mellitus (DM). Major extremity amputations (below and above knee) are one of the common surgical procedures performed due to DM complications. Objective: To review the amputations performed due to diabetes mellitus (DM) complications with other associated illness, commonly isolated bacteria, and the demography of the patients in a public general hospital. Materials and Methods: We retrospectively reviewed the cases of above and below the knee amputations due to DM complications from January 2012 to December 2016. The age, gender, duration of DM anyone having, bacteria isolated, vascular condition of the lower limbs, other diseases anyone having, post-surgery wound conditions and status of the ambulation after surgery were analyzed. Results: A total of 53 amputations of the limbs of 51 patients were performed. Below knee amputations were performed on 43 (81.83%) limbs and male gender were 35(68.62%). The mean age of the patient was 57.6±12.01 years (range 31-91 years). The three most common bacteria isolated were Klebsiella pneumoniae, Staphylococcus aureus, Enterobacter cloacae. About 85% of these bacteria were sensitive to commonly used first line of antibiotics like co-amoxiclav and ciprofloxacin. Fifty cases (98.03%) had diabetes for more than five years. End stage renal disease (ESRD) and ischaemic heart disease (IHD) were the other common co-morbidities observed. Conclusion: Major lower limb amputations (below and above the knee) due to uncontrolled blood sugar are common surgical procedures performed on DM. Majority of the bacteria were sensitive to commonly used first line of antibiotics but still 15% were not sensitive and bacteria isolation, sensitivity with the drugs were also important for the treatment of the infection.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"1998 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125595328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of percutaneous locked plating of extra-articular distal tibial metaphyseal fractures","authors":"Y. Abed, Mohamed Arafa","doi":"10.37515/ortho.8231.4205","DOIUrl":"https://doi.org/10.37515/ortho.8231.4205","url":null,"abstract":"Introduction: Management of fractures involving the distal tibial metaphysis is one of the most challenging and controversial issue due to poor soft tissue envelop. Multiple different fixation modalities are available with different outcome. Percutaneous plating of the distal tibia fracture is gaining more popularity due to minimal interruption of the fracture biology and favorable functional and radiological outcomes. Purpose: To evaluate the functional and radiological outcome of management of distal tibia extra articular metaphyseal fractures using locked plates with Minimally Invasive Plate Osteosynthesis (MIPO) technique. Methods: Twenty four patients with extra- articular distal tibia metaphyseal fractures were operated with locked compression plates using MIPO technique. They were followed up at regular intervals. Functional and radiological results were evaluated at the end of follow up. Results: All fractures united at average time of 12.21 weeks (range; 8-20 weeks). Postoperatively, two patients developed deep infection and two patients developed malunion. Mean AOFAS score was excellent 90.6 points (range: 52-100) at last follow up. Conclusion: MIPO technique using distal tibia locked plating is an effective procedure for fixation of distal tibia extra-articular metaphyseal fractures. It provides near anatomical fracture reduction with sufficient stability and preservation of the blood supply to the fracture fragments. It provides excellent functional results with acceptable rate of complications.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127074905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip Fractures during the COVID-19 Pandemic: Our Experience in a General Hospital in Singapore","authors":"E. Pagkaliwagan, Jessica Thor, A. Yeo, J. Loh, Charles Kon Kam King","doi":"10.37515/ortho.8231.4201","DOIUrl":"https://doi.org/10.37515/ortho.8231.4201","url":null,"abstract":"Introduction: Corona Virus 2019 (COVID-19) pandemic has spread rapidly and has caused overwhelming stress in healthcare systems worldwide. While the main focus of most healthcare systems are on measures in dealing with COVID19 cases, we aimed to look at making essential services available for non-COVID-19 patients and to describe our experience in handling proximal femoral fractures in the elderly patients in Singapore. Methods: We retrospectively reviewed cases of hip fracture surgeries on patients ages 65 years old and above at a single institution from 1 January 2020 – 30 April 2020. Results: The study had a total of 153 cases of hip fracture surgeries. The patients had a mean age of 82 years old (65-107) with 30% (46) males and 70% (107) females. There were 48% (74) neck of femur fractures and 51% (79) intertrochanteric fractures. Conclusion: Preparations for future pandemics should include measures to handle vulnerable group of patients such as elderly patients with Hip fractures. Maintaining optimized care, ensuring good outcomes and preventing mortality from these non-COVID-19 patients should still be maintained while maintaining protection and preventing burn out of the healthcare staff.