Malaysian Orthopaedic Journal最新文献

{"title":"Functional Bracing in a Femur Non-union Following Fracture Related Infection: A Case Report.","authors":"K Nazirul-Mubin, M Y Nazri, S Ahmad-Fadzli","doi":"10.5704/MOJ.2411.011","DOIUrl":"10.5704/MOJ.2411.011","url":null,"abstract":"<p><p>Non-union refers to a disruption in the process of fracture repair, which can be identified through sequential clinical and radiographic assessments. The distinction between septic and aseptic non-union is essential because the treatment strategies are fundamentally different. Non-unions are most often treated surgically as it helps to provide both mechanical stability and good biological environment to promote bone healing. However, there is also the option of managing it conservatively by proper immobilisation using functional brace which is an alternative for surgical procedures and widely reported in tibia non-union cases. To date, there has been no reported case of femur non-union successfully treated with a functional brace. This case report details the success of treatment using a functional brace in a mentally disabled gentleman who sustained a femur non-union following a fracture related infection.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"75-79"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Elbow Arthroplasty as the Treatment of Choice for a Young Man with Neglected Terrible Triad of the Elbow Joint and Schizophrenia: A Case Report.","authors":"S D Savio, Kyw Artha, Iglnaa Wiguna","doi":"10.5704/MOJ.2411.009","DOIUrl":"10.5704/MOJ.2411.009","url":null,"abstract":"<p><p>In young patients, the use of total elbow arthroplasty (TEA) is rarely preferred due to its high rate of mechanical failure. Poor compliance and psychological problems encountered may lead to increased difficulty in management. A 38-year-old male complained stiffness and pain on his left elbow. History of trauma was present 10 months ago, when he fell down from a tree of 6m high. Immediate closed reduction and immobilisation with backslab was performed, but he was lost to follow-up due to Schizophrenia. In physical examination, we found varus and recurvatum deformity with inability to flex the elbow beyond 30° and perform pronation. Plain radiograph and CT scan confirmed the terrible triad of elbow with callus formation. Total elbow arthroplasty with soft tissue release was then performed, resulting in satisfactory range of motion at one year follow-up. The management of neglected terrible triad of the elbow is challenging not only due to the bony problems, but also contracted muscles and fibrotic joint. TEA previously has been described in cases of inflammatory arthritis and degenerative arthritis, less in post-traumatic conditions especially in young patients. Though there is still scarcity in literatures discussing the burden of psychiatric problems in arthroplasty patients, but the existing literatures proved the correlation between psychiatric comorbidity with higher rate of post-operative adverse events. Total elbow arthroplasty can be considered as a surgical treatment for a young patient with neglected fracture dislocation of elbow with satisfactory result; however close post-operative monitoring and routine physiotherapy exercise should always be performed.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"66-70"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Pre-operative Correction of Vitamin D3 Deficiency in Controlling Post-operative Bone Pain after Unicompartmental Knee Arthroplasty.","authors":"A M Rajani, Ars Mittal, V U Kulkarni, K A Rajani, K A Rajani","doi":"10.5704/MOJ.2411.002","DOIUrl":"10.5704/MOJ.2411.002","url":null,"abstract":"<p><strong>Introduction: </strong>Hypovitaminosis D plays an important role in post-operative bone pain and muscle strength in arthroplasty surgeries. Its role in unicompartmental knee arthroplasty (UKA) has not been elucidated yet. The objective of this study was to determine the impact of hypovitaminosis D and its correction on post-operative bone pain after UKA.</p><p><strong>Materials and methods: </strong>A prospective cohort study involving 240 patients undergoing mobile-bearing medial UKA was conducted. Group A (na=80) received postoperative correction of Vitamin D3 Deficiency (VDD), Group B (nb=80) received pre-operative correction of VDD, while Group C (nc=80) had normal Vitamin D3 levels to begin with (≥30ng/ml). Correction was done by three doses of intramuscular injection of 600,000 IU Arachitol® (Vitamin D3) given at an interval of one week each. All groups were matched for demography and outcome measures. The level of bone pain by checking for tibial shin tenderness quantified by the visual analog scale (VAS) and evaluated pre-operatively, and at 2, 4, 6 and 12 weeks post-operatively.