Malaysian Orthopaedic Journal最新文献

{"title":"Effectiveness of Silent Mentor Program (SMP) Workshop on Enhancing Confidence in Surgical Skills.","authors":"L P Wong, H Alias, S L Tan, S L Khaing, T E Sia, A Saw","doi":"10.5704/MOJ.2503.006","DOIUrl":"https://doi.org/10.5704/MOJ.2503.006","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based surgical skills workshops using 'Silent Mentors' are employed in numerous surgical training programs worldwide, yet empirical evidence on their effectiveness remains limited. The objective of this study was to investigate whether participation in the surgical skills workshop within the Silent Mentor Program (SMP) resulted in an improvement in the surgical skills of the workshop attendees.</p><p><strong>Material and methods: </strong>Participants in the SMP at Universiti Malaya during the period from May 15, 2022, to September 24, 2023, were included in the study. Participants self-evaluated their surgical skill confidence levels in four fundamental surgical skills (chest tube insertion, central venous line insertion, endotracheal intubation, and skin suturing). The pre-workshop confidence scores were assessed and compared with immediate post-workshop scores.</p><p><strong>Results: </strong>The findings demonstrated that after the training, participants exhibited higher confidence in all four fundamental surgical skills. Skin suturing demonstrated the highest total confidence score post-workshop, with a median of 21 and an interquartile range (IQR) of 18-24. Endotracheal intubation and chest tube insertion followed closely, both with a median of 19. Conversely, central line insertion displayed the lowest total confidence score, registering a median of 18 (IQR=16-21). No statistically significant differences were observed in the confidence level scores for chest tube insertion, central line insertion, and endotracheal intubation between pre- and post-workshop assessments across all demographic characteristics.</p><p><strong>Conclusion: </strong>In conclusion, utilizing silent mentors in surgical skills training enhances proficiency in all four fundamental surgical skills, with skin suturing demonstrating particularly noteworthy improvements. The consistent confidence levels across demographic factors suggest the workshop's effectiveness across a broad spectrum of participants.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"39-48"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014481","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":"Implant Choice of Internal Fixation for Stable Femoral Neck Fractures in Elderly: Cannulated Screw Fixation versus Helical Blade Cephalomedullary Nailing.","authors":"Y H Roh, J S Ahn, C M Lim, K W Nam","doi":"10.5704/MOJ.2503.013","DOIUrl":"https://doi.org/10.5704/MOJ.2503.013","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of femoral neck fractures (FNFs) in elderly patients is increasing as average lifespans and the prevalence of osteoporosis increase. The optimal treatment strategy remains unclear. We compared the outcomes of cephalomedullary nail (CMN) and cannulated screw (CTS) fixations used to treat stable FNFs in patients over 65 years of age.</p><p><strong>Material and methods: </strong>Among elderly patients with Garden type 1 and 2 FNFs treated between January 2010 and May 2018, 44 who were followed-up for more than 1 year were included. There were 28 cases in the CTS group and 16 cases in the CMN group, and the average age at the time of surgery was 76.3 years (range, 65-88 years). Radiological and functional variables were analysed to compare the results by fixation device.</p><p><strong>Results: </strong>There were no significant differences between the groups in terms of functional outcomes or bone union times. However, operation and fluoroscopy times were significantly shorter in the CMN group. The neck shaft varus angulation and the extent of device sliding were greater in the CTS group. Multivariate analysis showed that CTS use was independently associated with major complications.</p><p><strong>Conclusion: </strong>The CMN is a useful tool for treating stable FNFs in the elderly. It is simpler to use than conventional CTS fixation and is associated with fewer complications.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"102-112"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038196","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":"Type 1 Monteggia Equivalent Fracture with Ipsilateral Distal Radius Fracture: A Case Report.","authors":"Y S Gokceoglu, E Y Ozger","doi":"10.5704/MOJ.2503.016","DOIUrl":"https://doi.org/10.5704/MOJ.2503.016","url":null,"abstract":"<p><p>In this case report, we present a 13-years-old patient who sustained a Monteggia equivalent fracture along with an ipsilateral distal radius fracture following a fall on the elbow. Comminuted ulnar fracture was treated with open reduction and internal fixation with a bridging plate. After restoring the ulnar length, the radial neck fracture was successfully reduced. The distal radius fracture was managed conservatively. Our literature review shows that, the patient is one of the comparatively older patients treated with open reduction and internal fixation in this area and that a successful outcome was achieved with early mobilisation. This case underscores the need for further studies to determine the optimal treatment strategy in such cases.