MyMedR

Leung PC

Med J Malaysia, 1986 Sep;41(3):260-3.

When referring to amputation, the immediate association tends to be amputation related to trauma. There is little doubt that injury is by far the commonest cause of amputation, but one must not forget that babies might also be born with amputations of the upper limb. This latter group of amelia composes the various types of congenital amputations.

Matched MeSH terms: Amputation, Traumatic/surgery

Qualitative study of prosthetic suspension systems on transtibial amputees' satisfaction and perceived problems with their prosthetic devices

Ali S, Abu Osman NA, Naqshbandi MM, Eshraghi A, Kamyab M, Gholizadeh H

Arch Phys Med Rehabil, 2012 Nov;93(11):1919-23.

PMID: 22579945 DOI: 10.1016/j.apmr.2012.04.024

To investigate the effects of 3 dissimilar suspension systems on participants' satisfaction and perceived problems with their prostheses.

Matched MeSH terms: Amputation, Traumatic/rehabilitation*

Fulltext Two stage penile reconstruction with free prefabricated sensate radial forearm osteocutaneous flap

Ramesh S, Serjius A, Wong TB, Jagjeet S, John R

Med J Malaysia, 2008 Oct;63(4):343-5.

PMID: 19385502 MyJurnal

Penile reconstructive surgeries are performed mainly as radical treatment for conditions associated with congenital abnormalities of the urethra or penis, after penile trauma, penile cancer, short penis, corporal fibrosis and in cases of gender reassignment. We present here a method of penile reconstruction with a pre fabricated radial forearm free flap incorporating the segment of the radius for structural support.

Matched MeSH terms: Amputation, Traumatic/surgery*

Infanticide in Malaysia: two case reports and a review of literature

Ong BB, Green M

Am J Forensic Med Pathol, 2003 Mar;24(1):64-9.

PMID: 12605001

In a strict and conservative society like Malaysia, the number of cases of infanticide has continued to occur. The authors present two typical cases of infanticide in Malaysia. Case 1 concerned a body of a fully mature newborn fetus disposed in a rubbish bin. The head was traumatically amputated by the rubbish truck's compactor. The umbilical cord was still attached to the body, with no reddening around the insertion. The severed neck showed features consistent with post-mortem amputation. The significant finding was expanded crepitant lungs, which floated in water. The histology of the lungs showed expanded alveoli. It was concluded that the baby had been born alive, but no cause of death could be elicited. Case 2 concerned a decomposed mature newborn found in a scrub forest. The internal organs showed advanced putrefaction, the lungs being collapsed, congested, and hemorrhagic, typical of decomposed lungs. No conclusion could be made about the state of birth or the cause of death because of the putrefied state of the body. The two cases illustrate the typical cases and problems faced by pathologists locally and probably elsewhere in the world. Most of the bodies are found in a putrefied state. Pathologists have to ascertain not only maturity and live birth but also the cause of death, which may be very subtle or masked by putrefaction. The problems of diagnosis of live birth are discussed.

Matched MeSH terms: Amputation, Traumatic/pathology

Fulltext Bilateral femoral neuropathy associated with disseminated intravascular coagulopathy: a case report

Cheok CY, Merican A, Ng WM

Med J Malaysia, 2006 Feb;61 Suppl A:97-9.

PMID: 17042241

We report a case of 20-year-old man who presented with bilateral femoral nerve palsy following resuscitation for traumatic massive blood loss and its consequence. A high suspicious index for this complication may lead to its early recognition. Its related pathoanatomy is discussed based on the described evidences in the literature. Nonoperative treatment remains as a recommended option for coagulopathy-related neuropathy.

Matched MeSH terms: Amputation, Traumatic/complications; Amputation, Traumatic/surgery*

Fulltext Automatic top loader washing machine related injury. A report of four cases with serious injury

Kwan MK, Saw A, Sara Ahmad T

Med J Malaysia, 2005 Mar;60(1):112-4.

PMID: 16250295 MyJurnal

We are reporting four cases of serious washing machine related injury that presented within a period of 5 months. All patients were young children with the mean age of 9 year-old and three had their dominant hand injured. The washing machines involved were the automatic top loader type and all injuries occurred during the spinning phase. Serious automatic washing machine injury is not uncommon in Malaysia. We feel that there is a need to improve the safety features especially during the spinning phase. The operating instructions and safety precautions on the washing machine should be displayed in different languages that can be understood well. Parents should also aware of the potential risks of this seemingly benign household appliance.