</p><p><strong>Results: </strong>Group B and C showed similar post-operative trends and remained significantly superior to Group A till the 6th-week follow-up. The biostatistical difference between Group A and the other two groups started decreasing after the completion of post-operative correction regime as noticed on the 6th-week follow-up. By 12 weeks post-operatively, all three groups had similar levels of bone pain.</p><p><strong>Conclusion: </strong>Vitamin D3 serves as an important preoperative investigation in patients undergoing UKA as it is a modifiable risk factor affecting post-operative bone pain. Its correction pre-operatively gives excellent post-operative pain control.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"7-15"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Lengthening Radius using Limb Reconstruction System - A Successful Treatment for Radius Shortening: A Case Report.","authors":"M R Muhammad-Zaidulkhair, R S Tan, I K Kamarul","doi":"10.5704/MOJ.2411.013","DOIUrl":"10.5704/MOJ.2411.013","url":null,"abstract":"<p><p>Fractures of the distal radius are the most common type of forearm fractures seen in children. The most serious outcome of physeal injuries is growth arrest, which can result in deformity and even significant differences in limb length. Therefore, we'd like to share our experience with treating a patient whose left radius stopped growing after she had a physeal injury in an accident. Case presentation: we encountered a 10-year-old girl, who was involved in a road traffic accident. She sustained closed fracture distal end left radius (Salter Harris 2). She sought medical assistance late, so osteoclasis, open reduction, and a k-wire on her left radius to fix the fracture, however it was complicated with growth arrest of left radius after the bone united. It was observed that her left radius was around 4cm shorter than her right. She had an osteotomy performed on her left radius and a LRS implanted. After six months post-surgery, there was no visible shortening of her left upper limb, and the radius had grown by around 4cm. There was no neurovascular impairment after left radius lengthening. After a year had passed after her operation, the patient said she had no complaints about her left upper limb. Despite the prevalence of the ilizarov method, the monorail external fixator, also known as LRS, is an option for bone lengthening of the radius. The LRS was utilised in our situation, and the results demonstrated its usefulness.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"84-87"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcome of Single-Stage Posterior Decompression and Stabilisation for Spine Metastasis.","authors":"C S Wang, Z Atan","doi":"10.5704/MOJ.2411.005","DOIUrl":"10.5704/MOJ.2411.005","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical treatment for indicated spinal metastases cases is an option to improve patients' outcomes. Local data in analysing the potential of patients' improvement after surgical treatment are limited. We intend to review the clinical outcomes of surgeries performed for cancer patients who were diagnosed with spinal metastases. We aim to identify factors associated with improved spinal pain, neurological deficit and patient survival.</p><p><strong>Material and methods: </strong>The medical records of 51 patients who were diagnosed with thoracolumbar spinal metastatic tumour and underwent palliative single-stage posterior approach spinal surgery between June 2015 and June 2022 were recruited retrospectively. Patient demographic data, pre-operative and post-operative pain scores, neurological assessment and survival duration were collected from the medical records. Radiological findings were studied using respective imaging and reports.</p><p><strong>Results: </strong>The mean age was 57.5 years, and the median survival was nine months after the surgical treatment. The post-operative pain improvements were statistically significant at two weeks (VAS improved from 5 to 2), and three months follow-up VAS was one (p<0.001 and p=0.009, respectively). At initial presentation, patients with a single-level spinal involvement had higher VAS compared to multiple spinal metastases (p=0.018). A total of 18 (35.3%) patients had improved one or more ASIA grades, of which eight (15.7%) of them had gain of ambulatory function (p<0.001). Twenty-seven (52.9%) patients were ambulatory post-operative. The slow growth type of primary carcinoma, post-operative ambulatory ability, and the absence of perioperative morbidity were factors associated with favourable survival duration (p=0.006, p<0.001 and p<0.001, respectively). Synchronous visceral metastases adversely affected the survival duration (p=0.008).