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"123-126"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020924","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":"Can Pre-operative MRI Predict the Need for Salter's Osteotomy in DDH Children Undergoing Open Reduction?","authors":"K C Vatsyan, K Rangasamy, N R Gopinathan, P Sudesh, A Shinha, A K Salaria","doi":"10.5704/MOJ.2503.010","DOIUrl":"https://doi.org/10.5704/MOJ.2503.010","url":null,"abstract":"<p><strong>Introduction: </strong>MRI having the multiplanar capability is a good choice for pre-operative planning in developmental dysplasia of hip (DDH). Although few previous studies utilised MRI to quantify dysplasia, predict outcomes, and the procedure required, there are no defined pre-operative conclusive criteria on when to do Salter's osteotomy?</p><p><strong>Material and methods: </strong>A prospective cohort study was conducted in unilateral idiopathic DDH cases those who underwent an open reduction in the age group of one to four years. Pre- and post-operative MRI was done to assess various acetabular and femoral parameters. Intra-operatively, osteotomy was planned. Based on stability assessment given by Zadeh <i>et al</i> Clinical follow-up assessment was done at three- and six-month post-op. Functional assessment using Modified McKay's criteria was done at six months follow-up.</p><p><strong>Results: </strong>Out of 15 cases, seven children underwent only open reduction (OR), whereas eight underwent OR with Salter's osteotomy. Based on pre-op acetabular index and anteversion, Salter's osteotomy should be done in 14 out of 15 cases, but intra-operative stability test precluded Salter's in 6 cases. Post-operative anterior sectoral angle and femoral head coverage percentage were better in OR with Salter's group than OR-only group, but not statistically significant. Functional assessment at final follow-up showed all OR with Salter's group cases were Grade I, whereas in OR-only group, 4 were Grade I and 3 were Grade II.</p><p><strong>Conclusion: </strong>Three-dimensional dynamic assessment using intra-operative stability test predicts the best possible interrelation between the articular surface of the femoral head and acetabulum and the need for osteotomy rather than preoperative MRI.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"77-85"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017091","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":"Reconstruction of Metacarpals of Two Rays with Double Barrel Osteocutaneous Fibular Flap in a Hand Injury with Composite Tissue Loss: A Case Report.","authors":"J K Mishra, S A Sahu, A Sindhuja, B K Kar, A Saha","doi":"10.5704/MOJ.2411.010","DOIUrl":"10.5704/MOJ.2411.010","url":null,"abstract":"<p><p>Free fibula flap has been a workhorse for head, neck, and extremity long bone defects. We discuss the reconstruction challenge in an unusual hand injury case involving the loss of multiple metacarpals and soft tissue with surprising preservation of finger vascularity. The reconstructive goals were addressed with a microvascular osteocutaneous fibula flap transfer with multiple osteotomies to create spitting images of metacarpals and soft tissue defects restored with the skin paddle. The outcome, in terms of functional gain, was sufficient for managing day-to-day activities. We share our experience in reconstructing this unique presentation of a complex hand injury.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"71-74"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847846","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":"Early Intervention in Post-operative Infectious Spondylodiscitis: Outcome of Aggressive Transforaminal Lumbar Interbody Fusion.","authors":"A Krishnan, B R Dave, D Degulmadi, S Mayi, R Rai, P Bang, M Dave, V Chauhan, S Bali, P Charde, A Anil, P Krishnan","doi":"10.5704/MOJ.2411.003","DOIUrl":"10.5704/MOJ.2411.003","url":null,"abstract":"<p><strong>Introduction: </strong>Conservative and surgical approach timeline in post-operative spondylodiscitis (POS) following lumbar disc herniation (LDH) surgery is ill defined, and patients have a protracted recovery phase with social, psychological, and financial implications.</p><p><strong>Material and methods: </strong>Retrospective analysis of patients operated by transforaminal lumbar interbody fusion (TLIF) in POS was done. Confirmed clinico-radiological diagnosed POS cases, not responding within three to four weeks were included. Normalisation of CRP and radiological stable reconstruction was assessed for objective clearance of POS and bony union.</p><p><strong>Results: </strong>Ninety-five patients were included in the study with minimum follow-up period of two years. The mean age was 51.63±13.63 years. There were organisms cultured in 55 patients (57.89%). The ODI improvement of the patients was noted to improve from 88.71±5.3 to 20.80±9.7 (8 weeks) and was incremental at 2 years follow-up (10.12±6.41) and maintained further at final follow-up at 9±4.3. Bony union achieved in all with stable reconstruction. The resumption of activities of daily living (ADL) was quick (15.90±8.20 days) and job (3.67±1.31 months) was achieved in all the patients. In poor outcomes, two patients didn't respond, and one patient died due to uncontrolled infection.</p><p><strong>Conclusion: </strong>Early diagnosis and intervention is the key to effective management of POS. Utilisation of aggressive TLIF yields faster ADL resumption.