Displaying publications 1 - 20 of 35 in total

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  1. Zamri MF, Ng BW, Jamil K, Abd Rashid AH, Abd Rasid AF
    Cureus, 2023 Mar;15(3):e36384.
    PMID: 37090315 DOI: 10.7759/cureus.36384
    Fibrous dysplasia is a benign condition but can lead to severe long-bone deformities. Three-dimensional (3D) printing technology is a rapidly developing field that has now been popularized to aid surgeons in preoperative planning. We report a case of hip deformity in a 21-year-old woman who suffered from fibrous dysplasia and underwent a corrective osteotomy. We utilized open-source 3D computing software for preoperative planning before producing an osteotomy guide to aid in the operation.
  2. Jamil K, Yahaya MY, Abd-Rasid AF, Ibrahim S, Abdul-Rashid AH
    Malays Orthop J, 2021 Jul;15(2):26-35.
    PMID: 34429819 DOI: 10.5704/MOJ.2107.005
    Introduction: The guided growth technique is an alternative to corrective osteotomy for treating angular deformities of the extremities. It has the advantage of being minimally invasive and is effective in a growing child. This study reports on the outcome of guided growth technique using a plate in correcting knee angular deformities.

    Material and Methods: We conducted a retrospective study of children with angular deformity of the knee treated by the guided growth technique from January 2010 to December 2015 in a tertiary centre. The guided growth technique was done using either the flexible titanium plate (8-plate) or the 2-hole reconstruction plate. Correction of deformity was assessed on radiographs by evaluating the mechanical axis deviation and tibiofemoral angle. The implants were removed once deformity correction was achieved.

    Results: A total of 17 patients (27 knees) were evaluated. Twenty-two knees (81.5%) achieved complete correction of the deformity. The median age was 4.0 (interquartile range 3.0-6.0) years and the median Body Mass Index (BMI) was 26.0 (25.0-28.0). There were 7 unilateral and 10 bilateral deformities with different pathologies (14 tibia vara, 3 genu valgus). The median rate of correction was 0.71° per month. One patient (1 knee) had screw pull-out and two patients (4 knees) had broken screws in the proximal tibia. Three patients (5 knees) failed to achieve complete correction and were subsequently treated with corrective osteotomies. Out of five patients (8 knees) who were followed-up for at least 12 months after removal of hardware, two had rebound deformities. No permanent growth retardation occurred in our patients.

    Conclusion: Our outcome for guided growth to correct knee angular deformity was similar to other studies. Guided growth is safe to perform in children below 12 years old and has good outcome in idiopathic genu valgus and Langeskiold II for tibia vara. Patients should be observed for recurrence until skeletal maturity following implant removal.

  3. Mohamed-Zain NA, Jamil K, Penafort R, Singh A, Ibrahim S, Abdul-Rashid AH
    Malays Orthop J, 2021 Jul;15(2):122-128.
    PMID: 34429832 DOI: 10.5704/MOJ.2107.018
    Introduction: To compare the anxiety levels demonstrated by children during cast removal procedure between oscillating saw vs cast shear methods.

    Material and methods: A randomised prospective study of 102 children (mean age 8.3 ± 3.5 years) with fractures involving upper or lower limbs. Children undergoing removal of cast were divided into 2 groups; either by an oscillating saw or a cast cutting shear. The level of anxiety was assessed by recording the heart rate with a portable fingertip pulse oximeter before, during and after removal of the cast. Objective assessment was performed by documenting the fear level on Children's Fear Scale (CFS).

    Results: There was a significant increase in the heart rate of children during cast removal while using the oscillating saw compared to cast shear (p<0.05). The noise level produced by the saw exceeded 80 dB (mean 103.3 dB). The fear level was significantly lower in the cast shear group (p<0.05).

    Conclusion: The noise produced by the oscillating saw was associated with an increased anxiety level in children undergoing cast removal. Cast shear is a simple and inexpensive instrument that can be used for cast removal in overly anxious children.

  4. Mohd-Razali S, Ahmad-Affandi K, Ibrahim S, Abdul-Rashid AH, Abdul-Shukor N
    Malays Orthop J, 2023 Mar;17(1):180-183.
    PMID: 37064633 DOI: 10.5704/MOJ.2303.021
    Purpura fulminans (PF) is a severe clinical manifestation of Neisseria meningitides infection that is associated with high mortality rates in children. Survivors are frequently left with debilitating musculoskeletal sequelae. There is a paucity of reports on the musculoskeletal pathology of purpura fulminans. We report on a 2-year-old boy with purpura fulminans due to meningococcemia. The child developed distal gangrene in both the upper and lower limbs. Amputations were done for both lower limbs. Histological examination of the amputated specimens showed an inflammatory process and features of osteonecrosis. The latest follow-up at the age of 6 years showed a right knee valgus due to asymmetrical growth arrest of the proximal tibia. PF and its complications are challenging to treat and may require a multidisciplinary approach to improve patient's functional ability.
  5. Muhammad AS, Jamil K, Abdul-Rashid AH, Abd-Rasid AF, Aizuddin NA
    PMID: 38619601 DOI: 10.1007/s00590-024-03943-5
    PURPOSE: This study aims to compare the functional and radiological outcomes following both guided growth surgery (GGS) and acute corrective osteotomy (ACO) correction of angular deformities in children with rickets.

