Malaysian Orthopaedic Journal最新文献

{"title":"Open Access: Pay or Go Away.","authors":"K Moustafa","doi":"10.5704/MOJ.2311.016","DOIUrl":"https://doi.org/10.5704/MOJ.2311.016","url":null,"abstract":"","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811817","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":"Outcomes of Management of Severe Clubfoot among Children by Ilizarov External Fixator.","authors":"M Nwet, R Vignesh, W Khaing, S San, Z W Ko","doi":"10.5704/MOJ.2311.003","DOIUrl":"https://doi.org/10.5704/MOJ.2311.003","url":null,"abstract":"<p><strong>Introduction: </strong>Clubfoot remains the most common birth defect involving the musculoskeletal system. There are various surgical and non-surgical treatment options available for the management of clubfoot. Using the minimally invasive Ilizarov external fixator method has been reported to have good success rates and fewer complications.</p><p><strong>Materials and methods: </strong>This study aimed at analysing the morphological and functional outcomes of treating severe clubfoot by Ilizarov external fixator among children from July 2017 to March 2020. Thirty-two children who had either failed Ponseti / surgery or neglected with 44 clubfeet of Dieglio type III and type IV were included in the study. A short-leg walking cast was applied for an additional six weeks after removing of Ilizarov frame and additionally followed by an orthosis for another six weeks. Outcomes were measured by the functional rating system by Laaveg and Ponseti and interpretation done at 1 month and 12 months after the ankle-foot arthrosis.</p><p><strong>Results: </strong>About 86.4% of the patients had good or excellent outcome scores. Pre and post-Demeglio scores and functional rating scores were statistically significant (p<0.001) by using Paired t-test. Complications included superficial pin site infections in 13 feet (29.54%), 5 feet (11.36%) had claw toes, 3 feet (6.81%) had linear skin necrosis and 2 feet (4.54%) had calcaneal fractures which were manageable with minor interventions.</p><p><strong>Conclusion: </strong>The study findings highlighted that the Ilizarov external fixator method can correct complex foot deformities of severe clubfoot with minimum morbidity. Further larger and long-term studies are needed to investigate the effects of the stiff hindfoot and possible degenerative changes on the function and symptoms of these patients as adults.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811818","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":"Dynamic Fixation versus Static Screw Fixation for Syndesmosis Injuries in Pronation External Rotation Ankle Fractures: A Retrospective Case Control Study.","authors":"C M Lim, S W Choi, B S Kim, S J Lee, H S Kang","doi":"10.5704/MOJ.2311.008","DOIUrl":"https://doi.org/10.5704/MOJ.2311.008","url":null,"abstract":"<p><strong>Introduction: </strong>The current standard treatment for ankle syndesmosis injury is static screw fixation. Dynamic fixation was developed to restore the dynamic function of the syndesmosis. The purpose of this study was to determine that which of static screw fixation and dynamic fixation is better for treatment of ankle syndesmosis injury in pronation-external rotation fractures.</p><p><strong>Materials and methods: </strong>Thirty patients were treated with dynamic fixation (DF group) and 28 patients with static screw fixation (SF group). The primary outcome was Olerud-Molander Ankle Outcome Score. The secondary outcome were Visual Analogue Scale score and American Orthopedic Foot and Ankle Society score, radiographic outcomes, complications and cost effectiveness. To evaluate the radiographic outcome, the tibiofibular clear space, tibiofibular overlap, and medial clear space were compared using the pre-operative and last follow-up plain radiographs. To evaluate the cost effectiveness, the total hospital cost was compared between the two groups.</p><p><strong>Results: </strong>There was no significant difference in primary outcome. Moreover, there were no significant difference in secondary outcome including Visual Analogue Scale score and American Orthopedic Foot and Ankle Society score and radiographic outcome. Two cases of reduction loss and four cases of screw breakage were observed in the SF group. No complication in the DF group was observed. Dynamic fixation was more cost effective than static screw fixation with respect to the total hospital cost.</p><p><strong>Conclusion: </strong>Although dynamic fixation provided similar clinical and radiologic outcome, dynamic fixation is more cost effective with fewer complications than static screw fixation in ankle syndesmosis injury of pronation-external rotation fractures.