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  1. Fulltext Retrospective Review of Kirschner Wire Fixation andCasting for Displaced Lateral Condylar Fracture of theHumerus in Children
    Gooi, S.G, Chee, E.K., Wong, C.L., Mohana, R., Khoo, E.H., Thevarajan, K.
    Malays Orthop J, 2008;2(2):17-20.
    MyJurnal
    This study was conducted to assess the optimum period for Kirschner wire fixation and cast immobilization for displaced lateral condylar fracture of the humerus in children. We retrospectively reviewed 12 patients with displaced lateral condyle humerus fracture, ranging in age from 3-9 y, with injuries that occurred between Jan 2005 and Dec 2006. All patients were treated with two Kirschner wire fixation and elbow immobilization. In all except 2 patients, the Kirschner wires were maintained for 3 to 4 weeks. Mean time for union was 3.78 weeks and mean humeroulnar arch motion at last review was 138.7 degrees. Only one patient had a 5 degree increased carrying angle in valgus as compared to the non-injured side, and 50% had prominent scars > 4mm. We conclude that fracture union can be expected within three to four weeks for most children after open reduction and fixation with 2 Kirschner wires.
    Matched MeSH terms: Retrospective Studies
  2. Fulltext Percentage of haemoglobin variants detected during HbA1c analysis in Hospital Kuala Lumpur
    Intan Nureslyna, S., Sabariah, M.N., Lim, C.R., Wan Nor Syafiqah, W.S., Chen, D.R., Choy, S.Y., et al.
    Malaysian Journal of Medicine and Health Sciences, 2013;9(2):13-17.
    MyJurnal
    HbA1c is an established index of glycaemic control and correlates strongly with risk of chronic diabetic complications. However, the accuracy of HbA1c measurement can be affected by many factors, among which is the presence of haemoglobin (Hb) variants. The aim of the study was to determine the percentage of Hb variant detected during HbA1c monitoring in Hospital Kuala Lumpur. The study also analysed non-reportable HbA1c results in the presence of Hb variants. A cross-sectional study using retrospective data of HbA1c results over five months’ period was analysed on Biorad Variant II Turbo, a high performance liquid chromatography (HPLC) assay. The Hb variants were grouped either as HbS, HbC, others (Hb variant apart from HbS or C), and a combination of HbS or C with Others. A total of 11,904 patients were included. Only 2.3% (273) had Hb variants; HbS trait (10.3%), others (89%), and the combination of HbS trait with others (0.7%). No patient with HbC variant or its combination was found. Only 2.2% of those with Hb variant had non-reportable HbA1c. Although the percentage of Hb variants detected during HbA1c analysis and non-reportable HbA1c results were low, their presence should be noted.
    Matched MeSH terms: Retrospective Studies
  3. Fulltext A trend analysis of major congenital anomalies in Penang, Malaysia
    Leela Anthony, Nagarajah Lee, Stephen Ambu, Lokman Hakim S.
    International e-Journal of Science, Medicine & Education, 2013;7(2):33-40.
    MyJurnal
    This study examined the trend of major congenital anomalies (CA) in the state of Penang using the ICD 10 database from 1999 to 2004. The data was collected from various health centres and hospitals. The aim was to study the magnitude of the problem for congenital anomalies in the state of Penang in terms of trends and also to calculate the incidence rate by districts. If a trend was noticed, this in turn will determine whether to carry out further in-depth studies in the future and to find out the linkages to the environment if any.
    Matched MeSH terms: Retrospective Studies
  4. Fulltext Discriminant and convergent validity of measurement tools in postgraduate medical education of a surgical-based discipline: towards assessment program
    Shahid Hassan, Mohamad Najib Mat Pa, Muhamad Saiful Bahri Yusoff
    Education in Medicine Journal, 2012;4(1):22-42.