    METHODS: A total of 8 and 7 children who had gradual GGS and ACO correction, respectively, for angular deformities due to rickets from 2002 to 2022 were recalled for follow-up. Demographic data, types of rickets, data on pharmacological treatment, biochemical parameters, recurrence of angular deformity and postoperative complications were obtained from the medical records. A radiographic evaluation of the leg was performed to determine the tibiofemoral angle. For functional evaluation, the Active Scale for Kids (ASK) and Lower Extremity Functional Scale (LEFS) instruments were used for children below and above 15 years old, respectively.

    RESULTS: In terms of the tibiofemoral angle, the GGS group documented greater angle changes compared to the ACO group, but the difference was not significant. In terms of functional outcomes, the overall score percentage of both groups was comparable with the GGS group showing a trend of higher score percentage compared to the ACO group. The GGS group presented no complication while 2 neurovascular injuries and 1 implant failure were recorded in the ACO group.

    CONCLUSION: Both GGS and ACO procedures resulted in similar radiographic and functional outcomes for the treatment of rickets in children. GGS may be advantageous in terms of reducing complications of surgery. Nevertheless, the choice of surgical intervention should be made based on the patient's circumstances and the surgeon's preference.

  6. Abdul Ghani ZD, Husin JM, Rashid AH, Shaari K, Chik Z
    J Ethnopharmacol, 2016 Oct 7.
    PMID: 27725236 DOI: 10.1016/j.jep.2016.10.022
    Piper Betle L. (PB) belongs to the Piperaceae family. The presence of a fairly large quantity of diastase in the betel leaf is deemed to play an important role in starch digestion and calls for the study of weight loss activities and metabolite profile from PB leaf extracts using metabolomics approach to be performed. PB dried leaves were extracted with 70% ethanol and the extracts were subjected to five groups of rats fed with high fat (HF) and standard diet (SD). They were then fed with the extracts in two doses and compared with a negative control group given water only according to the study protocol. The body weights and food intakes were monitored every week. At the end of the study, blood serum of the experimental animal was analysed to determine the biochemical and metabolite changes. PB treated group demonstrated inhibition of body weight gain without showing an effect on the food intake. In serum bioassay, the PB treated group (HF/PB (100mg/kg and 500mg/kg) showed an increased in glucose and cholesterol levels compared to the Standard Diet (SD/WTR) group, a decrease in LDL level and increase in HDL level when compared with High Fat Diet (HF/WTR) group. For metabolite analysis, two separation models were made to determine the metabolite changes via group activities. The best separation of PCA serum in Model 1 and 2 was achieved in principle component 1 and principle component 2. SUS-Plot model showed that HF group was characterized by high-level of glucose, glycine and alanine. Increase in the β-hydroxybutyrate level similar with SD group animals was evident in the HF/PB(500mg/kg) group. This finding suggested that the administration of 500mg/kg PB extracts leads to increase in oxidation process in the body thus maintaining the body weight and without giving an effect on the appetite even though HF was continuously consumed by the animals until the end of the studies and also a reduction in food intake, thus maintaining their body weight although they were continuously consumed HF.
  7. Abdul Ghani ZDF, Ab Rashid AH, Shaari K, Chik Z
    Appl Biochem Biotechnol, 2019 Oct;189(2):690-708.
    PMID: 31111377 DOI: 10.1007/s12010-019-03042-w
    The present studies are to evaluate the ability of PB to induce weight loss and urine metabolite profile of Piper betle L. (PB) leaf extracts using metabolomics approach. Dried PB leaves were extracted with ethanol 70% and the studies were performed in different groups of rats fed with high fat (HFD) and normal diet (ND). Then, fed with the PB extract with 100, 300, and 500 mg/kg and two negative control groups given water (WTR). The body weights were monitored and evaluated. Urine was collected and 1H NMR-based metabolomics approach was used to detect the metabolite changes. Results showed that PB-treated group demonstrated inhibition of body weight gain. The trajectory of urine metabolites showed that PB-treated group gave the different distribution from week 12 to 16 compared with the control groups. In 1H NMR metabolomic approach analysis, the urine metabolites gave the best separation in principle component 1 and 3, with 40.0% and 9.56% of the total variation. Shared and unique structures (SUS) plot model showed that higher concentration PB-treated group was characterized by high level of indole-3-acetate, aspartate, methanol, histidine, and creatine, thus caused an increased the metabolic function and maintaining the body weight of the animals treated.