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811812","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":"Is There a Doctor on Board? We Have an Emergency!","authors":"S Ibrahim, J Sathar","doi":"10.5704/MOJ.2311.017","DOIUrl":"https://doi.org/10.5704/MOJ.2311.017","url":null,"abstract":"","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811816","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":"Wide-Awake Hemi-hamate Arthroplasty for Chronic PIPJ Fracture-Dislocation: A Case Report.","authors":"I J Magtoto","doi":"10.5704/MOJ.2311.014","DOIUrl":"https://doi.org/10.5704/MOJ.2311.014","url":null,"abstract":"<p><p>Wide-awake local anaesthesia, no tourniquet (WALANT) has been reported for upper extremity procedures of varying complexities ranging from simple tendon repairs to more complicated soft tissue and bony reconstructions. Hemi-hamate arthroplasty under WALANT has yet to be described in English literature. We report a case of a chronic dorsal PIPJ fracture-dislocation who underwent open reduction followed by Hemi-hamate Arthroplasty under wide-awake anaesthesia. There was adequate visualization during the surgery with no additional anaesthesia required. Active intra-operative range of motion and joint stability testing was possible with no pain experienced throughout the procedure. 10-month post-operative follow-up showed excellent range of motion with occasional tolerable pain during maximal finger flexion and power grip. Wide-awake anaesthesia is a viable and safe alternative for hemi-hamate arthroplasty.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10722997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811824","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":"The Role of Computed Tomography and Radiographs in the Management of Intertrochanteric Fractures.","authors":"V J Patel, N B Patel, P M Tank, K A Upadhyay, K K Ashwin","doi":"10.5704/MOJ.2311.004","DOIUrl":"https://doi.org/10.5704/MOJ.2311.004","url":null,"abstract":"<p><strong>Introduction: </strong>The Intertrochanteric fracture is a common hip trauma encountered in elderly patients. There is a lack of general agreement regarding its surgical management and choice of implant. Purpose of this study to conclude the final decision matrix regarding surgical management of intertrochanteric fractures based on parameters assessed on plain radiographs and CT scan.</p><p><strong>Materials and methods: </strong>We have retrospectively evaluated 55 patients with intertrochanteric fractures presented to our institute after informed consent with radiographs and CT scans between July 2017 to July 2018. Assessment of various parameters regarding fracture geometry and classification as well as measurement was done.</p><p><strong>Results: </strong>Mean lateral wall thickness in present study was 20.76mm. Incidence of coronal fragments was 90.9% and absence of coronal fragment in 5 patients. We noted the cases with anterior comminution had also a posterior comminution rendered the fracture unstable in almost 20 % cases.</p><p><strong>Conclusion: </strong>Better understanding of fracture geometry by combined used of radiograph and CT scan enhanced preoperative planning, choice of suitable implant, helps in reduction manoeuvre and improving quality of osteosynthesis.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811823","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":"Impact of Previous Ankle Injuries on Professional Footballers' Preseason Functional Ankle Assessment.","authors":"A H Ahmad-Shushami, M S A-Hamid, M H Khair, M O Ali","doi":"10.5704/MOJ.2311.011","DOIUrl":"https://doi.org/10.5704/MOJ.2311.011","url":null,"abstract":"<p><strong>Introduction: </strong>Football is the most popular sport and is widely played around the globe, with approximately 400 million players in 208 countries. Lower extremity injuries showed the highest incidence, with ankle injuries being the most prevalent after hip and knee injuries. The purpose of this study was to describe the characteristics of the players who reported previous ankle injuries during pre-competition medical assessment (PCMA) during the 2022 seasons of the Malaysian professional club. In addition, the study also investigated the effect of previous injuries on current ankle function.</p><p><strong>Materials and methods: </strong>This was a retrospective cross-sectional study using secondary data from the preseason PCMA data from a professional club that competed in Malaysia. The ankle range of motion, anterior drawer test, and functional ankle assessments including the Biodex athlete single leg stability test and ankle joint muscle strength were performed during the PCMA.</p><p><strong>Results: </strong>A total of 45 footballers reported previous history of ankle injuries to the left (n=9), right (n=20), or both ankles (n=16). Footballers with prior ankle injuries exhibited significantly less ankle inversion (p = 0.008) and a larger proportion of positive ADT tests in the injured ankle (x²(1, N=90) =7.76, p=0.005) compared to the non-injured side. there was no significant difference in other ankle range of motion, ankle stability index, or ankle muscular strength between previously injured and uninjured ankles.</p><p><strong>Conclusions: </strong>During preseason screening, half of the footballers in this study reported previous history of ankle injury, putting them at risk of having future ankle injuries. Aside from inversion and the anterior drawer test, no significant differences in range of motion, stability index, or muscle strength were discovered. However, as injury causation is multifactorial, preventive measures should be taken to reduce the risk of injury.