    MyJurnal
    Background: Summative assessment in postgraduate examination globally employs multiple measures. A standard-setting method decides on pass or fail based on an arbitrarily defined cut-off point on a test score, which is often content expert’s subjective judgment. Contrary to this a standard-setting strategy primarily practices two approaches, a compensatory approach, which decides on overall performance as a sum of all the test scores and a conjunctive approach that requires passing performance for each instrument. However, the challenge using multiple measures is not due to number of measurement tools but due to logic by which the measures are combined to draw inferences on pass or fail in summative assessment. Conjoint University Board of Examination of Masters’ of Otolaryngology and Head-Neck Surgery (ORL-HNS) in Malaysia also uses multiple measures to reach a passing or failing decision in summative assessment. However, the standard setting strategy of assessment is loosely and variably applied to make ultimate decision on pass or fail. To collect the evidences, the summative assessment program of Masters’ of ORL-HNS in School of Medical Sciences at Universiti Sains Malaysia was analyzed for validity to evaluate the appropriateness of decisions in postgraduate medical education in Malaysia. Methodology: A retrospective study was undertaken to evaluate the validity of the conjoint summative assessment results of part II examination of USM candidates during May 2000-May 2011. The Pearson correlation and multiple linear regression tests were used to determine the discriminant and convergent validity of assessment tools. Pearson’s correlation coefficient analyzed the association between assessment tools and the multiple linear regression compared the dominant roles of factor variables in predicting outcomes. Based on outcome of the study, reforms for standard-setting strategy are also recommended towards programming the assessment in a surgical-based discipline. Results: The correlation coefficients of MCQ and essay questions were found not significant (0.16). Long and short cases were shown to have good correlations (0.53). Oral test stood as a component to show fair correlation with written (0.39-0.42) as well as clinical component (0.50-0.66). The predictive values in written tests suggested MCQ predicted by oral (B=0.34, P
    Matched MeSH terms: Retrospective Studies
  5. Fulltext A survey on physical factors and compressed breast thickness in voluntary mammography screening using ffdm system in malaysia: preliminary results
    Noriah Jamal, Humairah Samad Cheung, Siti Kamariah Che Mohamad, Ellyda Muhamad Nordin
    Jurnal Sains Nuklear Malaysia, 2013;25(1):29-34.
    MyJurnal
    This paper aims at presenting preliminary results of a survey on physical factors, namely tube
    potential (kV), tube current exposure time product (mAs) and compressed breast thickness (CBT)
    during voluntary mammography screening using Full-Field Digital Mammography (FFDM) System
    in Malaysia. Retrospective data were collected from 1128 FFDM images of 282 women from three
    major ethnic groups (Malay, Chinese and Indian) who underwent voluntary screening
    mammography at Breast Centre, International Islamic University Malaysia from January to March
    2008. Results from the present study were then compared with results from the previous study on
    Screen-Film Mammography System (SFM) according to the ethnic group for both Cranio-caudal
    (CC) and Mediol-Lateral (MLO) views. We found that the mean kV for CC view for the three ethnic
    groups are Malay (28), Chinese (28) and Indian (28), and for MLO view are Malay (29), Chinese
    (28) and Indian (29). These values are higher than the kV for SFM which were Malay (26), Chinese
    (27) and Indian (26) for CC and Malay (26), Chinese (27) and Indian (26) for CC and MLO views
    respectively. The mean mAs for CC and MLO views for FFDM were lower compared to SFM
    systems. These values were Malay (104), Chinese (108) and Indian (91) for CC views and Malay
    (106), Chinese (105), and Indian (94) for MLO views for the FFDM system. The values for SFM
    system are for CC and MLO views were Malay (120), Chinese (106) and Indian (126), and Malay
    (166), Chinese (132), Indian (183) respectively. The median CBT for CC and MLO views increased
    by 27% and 7% respectively on the FFDM compared to the SFM system. In conclusion, the FFDM
    operates with higher kV, lower mAs, and higher CBT when compared with SFM system. Median
    CBT on CC and MLO view with FFDM system are 27% and 7% higher respectively compared to
    the SFM. We are currently collecting data on mean glandular dose with FFDM systems to assess
    how the change in local mammography practice influences this value. This will allow comparison
    with related data from other parts of the world.
    Matched MeSH terms: Retrospective Studies
  6. Fulltext Bolton tooth-size dsicrepancies among University of Malaya's dental students
    Othman, S.A., Mookin, H., Asbollah, M.A., Hashim, N.A.
    Ann Dent, 2008;15(1):40-47.
