Displaying publications 1 - 20 of 52 in total

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  1. RODDIE TW
    Med J Malaya, 1955 Dec;10(2):162-6.
    PMID: 13308617
    Matched MeSH terms: Orthopedic Procedures*
  2. Ramanathan R
    Med J Malaysia, 1998 Sep;53 Suppl A:99-101.
    PMID: 10968190
    We studied 95 patients who underwent knee Arthroscopy under local anaesthesia between JANUARY 1995 till 1997. Materials used were 1% Xylocaine and 0.25% Bupivacaine of 20 mls each combined with midazolam 2 mg and IV pethidine 30 mgm for sedation. The patients were attached to monitors (pulse Oxymeter, ECG and BP and pulse recorders) and blood less field was created using a tornquet. The procedures lasted about 45 minutes. 90 out of 95 patients completed the procedures successfully without any complications. 2 developed respiratory embarrassments and were intubated and ventilated. 3 procedures abandoned and converted to general anaesthesia. The range of procedures done include meniscectomy, meniscal repair, synovial biopsy, debridement for osteoarthrosis, shaving of osteophytes, drilling of cartilage and bones and removal of loose bodies. This study is to show that knee arthroscopy under LA is a safe alternative in hospitals where GA time is limited.
    Matched MeSH terms: Orthopedic Procedures
  3. Leow HK, Hyzan Y, Gan EC, Hassan S
    Med J Malaysia, 1998 Sep;53 Suppl A:71-6.
    PMID: 10968185
    Acromio-clavicular joint (ACJ) dislocation usually occurs in young adults following trauma or sports injury. Fourteen patients underwent surgical treatment for symptomatic total ACJ dislocation (Rockwood and Matsen Type III-VI) in our unit between January 1996 and June 1997. Eight patients were operated within three weeks of injury and six in the chronic period (after three weeks). In the acute group, two patients had Botsworth procedure and six had Weaver-Dunn operations. All six in the chronic group had Rockwood procedure. Nine patients achieved excellent outcome with full range of shoulder movement, pain free and return to work within three months of surgery. Two patients had good outcome. Three other patients had satisfactory outcome with tolerable pain and light duty at three months. Two patients developed chronic shoulder pain and one had painful hypertrophic surgical scar. Two patients had screw breakage requiring revision surgery. In conclusion, surgical treatment for ACJ dislocation produces good results. We suggest that surgical treatment be the treatment of choice for young patients requiring early recovery and good shoulder function.
    Matched MeSH terms: Orthopedic Procedures*
  4. Singh, H.
    MyJurnal
    It is very rare indeed in the practice of children's orthopaedics today in Malaysia that the natural history of long bone osteomyelitis is seen. A case is presented where a shoulder abscess in a 3-year-old child developed into septic arthritis of the shoulder and subsequently chronic osteomyelitis of the adjacent humerus. The parents refused active surgical debridement and sequestrectomies. Three years later the child had regenerated a new humerus over the sequestra. Radiographs are presented illustrating the entire natural history of osteomyelitis with the regeneration of a new humerus.
    Matched MeSH terms: Orthopedic Procedures
  5. Samsudin OC, Aminuddin BS, Munirah S, Chua KH, Fuzina NH, Isa MR, et al.
    Med J Malaysia, 2004 May;59 Suppl B:15-6.
    PMID: 15468796
    Treatment of articular cartilage lesions remains a clinical challenge. The uses of prosthetic joint replace allograft and/or autograft transplant carry a risk of complications due to infection, loosening of its component, immunological rejection and morbidity at the donor site. There has been an increasing interest in the management of cartilage damages, owing to the introduction of new therapeutic options. Tissue engineering as a method for tissue restoration begins to provide a potential alternative therapy for autologous grafts transplantations. We aimed to evaluate how well a tissue engineered neocartilage implant, consist of human articular chondrocytes cultured with the presence of autologous serum and mixed in a fresh fibrin derived from patient, would perform in subcutaneous implantation in athymic mice.
    Matched MeSH terms: Orthopedic Procedures*
  6. Faisham WI, Zulmi W, Saim AHM, Biswal BM
    Med J Malaysia, 2004 Dec;59 Suppl F:78-81.