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10722998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811815","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":"Ruptured Anterior Tibial Artery Pseudoaneurysm following Ilizarov External Fixator: A Case Report.","authors":"S A Zakaria, N A Yacob","doi":"10.5704/MOJ.2311.015","DOIUrl":"https://doi.org/10.5704/MOJ.2311.015","url":null,"abstract":"<p><p>Genuine infrapopliteal aneurysms are quite rare, in contrast to pseudoaneurysms. The aetiology of pseudoaneurysms related to external fixation is attributed to various theories, including direct vascular damage due to misplaced pins or wires, overshooting or misguidance during osteotomy, distraction at the corticotomy site during an Ilizarov procedure, and continuous abrasion of the vessel caused by a wire inserted in close proximity to an artery. Arteriography proves valuable in documenting lesions and assessing deeper pseudoaneurysms, particularly when contemplating reconstruction; it plays a crucial role in guiding management decisions. For significant tears and symptomatic aneurysms, resection and reconstruction are the gold standard treatment.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811820","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":"Bilateral Tibial Tuberosity Periosteal Sleeve Fracture in an Adolescent: A Case Report.","authors":"M Luqman, A F Rasid, K Jamil, A H Abd-Rashid","doi":"10.5704/MOJ.2311.013","DOIUrl":"https://doi.org/10.5704/MOJ.2311.013","url":null,"abstract":"<p><p>Tibial tuberosity avulsion fracture is a rare injury, and bilateral occurrence is more uncommon. Periosteal sleeve fracture is a unique fracture pattern which was first described in the lower pole of patella in children. We are reporting a rare case of bilateral tibial tuberosity sleeve fracture in a teenage boy which occurred while sprinting. The patient underwent open reduction, pull through suture fixation of the bilateral tibial tuberosity and screw fixation of left tibial tuberosity. Post-operative rehabilitation included gradual increment of range of motion with hinged brace and quadriceps muscle strengthening. Close follow-up was done to monitor the progression of his recovery. At six months follow-up, the patient recovered well. Both knees had full range of motion with an intact extensor mechanism.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811809","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":"Do We Ever Need to Fix Clavicle Fractures in Adolescents?","authors":"Kbl Lim, R A Olandres, X Cheow, M Thng, Nmhz Teo, N Pereira, Pxe Chan, Nkl Lee","doi":"10.5704/MOJ.2311.006","DOIUrl":"https://doi.org/10.5704/MOJ.2311.006","url":null,"abstract":"<p><strong>Introduction: </strong>Clavicle fractures in adults are increasingly being treated by surgical fixation following reports of symptomatic non-union, malunion and poor functional outcome with conservative treatment. This has led to a similar trend in the management of clavicle fractures in adolescents. This study aims to evaluate the outcome and complications of non-operatively treated clavicle fractures in adolescents.</p><p><strong>Materials and methods: </strong>This is a retrospective, single institution study on adolescents aged 13-17 years who sustained a closed, isolated clavicle fracture, between 19972015. Clinical records were reviewed for demographic information, injury mode, time to radiographic fracture union, time to re-attainment of full shoulder range of motion (ROM), and time to return to full activities and sports. Complications and fracture-related issues were recorded. Radiographs were analysed for fracture location, displacement and shortening.</p><p><strong>Results: </strong>A total of 115 patients (98 males, 17 females; mean age:13.9 ± 0.89 years) were included for study. 101 (88%) sustained a middle-third fracture while the remainder sustained a lateral-third fracture. A total of 96 (95%) of the middle-third fractures were displaced, and 12 (86%) of the lateral-third fractures were displaced. All displaced fractures in this study had shortening. Sports-related injuries and falls accounted for 68 (59%) and 34 (30%) of the cases respectively. Overall, the mean time to radiographic fracture union was 7.8 ± 4.35 weeks; there were no cases of non-union. Full shoulder ROM was re-attained in 6.6 ± 3.61 weeks, and full activities and sports was resumed in 11.4 ± 4.69 weeks. There were 5 cases of re-fracture and a single case of intermittent fracture site pain.</p><p><strong>Conclusion: </strong>Clavicle fractures in adolescents can and should be treated non-operatively in the first instance with the expectation of good outcomes in terms of time for fracture union, reattainment of shoulder full range of motion, and return to activities. Surgical stabilisation should be reserved for cases for which there is an absolute indication.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10722994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811811","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}