  8. Alias H, Abdul Rashid AH, Lau SCD, Loh CK, Sapuan J, Ibrahim S, et al.
    Front Pediatr, 2019;7:529.
    PMID: 31956645 DOI: 10.3389/fped.2019.00529
    Background: Congenital infantile fibrosarcoma (CIF) is a rare malignant soft tissue tumor that predominantly occurs in children under 1 year of age. CIF is frequently misdiagnosed with other conditions like hemangioma of infancy, infantile fibromatosis, or kaposiform hemangioendothelioma. Disseminated intravascular coagulopathy (DIVC) is rarely reported to be associated with CIF. Case presentation: We describe an infant who presented with a large mass over the right arm. She was initially treated conservatively as hemangioma but was later confirmed by tissue histopathological examination to have CIF as the mass rapidly increased in size. She developed massive intra-tumoral bleed with DIVC whilst receiving neoadjuvant chemotherapy requiring multiple blood products transfusion. An urgent near-total resection of the tumor was performed in view of life threatening bleeding despite multiple blood transfusions. Post-operatively, she received further adjuvant chemotherapy. Subsequently, she remained in complete remission 32 months off-treatment and has full function of the affected limb. Conclusions: CIF is an important condition to be considered in infant who has large mass over the extremity. DIVC could be associated with large CIF and when it occurs can be life-threatening. Whenever feasible early surgery should be performed in very young patients with large CIF to prevent mortality from bleeding.
  9. Jamil K, Abdul Rashid AH, Ibrahim S
    J Pediatr Orthop B, 2015 Jan;24(1):46-9.
    PMID: 25192368 DOI: 10.1097/BPB.0000000000000101
    Tibia vara and slipped upper femoral epiphysis (SUFE) share a common risk factor, but their relationship is unclear. In both conditions, the patients are usually obese. To the best of our knowledge, there have been only two previous reports in the literature that have described the occurrence of tibia vara and SUFE in three patients. We report a child who was treated for bilateral tibia vara at the age of 3 years and subsequently developed a SUFE at the age of 13 years.
  10. Abd Rashid AH, Ramli R, Ibrahim S
    Surg Infect (Larchmt), 2014 Oct;15(5):656-8.
    PMID: 24828080 DOI: 10.1089/sur.2012.192
    Clostridium perfringens myonecrosis following an elective surgical procedure in a previously healthy child is a rare incident.
  11. Sadeghilar A, Rashid AH, Ibrahim S
    J Pediatr Orthop B, 2014 May;23(3):244-6.
    PMID: 24445537 DOI: 10.1097/BPB.0000000000000033
    Dislocation or subluxation of the hip is considered as the most common hip problem in patients with Down syndrome. Recommended treatment of chronic dislocation treatment is open reduction combined with femoral and/or pelvis osteotomies. We report a Down syndrome child with chronic hip dislocation who was successfully treated with adductor tenotomy and closed reduction, which has not been reported previously.
  12. Jamil K, Abdul Rashid AH, Ibrahim S
    J Pediatr Orthop B, 2014 Mar;23(2):204.
    PMID: 24447939 DOI: 10.1097/01.bpb.0000434259.00524.7f
  13. Lloyd S, Rashid AH, Das S, Ibrahim S
    Anat Sci Int, 2014 Mar;89(2):122-5.
    PMID: 24158808 DOI: 10.1007/s12565-013-0211-0
    Tibial hemimelia is a rare anomaly of unknown etiology. This condition can occur sporadically or may have a familial inheritance. It is characterized by deficiency of the tibia with a relatively intact fibula. The anomaly may be unilateral or bilateral. We report a case of a 2-year-old girl who presented with right lower limb deformity since birth. She was diagnosed with proximal femur focal deficiency with absence of the ipsilateral tibia. She presented with a shorter right lower limb and a deformed foot. She was treated with a through-knee amputation. Anatomical dissection of the amputated limb was carried out to verify the anomalies. The dissection showed that the distal phalanx of the great toe was trifid. The anatomical and clinical significance of this interesting case is discussed.
  14. Muhammad Abdul Jamil MK, Abdul Rashid AH, Ibrahim S
    J Pediatr Orthop B, 2013 May;22(3):207-12.
    PMID: 22182834 DOI: 10.1097/BPB.0b013e32834ecc01
    This preliminary report is on two patients with congenital pseudoarthrosis of the tibia who had a persistent nonunion following intramedullary rodding and bone grafting. We do not advocate repeated surgery to achieve union. When limb length discrepancy becomes greater than 5 cm, we proceeded with an Ilizarov procedure with the primary aim of equalizing limb length rather than achieving union. Healing of the pseudoarthrosis occurred in both patients after lengthening over the intramedullary rod without compression of the nonunion site. We believe that union occurs because of hyperaemia during the lengthening. This approach minimizes the repeated surgeries that are usually needed and thus ensures a more normal childhood without frequent hospitalizations.