    PMID: 15941172
    The clinical presentation and behaviour of giant cell tumour of bone vary. The progression of the disease and metastasis are unpredictable, but the overall prognosis is good. Six patients with pulmonary metastases of giant cell tumour have been treated at our institution since 1998. This represents 15% of all patients treated for giant cell tumour of the bone. Early detection and treatment of this tumour is important as complete resection of this tumour have favourable prognosis. Multiple lung nodules which preclude resection may remain dormant and asymptomatic with systemic chemotherapy.
    Matched MeSH terms: Orthopedic Procedures/methods
  7. Rasit AH, Sharaf I, Pan KL
    Med J Malaysia, 2004 Dec;59 Suppl F:52-3.
    PMID: 15941163
    Sleeve fracture of the inferior pole of the patella is a rare and distinctive fracture in children with few published reports. These fractures are frequently misdiagnosed and neglected. We highlight a case of a neglected and misdiagnosed sleeve fracture of the patella in an eleven-year-old boy. This was initially diagnosed as an avulsion fracture of the tibial tubercle. A good outcome was achieved after open reduction and internal fixation.
    Matched MeSH terms: Orthopedic Procedures/instrumentation
  8. Nizlan MNM, Suhail A, Samsudin OC, Masbah O
    Med J Malaysia, 2004 Dec;59 Suppl F:65-8.
    PMID: 15941168
    A case of traumatic posterior cruciate ligament (PCL) avulsion fracture presenting with unusual radiographic findings is described. CT scan of the right knee showed features suggestive of combined ACL and PCL avulsion fractures. Arthroscopic findings showed that the injury was in fact a PCL avulsion fracture that was displaced anteriorly so as to mimic an ACL avulsion fracture on CT scan.
    Matched MeSH terms: Orthopedic Procedures/instrumentation
  9. Yusof MI, Yusof AH
    Med J Malaysia, 2004 Dec;59(5):574-7.
    PMID: 15889557
    Staphylococcus aureus infection remains the commonest organism causing musculoskeletal infection and antibiotic is the mainstay of treatment apart from adequate and appropriate surgical intervention. The exact figure of antibiotic resistance in orthopaedic practice is not known but it is expected to be higher than previously reported as the use of antibiotics is rampant. Its sensitivity to various antibiotics differs from one center to another making local surveillance necessary. From 66 patients with musculoskeletal infections studied in our centre, Staphylococcus aureus was cultured in 50-65% of patients, depending on the sample taken. Fifteen percent of this were methicillin resistant Staphylococcus aureus (MRSA). Staphylococcus aureus was found to be sensitive to cloxacillin in 95% of patients' sample. MRSA remained highly sensitive to vancomycin, clindamycin and fucidic acid.
    Matched MeSH terms: Orthopedic Procedures/adverse effects*
  10. Chooi YS, Siow YS, Chong CS
    J Bone Joint Surg Br, 2005 Feb;87(2):257-9.
    PMID: 15736753
    We report a case of vertebral osteochondroma of C1 causing cord compression and myelopathy in a patient with hereditary multiple exostosis. We highlight the importance of early diagnosis and the appropriate surgery in order to obtain a satisfactory outcome.
    Matched MeSH terms: Orthopedic Procedures/methods
  11. Chidambaram S, Abd Halim AR, Yeap JK, Ibrahim S
    Med J Malaysia, 2005 Jul;60 Suppl C:91-8.
    PMID: 16381291
    Revision surgery following failed open reduction for developmental dysplasia of the hip (DDH) is technically demanding. We reviewed 12 patients in our institution that required a revision surgery between January 1994 and December 2003. The aims of this study are to identify the causes of redislocation after the primary open reduction and to determine the clinical and radiological outcome after the revision surgery. The mean age at presentation for DDH was 31 months (range 1-84) and the mean age at primary open reduction surgery was 38 months (range 15-84) and the mean age at revision surgery was 69 months (range 21-180). The mean follow-up period after revision surgery was 20 months (range 3-84). All the revision surgery was performed via an anterior Smith Peterson approach. The most common cause for redislocation was inadequate exposure and failure to release the obstructing soft tissues around the hip. The bony factors for redislocation included failure to perform a femoral shortening and excessive derotation of an anteverted femoral head combined with a Salter osteotomy. Three cases with posterior acetabular wall deficiency needed immobilization of the hip in extension as the hip tended to dislocate in flexion. Six patients had limb length discrepancy ranging from 1 cm to 4 cm and 50% developed avascular necrosis. Only 2 patients were asymptomatic and the majority had a limp and limitation of motion. All were pain free except one. In view of the technically demanding surgery and poor results after revision, the surgeon should recognize the pathology and ensure that the primary procedure achieves a stable and concentric reduction.
