METHODS: All 30 of our patients underwent a standardized limited open CTR by a designated surgeon. Post operatively, they were randomized into a splinted (n=16) and a nonsplinted (n=14) group. The splint was kept for a week. Patients were reviewed at regular intervals of one week, two months and six months. At each follow up, these patients were clinically assessed for the following outcome measures: VAS (visual analogue score), 2PD (two-point discrimination), pinch grip, grip, Abductor Pollicis Brevis (APB)) power and completion of the Boston questionnaire.
RESULTS: All patients presented with significant improvement in the postoperative evaluation in the analyzed parameters within each group. However, there was no significant difference between the two groups for any of the outcome measurements at sequential and at final follow-up.
CONCLUSION: We conclude that wrist splinting in the immediate post-operative period has no advantage when compared with the unsplinted wrist after a limited open carpal tunnel release.
MATERIALS AND METHODS: A prospective study was conducted in a tertiary referral cen re using the Scoliosis Research Society-22 (SRS-22) questionnaire during the patients' annual follow up, betwee February to April 2014. Thirtyseven patients who met the inclusion criteria were enrolled.
RESULTS: The mean pre-operative Cobb's angles were 57.8o ± 12.7o and mean post-operative angle of 20.0o ± 10.4o, resulting in average correction of 65.9 ± 14.4%. Mean preoperative rib hump was 61.1 ± 15.4 mm with mean postoperative rib hump of 15.8 ± 17.8 mm, resulting in average reduction of 77.7 ± 23.7%. Mean of post-operative total SRS score was 4.1 ± 0.5. Using Spearman rank correlation, the percentage of Cobb's angle correction versus the SRS-22 score showed correlation of 0.17 (P=0.33) while the percentage of rib hump reduction versus SRS-22 score showed a correlation of 0.11 (P=0.53).
CONCLUSION: In this study, the average total SRS-22 score was 4.1 ± 0.5 (range, 3.1-4.9) post-operatively indicating very high satisfaction rate overall. Despite attempts at greater curve correction and rib hump reduction, there is no direct correlation between patient satisfaction and radiographic parameters.
METHODOLOGY: This cross sectional study on tibiofemoral angle was conducted among 160 normal healthy children using clinical measurement method. The children between 2 18 months to 6 years old were assigned to 5 specific age groups of 32 children with equal sex distribution.
RESULT: This study had shown a good inter-observer reliability of tibiofemoral angle measurement with intraclass correlation coefficient (ICC) of 0.87 with narrow margin of 95% confident interval (95% CI: 0.73, 0.94). The mean tibiofemoral angle for children at 2 , 3 , 4 , 5 and 6 years old were 2.25° (SD=0.53), 8.73° (SD=0.95), 7.53° (SD=1.40), 7.27° (SD=1.14) and 6.72° (SD=0.98) respectively. The age when they achieved maximum valgus tibiofemoral angle was 3 years old. The maximum mean (SD) tibiofemoral angle for boys, girls and all children were 8.91° (SD=1.17), 8.56° (SD=0.62) and 8.73° (SD=0.95)respectively. The mean tibiofemoral angle showed no statistically significant difference between girls and boys except for the 5-year-old group, in which the mean TF angle for girls was 7.560 (SD=0.95) and for the boys was 6.970 (SD=1.26) with p-value of 0.037.
CONCLUSION: Measurement of tibiofemoral angle using the clinical method had a very good inter-observer reliability. The tibiofemoral angle in Malay population was valgus since the age of 2 years with maximum angle of 8.730 (SD=0.95) achieved at the age of 3 years.
CASE REPORT: This report highlights two rare variants of Monteggia fracture-dislocation seen in children. The first case was a 12-year old girl alleged to have fallen from a 15- feet tall tree and sustaining a combined type III Monteggia injury with ipsilateral Type II Salter-Harris injury of distal end radius with a metaphyseal fracture of the distal third of the ulna. The second case was a 13-year old who had sustained a closed fracture of atypical Type I Monteggia hybrid lesion, in a road traffic accident.
CONCLUSION: This report highlights the rare variants of Monteggia fracture dislocation which could have been missed without proper clinical examinations and radiographs.