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  1. Kow, Ren Yi, Zaharul Azri Mustapha Zakaria, Ruben Jaya Kumar, Low ,Chooi Leng, Khairul Nizam Siron Baharom
    MyJurnal
    Multiple carpometacarpal joint (CMCJ) dislocations are rare and are easily missed. The anatomical configuration renders stability to the joints. As a result, a high-velocity impact is required to dislocate the joint. We present two cases of multiple carpometacarpal joint dislocations with different mechanisms of injury and their subsequent management at our centre. In case 1, a 29-year-old gentleman presented with acute dislocations of the CMCJs involving the right middle, ring, and little fingers. An open reduction and fixation with Kirschner wires were done to stabilize the dislocated CMCJs and he subsequently recovered. In case 2, a 25-year-old gentleman had the CMCJ dislocations detected late due to other more profound injuries. Partial arthrodesis was performed to address the instability of the CMCJs of the right index, middle and ring fingers. He subsequently recovered and returned to work 6-months postoperatively. The diagnosis of carpometacarpal joint dislocation can be easily missed especially when there is a concurrent distracting injury. It is crucial to maintain a high index of suspicion as early diagnosis and prompt treatment is paramount to yield a better outcome
  2. Kow, Ren Yi, Dhiauddin Hai Ismail, Jamaluddin Shafie, Ruben Jaya Kumar, Nor Hafliza Md Salleh, Low, Chooi Leng
    MyJurnal
    Marjolin’s ulcer is a malignant cutaneous ulcer
    that undergoes transformation from a previously
    traumatized or chronically inflammed skin.1 Causes
    leading to ulcerations can be burn injury, trauma,
    chronic osteomyelitis and varicose ulcers.2 It is named
    after a French surgeon, Jean Nicolas Marjolin, who
    first described the condition in patients who developed
    malignant ulcers from burn scars.3 We report a case of
    a chronic non-healing foot ulcer that has become a
    Marjolin’s ulcer after 12 years. (Copied from article).
  3. Kow, Ren Yi, Hazwan Ab Wahid, Ed Simor Khan Mor Japar Khan, Colin Komahen, Low, Chooi Leng, Ruben Jaya Kumar
    MyJurnal
    Cervical spine injury is commonly associated with
    road-traffic accidents. The true incidence of cervical
    spine injuries is unknown due to under-reporting of
    such injuries. Cervical spine injury is associated with
    high morbidity and mortality if it is missed. With the
    advancement of imaging modalities, the number of
    missed cervical injuries has reduced. Nevertheless, some
    clinicians are dependent solely on imaging tools to rule
    out cervical spine injury in a trauma victim. We report
    two cases of “near miss” C6 fracture to highlight the
    importance of a detailed clinical history and clinical
    examination with imaging as an adjunct to rule out
    cervical injury.
  4. Ren Yi Kow, Zamri Ab Rahman, Ruben Jaya Kumar, Zaharul Azri Mustapha@Zakaria, Low, Chooi Leng
    MyJurnal
    Femoral nailing is the overall “gold standard” in
    treating femoral shaft fractures. However, plate
    osteosynthesis at the femoral shaft is still being done
    in selected patients. We report a case of right femoral
    implant failure after a broad limited contact dynamic
    compression plate (LC-DCP) insertion and its
    subsequent management using our minimally invasive
    technique. Our technique is biologically compliant
    as well as cosmetically friendly. We converted a loadbearing
    implant into a load-sharing implant in view that
    obesity is a significant predictive factor of non-union in a
    femoral fracture treated with locking plate. The patient
    subsequently recovered well with no complication.
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