    MyJurnal
    The objective of this retrospective study was to investigate what percentage of the dental students in the University of Malaya has a tooth size discrepancy. The sample comprised 40 good quality pre-treatment study models with fully erupted and complete permanent dentitions from first molar to first molar, which were selected from the dental students of the University of Malaya. The mesiodistal diameter tooth sizes were randomly measured manually from first molar to first molar using digital calliper (Mitutoyu) accurate to 0.01 mm, and the Bolton analyses for anterior and overall ratios were calculated by scientific calculator. Reproducibility analysis for intra- and interexaminer calibrations was assessed by measuring 10 study models twice, a week apart. A paired sample t-test and the correlation coefficient were used to evaluate the systematic and random errors of the measurements using Statistical Package for Social Sciences (SPSS) version 12.0. The reproducibility of the intra and inter-examiners for the sum of upper and lower mesiodistal tooth size were high (average mean difference = 0.62, r = 0.82). This study found 47.5% of the samples had anterior, and about 10% had overall· tooth width ratios greater than 2 standard deviations from Bolton's mean. Large percentage of the dental students of the University of Malaya has tooth size discrepancies outside of Bolton 2 standard deviations. It would seem prudent to routinely perform the tooth size analysis and include the findings into orthodontic treatment planning.
    Matched MeSH terms: Retrospective Studies
  7. Fulltext Conservative Treatment in Patients With Type 2 Odontoid Fracture - Functional Outcome Following Halovest Immobilization
    Zairul, A., Vicknesh, A., Zulkefli, A., Ramanathan, R.
    Malays Orthop J, 2010;4(2):13-16.
    MyJurnal
    Objective: to assess the severity of neck pain and functional status (neck motion and return to pre-injury daily activity) in patients with type 2 odontoid fracture following conservative treatment by halo vest immobilization. Methodology: A retrospective cohort study of 21 patients with type 2 odontoid fracture treated conservatively with halo ves immobilization from January 2007 and followed-up til December 2009. Fracture union and complications related to treatment were documented. At the final follow up visit (1 year post injury), the patient’s neck pain, neck range o motion and return to pre-injury daily activities were assessed. Result: Twenty-one patients were included in the study. Fracture union was documented in 17 patients (81%) only 4 suffered from nonunion. Despite the good union rate only 8 patients (38.1%) achieved a good neck range o motion and returned to pre injury daily activity. Neck pain was minimal in all patients. Conclusion: Type 2 odontoid fractures treated with halo vest results in good union and minimal residual neck pain; however, it causes neck stiffness.
    Matched MeSH terms: Retrospective Studies
  8. Fulltext Bipolar Hemiarthroplasty in Elderly Patients Presenting WithDisplaced Intracapsular Femoral Neck Fractures ..
    Krishnan, H., Yoon, T.R., Park, K.S.
    Malays Orthop J, 2010;4(1):26-31.
    MyJurnal
    This retrospective study was undertaken to analyze perioperative parameters, functional outcomes and complications of cemented versus uncemented bipolar hemiarthroplasty in elderly patients presenting with displaced intracapsular femoral neck fracture. The authors reviewed 17 patients that underwent cemented bipolar hemiarthroplasty and 21 patients that underwent uncemented bipolar hemiarthroplasty. The mean follow-up duration in the cemented and uncemented group was 29.9 and 30.5 months respectively. Intraoperative and postoperative blood loss was higher in the cemented group. On the last follow-up the mean HHS was 74.7 in the cemented group and 84.2 in the uncemented group. No statistically significant difference was evident in the pain score. In summary, bipolar hemiarthroplasty was found to be a good option for displaced intracapsular femoral neck fractures, and overall outcome was marginally better in the uncemented group in terms of postoperative of blood loss and functional outcome at last follow up.
    Matched MeSH terms: Retrospective Studies
  9. Fulltext Retrospective review on patients admitted for violent crime in Permai Hospital, Malaysia
    Najwa Hanim, M.R., Abdul Kadir, A.B., Badiah, Y.
    Malaysian Journal of Psychiatry, 2011;20(1):1-8.