Matched MeSH terms: Amputation, Traumatic/etiology*

Fulltext Successful revascularisation of near total amputation of the upper limb after ten hours of warm ischaemia

Merican AM, Kwan MK, Cheok CY, Wong ELW, Sara TA

Med J Malaysia, 2005 Jun;60(2):218-21.

PMID: 16114164

Near total amputation of the upper limb if unsalvageable would cause severe disability. However, delayed revascularisation can be life threatening. We report two cases of revascularisation of the upper limb following near total amputation that was successful and functional after a warm ischaemic time of ten hours. The first was a traction avulsion injury of the arm leaving major nerves contused but in continuity. The second was a sharp injury through the mid-forearm attached by only a bridge of skin. Attempting revascularisation of a proximal injury beyond 6 hours, in selected cases is worthwhile.

Matched MeSH terms: Amputation, Traumatic/surgery*

Fulltext Hand replantation and revascularization--six years experience in Hospital Kuala Lumpur 1990-1995

Razana A, Hyzan MY, Pathmanathan V, Gill RS

Med J Malaysia, 1998 Sep;53 Suppl A:121-30.

PMID: 10968194

A retrospective study was conducted in 130 patients who underwent replantation or revascularization of 195 amputations in Hand and Microsurgery Unit Hospital Kuala Lumpur from 1990 to 1995. There were 130 patients with 195 amputations in the duration of 6 years study, which were mainly males (111 patients, 85.4%). The commonest age group involved was 19-25 years old (49 cases, 63.7%). There were 146 complete amputations replanted and 49 cases of incomplete amputations were revascularized. The commonest part involved was thumb and index finger (23% of cases each) and majority was caused by industrial accident (60.8%). However in pediatric age group home accident was the leading cause of the amputation (93.8%). The overall survival rate for the amputation was 65.6%. Revascularization had a better survival rate (77.6%) than replantation (61.6%). A clean cut wound and ischaemic time less than 12 hours gave better survival rate. However, there was no significant different chance of survival on distribution of injured parts and ischaemic time (< 12 hours).

Matched MeSH terms: Amputation, Traumatic/surgery

Fulltext Continuous brachial plexus block--regional anaesthesia for reimplantation surgery of the hand: a preliminary study

Sivarajah RS, Keh SA, Ong G, Teo WS, Delilkan AE

Med J Malaysia, 1984 Jun;39(2):112-5.

PMID: 6513849

Continuous brachial plexus block in six patients undergoing reimplantation of severed fingers or hand is described. The technique involved placement of a catheter within the neurovascular sheath enclosing the brachial plexus. This enabled us to give the local anaesthetic as required to last the whole duration of surgery.

Matched MeSH terms: Amputation, Traumatic/surgery*

Fulltext Economic impact of managing acute diabetic foot infection in a tertiary hospital in Malaysia

Lam AWC, Zaim MR, Helmy HH, Ramdhan IMA

Malays Orthop J, 2014;8(1):46-49.

MyJurnal

Diabetic foot disease is the leading cause of non-traumatic amputations of the lower limb, hence a major health care and socioeconomic burden. It has been found that most of the costs occur in the inpatient setting; therefore this study is to quantify the costs of managing inpatient diabetic foot infections (DFI). We treated 182 inpatients from May 2012 till April 2013 and analysed the cost of antibiotic usage, wound dressing, surgical procedure, admission and basic investigation costs. The total cost was ~ USD 11,000 (2013). This number, however, only reflects the cost for managing an acute infection. The price for follow-up care as an outpatient, rehabilitation and indirect costs (emotional suffering, reduced productivity) is estimated to be much more.
Study site: Diabetic Inpatient Registry, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia

Matched MeSH terms: Amputation, Traumatic

Satisfaction and problems experienced with wrist movements: comparison between a common body-powered prosthesis and a new biomechatronics prosthesis

Abd Razak NA, Abu Osman NA, Kamyab M, Wan Abas WA, Gholizadeh H

Am J Phys Med Rehabil, 2014 May;93(5):437-44.