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"16-26"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847671","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":"Rotator Cuff Tears and Mid-Term Shoulder Outcomes after Intramedullary Nail Fixation for Humeral Shaft Fracture: A Minimum Five-year Follow-up Study.","authors":"R Furuhata, A Tanji, S Nakamura, T Urabe","doi":"10.5704/MOJ.2411.008","DOIUrl":"10.5704/MOJ.2411.008","url":null,"abstract":"<p><strong>Introduction: </strong>Antegrade intramedullary nail fixation for humeral shaft fractures yields satisfactory union rates. However, one of the related concerns is damage to the rotator cuff during nail insertion, which may affect long-term outcomes. The effect of a rotator cuff lesion on mid- and long-term shoulder outcomes remains unknown. This study aimed to investigate the incidence of rotator cuff tears 5 years or more after intramedullary nailing for humeral shaft fractures and to determine the impact of post-operative rotator cuff tears on mid-term outcomes.</p><p><strong>Material and methods: </strong>We retrospectively identified 27 patients who underwent antegrade intramedullary nail fixation for traumatic humeral shaft fractures and received follow-up for at least 5 years post-operatively. The patients were divided into two groups: those without tears and those with partial or complete tears, diagnosed using ultrasonography. We compared the functional and radiological shoulder outcomes between the two groups.</p><p><strong>Results: </strong>Of the 27 patients, 10 had partial or complete supraspinatus tears with a mean follow-up of 7.5 years postoperatively. The incidence of acromial spurs was significantly higher in patients with partial or complete tears than in those without tears (P<0.001). There were no significant differences in the age and sex-adjusted Constant score, or the American Shoulder and Elbow Surgeon score between the two groups.</p><p><strong>Conclusion: </strong>Our results revealed that 37% of patients developed partial or complete supraspinatus tendon tears in the mid-term. Post-operative rotator cuff tears were significantly associated with the formation of acromial spurs; however, they had no significant effect on mid-term shoulder functional outcomes.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"59-65"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847898","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":"Fibula Pro-tibia or Tibial Pro-fibula Dilemma: Order Defines Meaning.","authors":"R Y Kow, C L Low, N Mohd-Yusof","doi":"10.5704/MOJ.2411.014","DOIUrl":"10.5704/MOJ.2411.014","url":null,"abstract":"","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"88-89"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847742","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":"Functional and Radiological Outcome of Anterior Plate Stabilisation of the Sacroiliac Joint in Unstable Pelvic Injury.","authors":"M H Din, A M Aziz, Y Sahran, M A Mohamed-Saat, N S Abdul-Ghani, W I Faisham, A T Musa","doi":"10.5704/MOJ.2411.007","DOIUrl":"10.5704/MOJ.2411.007","url":null,"abstract":"<p><strong>Introduction: </strong>Sacroiliac joint disruption, resulting from high energy trauma can cause significant morbidity if no proper treatment given. Many techniques can be used to stabilise pelvic ring injuries. We studied the functional and radiological outcome following open reduction and anterior fixation of the sacroiliac joint and agreement between both outcomes.</p><p><strong>Material and methods: </strong>This retrospective study involved 15 patients with unstable pelvic injuries requiring surgical intervention from January 2015 to December 2020 who undergone anterior stabilisation of the sacroiliac joint. Radiological outcome assessments were done postoperatively by using Lindahl criteria. The complete functional outcome was assessed at least six months postoperatively when patients were able to weight bear by using Majeed system. Descriptive statistical analysis was performed using IBM SPSS Statistics Version 27.</p><p><strong>Results: </strong>The participants consist of 73.3% male and 26.7% female patients. A total of 66.7% of patients had a Tile type B pelvic ring injury, and the remaining 33.3% had a Tile type C pelvic ring injury. Based on the Majeed system, 73.3% of patients had excellent functional outcomes, and based on Lindahl criteria; there were 60% of patients who had excellent radiological outcome. However, there was no significant agreement between functional and radiological outcomes.</p><p><strong>Conclusion: </strong>Definitive fixation of the sacroiliac joint by anterior plate stabilisation provided an excellent functional and radiological outcome mainly due to good anatomical reduction and mechanical stability. However, further study may be needed to evaluate the correlation between functional and radiological outcomes and compare the various method of fixation with a larger sample size.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"51-58"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847743","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":"APAME 2024 - Sydney Declaration on Predatory or Pseudo Journals and Publishers.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"18 3","pages":"1"},"PeriodicalIF":0.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847970","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}