  15. Kadir KH, Abdul Rashid AH, Das S, Ibrahim S
    J Foot Ankle Surg, 2011 Mar-Apr;50(2):252-6.
    PMID: 21354013 DOI: 10.1053/j.jfas.2010.10.017
    Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.
  16. Khademolhosseini M, Abd Rashid AH, Ibrahim S
    J Pediatr Orthop B, 2013 Mar;22(2):123-6.
    PMID: 23222035 DOI: 10.1097/BPB.0b013e32835b2e14
    A retrospective study of nerve injuries with displaced supracondylar fractures of the humerus in children younger than 12 years of age, treated in Hospital Universiti Kebangsaan Malaysia. Our objectives were to determine the incidence of primary and iatrogenic nerve injuries in supracondylar humerus fractures Gartland types II and III and to determine the outcome of nerve recovery. A total of 272 patients with displaced supracondylar humerus fractures who required admission to Hospital Universiti Kebangsaan Malaysia from January 2000 to December 2007 were reviewed. There were 182 boys (67%) and 90 girls (33%). The mean age was 6.0 years, ranging from 1 to 12 years. Of 272 supracondylar fractures, 79 were type II and 193 were type III. Fifty-one (19%) patients had closed reduction, 160 (59%) had closed reduction and percutaneous crossed Kirschner (K) wires, and 61 (22%) had open reduction and crossed K-wires. Associated nerve injuries involving the median, radial, and ulnar nerves were observed in 48 (18%) patients. Nerve injuries were observed in nine (3%) patients upon admission. Thirty-nine (14%) patients developed nerve injuries following treatment. Of these 39 patients, 34 had ulnar, three had radial, and two had median nerve injuries. Nerve exploration was performed in five patients (in four patients following debridement of open fracture and in one because of unacceptable postoperative radiographs, and they subsequently underwent open reduction and exploration). Except for these five patients, the K-wires were not removed earlier nor were the nerves surgically explored in others. The nerve injuries resolved clinically on an average time of 3.5 months (range from 3 weeks to 8 months). Our study found complete resolution of all patients with nerve injuries confirmed by clinical assessment. On the basis of our study, we believe that there is no indication to remove the K-wires immediately or to explore the nerve surgically following a mini-open technique, which reduces the risk of penetrating a nerve during pinning.
  17. Abd Rashid AH, Ibrahim S
    Strategies Trauma Limb Reconstr, 2010 Dec;5(3):145-7.
    PMID: 21286359 DOI: 10.1007/s11751-010-0089-5
    Nonunion following diaphyseal forearm fracture is an uncommon complication in children. Compression plate fixation with bone grafting has been the standard method to treat this complication. We report a case of hypertrophic nonunion of the ulna in a child who was treated surgically using an elastic stable intramedullary nail (ESIN) without bone grafting. The nonunion healed 4 months after surgery.
  18. Anuar-Ramdhan IM, Remli R, Abdul-Rashid AH, Ibrahim S
    Malays Orthop J, 2020 Jul;14(2):126-129.
    PMID: 32983387 DOI: 10.5704/MOJ.2007.010
    Tardy ulnar nerve palsy is a known complication of cubitus valgus. The options for treating the ulnar neuropathy include anterior nerve transposition or neurolysis. We report on an 11-year-old boy who had a tardy ulnar nerve palsy due to cubitus valgus resulting from a non-union of a lateral condyle fracture of the humerus. Anterior transposition of the ulnar nerve was not done after the closing wedge osteotomy of the distal humerus. The close wedge osteotomy relieved the tension on the nerve and not transposing the ulnar nerve anteriorly prevented an iatrogenic nerve injury. The patient had no restriction with activities of daily living at the six years follow-up although neurological recovery was incomplete.
  19. Hayyun MF, Jamil K, Abd-Rashid AH, Ibrahim S
    Malays Orthop J, 2021 Mar;15(1):132-134.
    PMID: 33880161 DOI: 10.5704/MOJ.2103.021
    Femoral neck stress fractures are rare in children. To the best of our knowledge, the tension type stress fracture has been reported only twice in the English language literature. We report on a five years follow-up of a 10-year-old boy with this injury which was initially missed. The fracture healed after screw fixation. We highlight the importance of considering stress fracture as a differential diagnosis in a child with chronic hip pain. A careful physical examination and the appropriate imaging will avoid missing the diagnosis.
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