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130500188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is prophylactic fixation preferable to active surveillance of the unaffected contralateral hip in unilateral slipped capital femoral epiphysis?- A Systematic Review","authors":"V. Shetty, K. Akhtar","doi":"10.37515/ortho.8231.4105","DOIUrl":"https://doi.org/10.37515/ortho.8231.4105","url":null,"abstract":"Slipped capital femoral epiphysis is one of the commonest musculoskeletal disorders amongst children. Whilst its management is reasonable well established, the treatment of the unaffected contralateral hip is controversial. The incidence of subsequent contralateral slip has been reported to be between 19 and 63%. The two treatment modalities are prophylactic fixation at initial presentation or active surveillance and fixation on diagnoses of subsequent slip. Both approaches have their merits but there is no clear consensus. Known risk factors include age, sex, young age at initial presentation, endocrine disorders and obesity. Clinical, epidemiological and radiological predictors have been assessed retrospectively but have limited prospective accuracy. We performed a systematic review of the existing literature as per PRISMA guidelines to determine which treatment modality is more effective. Qualitative analysis of the literature also yielded interesting insights into different aspects of the management of the contralateral hip in unilateral SCFE.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124999849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative versus Non-Operative Management of The Medial Malleolus in Bimalleolar and Trimalleolar Fractures – A Systematic Review","authors":"W. W. Ang, Shanxi A Jen, Z. Lim, Bellamy Brodie, N. Q. Q. Xian, A. Overton, C. Charalambides","doi":"10.37515/ortho.8231.4104","DOIUrl":"https://doi.org/10.37515/ortho.8231.4104","url":null,"abstract":"Purpose Ankle fractures are the fifth most common fracture worldwide. Some reviews have shown that non-operative management of isolated medial malleolar fractures has satisfactory outcomes, and more recent studies have suggested the same may apply in bimalleolar and trimalleolar fractures (BTMF). Importantly, non-operative management has the added benefits of avoiding complications including wound infection, and protruding metalwork. This systematic review aims to compare operative and non-operative management of medial malleolar fractures in the context of BTMF. Methods A search syntax of MeSH terms was used to search ScienceDirect, Scopus, Cochrane Library, and PubMed databases. The methodological quality of the included studies was assessed according to the MINORS criteria. Data extracted included patient demographics, operative techniques, functional outcome scores (EQ-5D, OMAS, MOXFQ, VAS, AOFAS return to work/sports) and complication rates Results A total of four studies were included: one randomised-controlled and three prospective study. Two of these directly compared operative and non-operative approaches, while the remaining two reported solely an operative cohort. Of 373 total fractures, 274 were managed operatively and 99 non-operatively. There was no significant difference across all functional scores between operative and non-operative approaches to medial malleolar fractures in the comparative studies. However, there was an association for higher rates of mal/non-union in the non-operative groups (10.5% vs 5.0%). Conclusion Although there is existing belief that operative approach to BTMF would lead to better outcomes, there is currently no evidence that shows operative is superior to non-operative management. Orthopaedic surgeons should consider the morbidity of post-operative complications when deciding the treatment for medial malleolar fractures in BTMF, particularly in the elderly. Further studies need to be performed on this topic before a definitive conclusion can be made.","PeriodicalId":252930,"journal":{"name":"Hong Kong Journal of Orthopaedic Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131803777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}