</p><p><strong>Conclusion: </strong>Single-stage posterior decompression and stabilisation improved the clinical outcomes of spinal pain and neurological deficit in metastatic spinal tumours. Type of primary tumour, visceral metastasis, perioperative morbidity, and post-operative ambulatory status significantly impact post-operative survival duration.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"32-41"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dabigatran-induced Enterococcus Necrotizing Fasciitis in Medically Unfit Patient with Successful Conservative Treatment Outcome: A Case Report.","authors":"M K Faris, M S Izzuddin, M A Norazrin, M K Thiru","doi":"10.5704/MOJ.2411.012","DOIUrl":"10.5704/MOJ.2411.012","url":null,"abstract":"<p><p>A 54-year-old gentleman with underlying hypertension and congestive cardiac disease was diagnosed with left lower limb necrotizing fasciitis following commencement of oral dabigatran. Small bruises on the limb progressed to full-blown sepsis. The calculated perioperative risk for surgery was unfavourable. Immediate diagnosis combined with targeted medical treatment managed to produce a medical wonder.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"80-83"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Cost-Effectiveness of Daycare Anterior Cruciate Ligament Reconstruction - A Retrospective Case Series.","authors":"J Khan, R Ali, S Fahad, F Mariam, N Baloch","doi":"10.5704/MOJ.2411.001","DOIUrl":"10.5704/MOJ.2411.001","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple reviews of the applicability, cost-effectiveness, and safety of daycare reconstruction of anterior cruciate ligament have been published in French, American, and British setups, but have not been described in our population.</p><p><strong>Materials and methods: </strong>In this study, 25 patients who underwent Anterior Cruciate Ligament Reconstruction (ACLR) as a daycare surgery in our setup were assessed retrospectively. Post-operatively patients were reviewed for pain, complications, conversion from daycare to inpatients, readmission within two weeks post ACLR and cost-effectiveness.</p><p><strong>Results: </strong>None of the patients required readmission within two weeks post-operatively, two patients were admitted on request from Surgical Day Care (SDC) to inpatient postoperatively, two patients developed urinary retention. Daycare ACLR was also cost-effective, as shown by cost analysis a reduction of cost by 26.9 %.</p><p><strong>Conclusion: </strong>Daycare ACLR is safe, feasible, and cost-effective treatment modality for young patients and can provide a substantial cost saving.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"2-6"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Functional Outcomes of Giant Cell Tumours around the Knee treated by Extended Curettage followed by Bone Grafting, Cementation, or a Combination.","authors":"A Q Khan, Q Raza, M B Abbas, M Chowdhry, M J Khan","doi":"10.5704/MOJ.2411.006","DOIUrl":"10.5704/MOJ.2411.006","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrence after Giant Cell Tumour (GCT) treatment depends on the type of treatment used. Poly-Methyl-Meth-Acrylate (PMMA) after extended curettage provides structural support and allows for early identification of recurrence but carries a risk of thermal damage to the surrounding healthy tissue. The aim of this study was to compare long-term functional outcomes and complications in patients with GCT around the knee treated with extended curettage and bone grafting or cementation.</p><p><strong>Material and methods: </strong>All patients with biopsy-proven GCT, involving either the distal femur or proximal tibia, and treated with either curettage with bone grafting (CBG), curettage with bone cementation (CBC), or curettage combined with grafting and cementation (the Sandwich technique) were included. They were further classified according to Campanacci grading. Patients were followed for a minimum of two years, and all complications were recorded.</p><p><strong>Results: </strong>The three groups showed a statistically significant difference in terms of persistent pain after surgery (p=0.03), development of long-term arthritis (p=0.01), as well as overall complications (p=0.005). There was no significant difference in terms of the overall recurrence rate between each group (p>0.05). For Campanacci Grade II lesions, there was a statistically significant difference in terms of local recurrence (p=0.01), with lower recurrence rates observed after cementation procedures.