    Matched MeSH terms: Orthopedic Procedures*
  12. Piovella F, Wang CJ, Lu H, Lee K, Lee LH, Lee WC, et al.
    J Thromb Haemost, 2005 Dec;3(12):2664-70.
    PMID: 16359505
    BACKGROUND: The incidence of postsurgical venous thromboembolism is thought to be low in Asian ethnic populations.

    OBJECTIVE: We studied the incidence of deep-vein thrombosis (DVT) in Asian patients undergoing major orthopedic surgery of the lower limbs.

    PATIENTS/METHODS: We performed a prospective epidemiological study in 19 centers across Asia (China, Indonesia, South Korea, Malaysia, Philippines, Taiwan, and Thailand) in patients undergoing elective total hip replacement (THR), total knee replacement (TKR) or hip fracture surgery (HFS) without pharmacological thromboprophylaxis. The primary endpoint was the rate of DVT of the lower limbs documented objectively with bilateral ascending venography performed 6-10 days after surgery using a standardized technique and evaluated by a central adjudication committee unaware of local interpretation.

    RESULTS: Overall, of 837 Asian patients screened for this survey, 407 (48.6%, aged 20-99 years) undergoing THR (n = 175), TKR (n = 136) or HFS (n = 96) were recruited in 19 centers. DVT was diagnosed in 121 of 295 evaluable patients [41.0%, (95% confidence interval (CI): 35.4-46.7)]. Proximal DVT was found in 30 patients [10.2% (7.0-14.2)]. Total DVT and proximal DVT rates were highest in TKR patients (58.1% and 17.1%, respectively), followed by HFS patients (42.0% and 7.2%, respectively), then THR patients (25.6% and 5.8%, respectively). DVT was more frequent in female patients aged at least 65 years. Pulmonary embolism was clinically suspected in 10 of 407 patients (2.5%) and objectively confirmed in two (0.5%).

    CONCLUSIONS: The rate of venographic thrombosis in the absence of thromboprophylaxis after major joint surgery in Asian patients is similar to that previously reported in patients in Western countries.

    Matched MeSH terms: Orthopedic Procedures/adverse effects*
  13. Yeap JS, Lim JW, Vergis M, Au Yeung PS, Chiu CK, Singh H
    Med J Malaysia, 2006 Jun;61(2):181-8.
    PMID: 16898309
    The national clinical practice guideline has recommended that prophylactic antibiotic be given in orthopaedic surgery involving joint replacements and internal fixation of fractures. The aim of this study is to assess the current antibiotics prophylaxis practice in a state level hospital. One hundred and three patients (68 males, 35 females; mean age 41.6 +/- 22.2 years) undergoing internal fixation for closed fractures and joint replacement surgery were included in this prospective study. The choice of pre and post-operative antibiotics, their dosages and duration of administration were recorded. The pre-operative antibiotics were only deemed to have been given if it was documented in the case notes and in the case of post-operative antibiotics if it was signed on the drug chart. Eighty eight percent were given pre-operative prophylactic antibiotics and 92% were given post-operative antibiotics. For patients undergoing internal fixation of fractures, the most commonly used antibiotic for both pre and post-op is intravenous cefuroxime. For joint replacement surgery, the most commonly used antibiotic is intravenous cefoperazone. The duration or number of doses of post-operative antibiotics was highly variable. It was not stated in 56% of the post-operative instructions. Post-operative antibiotic was ordered for 48 hours or longer in 10%. In conclusion, prophylactic antibiotics appear to be widely practised. The first line antibiotics as recommended by the present guideline were not given in any of the patients. Second generation followed by third generation cephalosporins are the most popular antibiotics, with a trend towards using third generation cephalosporins in arthroplasty patients. Single dose prophylaxis was rarely practised.
    Matched MeSH terms: Orthopedic Procedures*
  14. Ng ES, Ting JR, Foo SL, Akram SA, Fadzlina AA, Alywiah JS, et al.
    Med J Malaysia, 2006 Dec;61 Suppl B:23-6.