PMID: 24429510 DOI: 10.1097/PHM.0b013e3182a51fc2

This report compares wrist supination and pronation and flexion and extension movements with the common body-powered prosthesis and a new biomechatronics prosthesis with regard to patient satisfaction and problems experienced with the prosthesis. Fifteen subjects with traumatic transradial amputation who used both prosthetic systems participated in this study. Each subject completed two questionnaires to evaluate their satisfaction and problems experienced with the two prosthetic systems. Satisfaction and problems with the prosthetic's wrist movements were analyzed in terms of the following: supination and pronation; flexion and extension; appearance; sweating; wounds; pain; irritation; pistoning; smell; sound; durability; and the abilities to open a door, hold a cup, and pick up or place objects. This study revealed that the respondents were more satisfied with the biomechatronics wrist prosthesis with regard to supination and pronation, flexion and extension, pain, and the ability to open a door. However, satisfaction with the prosthesis showed no significant differences in terms of sweating, wounds, irritation, pistoning, smell, sound, and durability. The abilities to hold a cup and pick up or place an object were significantly better with the body-powered prosthesis. The results of the survey suggest that satisfaction and problems with wrist movements in persons with transradial amputation can be improved with a biomechatronics wrist prosthesis compared with the common body-powered prosthesis.

Matched MeSH terms: Amputation, Traumatic/rehabilitation*

Replantation and revascularization of amputated upper limb appendages outcome and predicting the factors influencing the success rates of these procedures in a tertiary hospital: An 8-year retrospective, cross-sectional study

Kamarul T, Mansor A, Robson N, Albusaidi SH, Suhaeb AM, Samsudin EZ

J Orthop Surg (Hong Kong), 2018 1 13;26(1):2309499017749983.

PMID: 29320962 DOI: 10.1177/2309499017749983

PURPOSE: Worldwide advances in microsurgery have made salvaging of amputated hand via replantation and revascularization common procedures. The present study examines the outcome of these procedures in a tertiary hospital in Malaysia.

METHODS: Patients with hand amputation who underwent replantation or revascularization from 2005 to 2012 were identified and reviewed for patient characteristics, amputation characteristics and survival rates. Successfully treated patients were interviewed to assess the functional outcome using Quick Disability of the Arm, Shoulder and Hand (Quick-DASH) questionnaire and Michigan Hand Outcome Questionnaire (MHQ). Statistical analysis was performed to evaluate outcome and elicit predictive factors.

RESULTS: Fifty-five patients were enrolled: 37 (67.3%) underwent replantation and 18 (32.7%) underwent revascularization. The overall success rate of 78% ( n = 43) was within the range of previously reported data (61.6% to 96.0%). Ischaemic time <6 h provided significantly better survival rates ( p < 0.05). Functional outcomes were successfully assessed in 34 patients (79%), at a mean follow-up of 40 months (range 11-93 months). The overall Quick-DASH and MHQ scores were 42.82 ± 23.69 and 60.94 ± 12.82, respectively. No previous reports of functional outcome were available for comparison. Both Quick-DASH ( p = 0.001) and MHQ scores ( p < 0.001) were significantly higher for finger injuries, followed by thumb, wrist and palm injuries.

CONCLUSION: Ischaemic time and level of injury are important predictors of success rate of replantation and revascularization of amputated upper limb appendages.

Matched MeSH terms: Amputation, Traumatic/surgery*

Aesthetic refinements in second toe-to-thumb transfer surgery

Zhao J, Tien HY, Abdullah S, Zhang Z

Plast Reconstr Surg, 2010 Dec;126(6):2052-2059.

PMID: 21124145 DOI: 10.1097/PRS.0b013e3181f44994

BACKGROUND: Second toe-to-thumb transfer is a good alternative to using the great toe for reconstruction of the thumb. It achieves excellent function and reduces morbidity to the donor foot. However, cosmesis is often poor. The second toe has three unattractive features, a narrow "neck," a bulbous tip, and a short nail.

METHODS: The authors describe a modified second toe transfer that addresses cosmesis in six patients. These include (1) harvesting a flap from the adjacent side of the great toe and insetting it into the volar aspect of the second toe to give more bulk, (2) making skin excisions on each side of the tip to reduce the bulbous appearance, and (3) excising the eponychium to produce apparent lengthening of the nail.

RESULTS: The mean follow-up period was 18 months (range, 6 to 36 months). The procedure resulted in good function and improved cosmesis in all six cases. Part of the great toe flap was lost in one case. The mean two-point discrimination in the transferred toes was 10.1 mm, with protective sensation present in the flaps. The range of motion of the transferred toe was 14 to 38 degrees at the metatarsophalangeal joint, 16 to 55 degrees at the proximal interphalangeal joints, and 20 to 36 degrees in the distal interphalangeal joints. All patients except one were happy with the appearance of the transferred toe.

CONCLUSION: This novel approach will allow patients to take advantage of the lower morbidity to the donor site afforded by second toe-to-thumb transfer and provide the patients with a more aesthetic appearance of the new thumb.

Matched MeSH terms: Amputation, Traumatic/surgery*

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