</p><p><strong>Conclusion: </strong>The study indicates that the Sandwich technique was associated with a lower rate of complications compared to CBG or CBC. Patients in the CBG group reported persistent pain, while those in the CBC group exhibited early arthritic changes within five years of the index surgery. Although there was no overall difference in recurrence rates, cementation procedures had a significantly lower rate of recurrence in Campanacci Grade II lesions.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"42-50"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Comparison of Hydroxyapatite from Clam Shell Waste and Eggshell Waste Compared to Commercial Synthetic Hydroxyapatite.","authors":"M Idulhaq, A Mudigdo, P Utomo, B Wasita, M E Trapsilantya","doi":"10.5704/MOJ.2411.004","DOIUrl":"10.5704/MOJ.2411.004","url":null,"abstract":"<p><strong>Introduction: </strong>This study compares the quality of hydroxyapatite in Anadara granosa waste and laying chicken eggshell waste to commercial synthetic hydroxyapatite.</p><p><strong>Material and methods: </strong>This experimental research included 27 samples of hydroxyapatite derived from clam shell waste (CSW-HAP), hydroxyapatite derived from eggshell waste (ESW-HAP), and commercial synthetic hydroxyapatite, with nine samples of each. The calcination method was used to process clam shell waste and eggshell waste into hydroxyapatite, which was then compared with synthetic hydroxyapatite from Bongros® for calcium and phosphate content. Scanning electron microscopy was used to compare their morphological structures.</p><p><strong>Result: </strong>The mean calcium levels in the CW-HAP, EW-HAP, and control groups were 41.3±2.9%, 41.5±2.3%, and 39.6±5.0%, respectively. According to One Way ANOVA, there was no significant difference between the CW-HAP or EW-HAP groups and the control group (p=0.49). The mean phosphate levels in the CW-HAP, EW-HAP, and control groups were 8.1±1.2%, 8.1±1.3%, and 9.4±2.0%, respectively. The results were also not significant (p=0.146).</p><p><strong>Conclusion: </strong>Clam shell waste and eggshells can be an alternative source of hydroxyapatite substitution, as demonstrated by the structural and porous formation of hydroxyapatite obtained from these sources (CW-HAP and EW-HAP) when compared to commercial synthetic hydroxyapatite.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"27-31"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric Analysis of Malaysian Orthopaedic Journal using Scopus Database.","authors":"R Y Kow, C L Low, A A Abbas, A H Zulkifly","doi":"10.5704/MOJ.2407.001","DOIUrl":"10.5704/MOJ.2407.001","url":null,"abstract":"<p><strong>Introduction: </strong>The Malaysian Orthopaedic Journal (MOJ) (ISSN 1985-2533 / 2232-111X) is the official publication of the Malaysian Orthopaedic Association (MOA) and the ASEAN Orthopaedic Association (AOA). In May 2007, MOA published the first standalone issue of MOJ with the aim of disseminating new knowledge and providing updates in orthopaedics, trauma and musculoskeletal research. Since then, MOJ has grown significantly, achieving indexing in numerous databases and attaining a 2nd Quartile (Q2) rank in the Scopus database in 2022. This bibliometric analysis aims to explore the trends and distribution of articles published in MOJ.</p><p><strong>Materials and methods: </strong>Bibliometric data for MOJ was extracted from the SCOPUS database, covering the years from its indexing to 2022. Information such as authors, country, document type, author's keywords, citations, and other parameters were extracted using the bibliometrix package in the R Studio software. The data were then presented in tables and illustrative graphs using the same software.</p><p><strong>Results: </strong>A total of 305 articles were retrieved from the Scopus database during the study period. Two-thirds of the articles were original articles and review articles. The highest number of citations received by an article is 56, and top ten articles in MOJ were authored by researchers from seven different countries, highlighting the journal's diversity. Despite receiving submissions from various countries, there is minimal collaboration between authors of different countries. Keywords such as \"covid-19\" and \"pandemic\" dominate the authors' keyword section due to the once-in-a-life-time COVID-19 which during the study period, resulting in numerous publications related to this issue.</p><p><strong>Conclusion: </strong>This bibliometric analysis reviews all the articles indexed in the Scopus database and provides insight into the contributors' information and the trends in orthopaedic research. By identifying the lack of collaboration between countries, it is hoped that this analysis can inspire more orthopaedic surgeons and researchers to collaborate and produce high-quality publications.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 2","pages":"1-9"},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}