    PMID: 17600989
    The conventional upper arm tourniquet used for hand and wrist operations may cause significant discomfort to patient when the procedure is performed under local anaesthesia. Forearm tourniquet causes less muscle ischeamia and pain. The discomfort experienced while using a forearm and upper arm tourniquet was assessed in 96 healthy subjects. Tourniquet placed on both sides was inflated sequentially to 250mmhg for five minutes on different hand. The discomfort level was assessed using a small visual analogue scale and complications were recorded. In the upper arm tourniquet, 24.9% had mild, 60.5% had moderate and 14.6% had severe pain whereas with forearm tourniquet, 99% had mild pain and only 1% had moderate pain. Seventy-nine percent of the subjects tested with forearm tourniquet had no discomfort at all. The average discomfort level for upper arm and forearm tourniquet was 4.72 and 0.39 respectively, which is statistically significant. Complications that were observed only in upper arm tourniquet included prolonged tingling, burning sensation and discomfort and stiffness of the upper limb. We concluded that forearm tourniquet was safe and well tolerated and should be used more often when indicated.
    Matched MeSH terms: Orthopedic Procedures/instrumentation*
  15. Pan KL, Ong GB, Potukuchi AP
    Med J Malaysia, 2006 Dec;61 Suppl B:55-7.
    PMID: 17600994
    We report a case of an 11-year-old boy with osteosarcoma of the proximal humerus treated with wide excision and reconstruction with a cement spacer-prosthesis. After seven years of follow-up, the patient is now almost a young adult. We present his current physical and functional status, which seems to defray the initial doubts regarding long-term problems when we chose this method of reconstruction.
    Matched MeSH terms: Orthopedic Procedures/instrumentation*
  16. Chan KY, Singh VA, Oun BH, To BH
    Med J Malaysia, 2006 Dec;61 Suppl B:3-7.
    PMID: 17605178
    Glove perforation during surgery has always been a matter of concern as it increases the infection rate and the risk of transmission of blood borne diseases. To determine the common causes, the site and the awareness of glove perforations in orthopaedic surgery, a prospective study was conducted to assess the rate of glove perforation during 130 consecutive orthopaedic operations. All gloves worn by the surgical team were assessed after the surgery using the water-loading test. A total of 1452 gloves were tested, and the rate of perforation was 3.58%. Most of these perforations (61.5%) were unnoticed. The main surgeons had the most perforations (76.9%), followed by first assistants (13.5%) and second assistants (9.6%). Most perforations occurred at the non-dominant hand. The commonest site of perforation was the index finger followed by the thumb. Shearing force with instruments accounted for 45% of the noticed perforations. Majority of these occurred during nailing procedures (33%) and internal fixation without the use of wires (19%). Our rate of glove perforation is similar to other series. Most of them went unnoticed and were mainly due to shearing injuries rather than perforation by sharps. Therefore, there is an increased risk of contamination and break in asepsis during surgery.
    Matched MeSH terms: Orthopedic Procedures/instrumentation*
  17. Mohamad F, Parent S, Pawelek J, Marks M, Bastrom T, Faro F, et al.
    J Pediatr Orthop, 2007 Jun;27(4):392-7.
    PMID: 17513958
    To evaluate the perioperative complications associated with surgical correction in neuromuscular scoliosis and to identify the risk factors associated with these complications.
    Matched MeSH terms: Orthopedic Procedures/adverse effects*
  18. Muhammad Anwar Hau A
    Med J Malaysia, 2008 Sep;63 Suppl C:74.
    PMID: 19227678
    Matched MeSH terms: Orthopedic Procedures/statistics & numerical data*
  19. J Orthop Surg (Hong Kong), 2011 Apr;19(1):1-2.
    PMID: 21519066
    Matched MeSH terms: Orthopedic Procedures/education; Orthopedic Procedures/history*
  20. Jamal SM, Fathil SM, Nidzwani MM, Ismail AK, Yatim FM
    Med J Malaysia, 2011 Aug;66(3):231-3.
    PMID: 22111446
    The study compared the effectiveness of ketamine and midazolam/fentanyl as procedural sedation and analgesia agents for reduction of fractures and dislocated joints. Forty-one adult patients were enrolled by convenience sampling. They were randomized to receive ketamine or midazolam/fentanyl. Depth of sedation, pain score, procedural outcome and memory of the procedure were documented. The ketamine group had deeper sedation, but there was no statistical difference in other variables between the two groups. Three patients in the midazolam/fentanyl group had oxygen desaturation. More adverse effects were associated with ketamine. Intravenous ketamine is as effective as midazolam/fentanyl for procedural sedation.
    Matched MeSH terms: Orthopedic Procedures/adverse effects
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