    MyJurnal
    Objective: To study the demographic data of patients and the pattern of crime in the study group, to look at the outcome of assessment by psychiatrist on fitness to plea and insanity at time of offense and to assess association between the nature of crime with presence of psychopathology during the crime. Method: This is a retrospective study. All available case notes for 342 forensic admissions from January 2007 until March 2010 were reviewed. All related information on 135 patients that committed violent crime was taken for analysis. Result: Majority of patients were male, Malay, single, education up to secondary school and unemployed. Only 38% of patients had encountered psychiatric services, 20% had previous imprisonment and 49% had history of substance usage. In cases involving victims (87%), 64% the victims were known to the patient, 53% had hallucination or delusion or both at the time of crime and 90% was found to have some diagnosis of mental illness after psychiatrist assessment. Only 81% of formal forensic reports were available in the case note and it showed 94% were fit to plea and 82% were at sound mind at the time of offense. Conclusion: Substance abuse had high prevalence among the patient. Almost 2/3 never had any encounter with psychiatric services before the admission. Even with the high percentage of patient diagnosed with mental illness, they were still found to be fit to plea in court and are at sound mind at the time of offense
    Matched MeSH terms: Retrospective Studies
  10. Fulltext Co-morbid physical illness among long-stay patients in a psychiatric institution
    Mohamad Isa, M.F., Tan, C.L., Gill, J.S.
    Malaysian Journal of Psychiatry, 2010;19(2):1-7.
    MyJurnal
    About 60% of people with mental illness developed co-morbid medical and physical illness that invariably worsens their lives. However, most of the studies regarding this issue were done either in the out-patient or community settings, ignoring long stay inpatients. Locally, no data exists among long stay patients in psychiatric institutions. The aim of this retrospective study was to look at the prevalence of physical illness among long-stay patients and to compare the occurrence of physical illness before and after admission to the psychiatric institution. We found that 85 (63.4%) out of 134 subjects there was suffering with co-morbid physical and medical illnesses. There were 33 (24.6%) subjects with hyperlipidaemia, 22 (16.4%) subjects with hypertension and 17 (12.7%) subjects with diabetes. Approximately 75 (55.9%) subjects developed medical illness after admission. In conclusion, long-stay psychiatric patients are at a high risk of developing medical problems that tends to begin after admission to the psychiatric institution.
    Study site: Hospital Bahagia, Ulu Kinta, Perak, Malaysia
    Matched MeSH terms: Retrospective Studies
  11. Fulltext Intertrochanteric fracture fixation with dynamic hip screw: is tip-apex distance measurement useful for predicting fixation failure?
    Goh, K.L., Zamzuri, Z., Mohd Ariff, S., Mohamed Azril, M.A.
    International Medical Journal Malaysia, 2016;15(1):31-34.
    MyJurnal
    Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness.
    Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication.
    Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration.
    Conclusion: TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture.
    KEYWORDS: Intertrochanteric fracture, dynamic hip screw, tip-apex distance, screw cut-out
    Matched MeSH terms: Retrospective Studies
  12. Fulltext Intra-articular hyaluronic acid (HA) and platelet rich plasma (PRP) injection versus hyaluronic acid (HA) injection alone in patients with grade III and IV knee osteoarthritis (OA): a retrospective study on functional outcome
    Saturveithan C, Premganesh G, Fakhrizzaki S, Mahathir M, Karuna K, Rauf K, et al.
    Malays Orthop J, 2016 Jul;10(2):35-40.
    PMID: 28435559 MyJurnal DOI: 10.5704/MOJ.1607.007
    Introduction: Intra-articular hyaluronic acid (HA) is widely utilized in the treatment of knee osteoarthritis whereas platelet rich plasma (PRP) enhances the regeneration of articular cartilage. This study analyses the efficacy of HA and PRP in grade III and IV knee osteoarthritis. Methodology: This is a cross sectional study with retrospective review of 64 patients (101 knees) which includes 56 knees injected with HA+ PRP, and 45 knees with HA only. Results: During the post six months International Knee Documentation Committee (IKDC) evaluation, HA+PRP group showed marked improvement of 24.33 compared to 12.15 in HA group. Decrement in visual analogue score (VAS) in HA+PRP was 1.9 compared to 0.8 in HA group. Conclusion: We propose intra-articular HA and PRP injections as an optional treatment modality in Grade III and IV knee osteoarthritis in terms of functional outcome and pain control for up to six months when arthroplasty is not an option.
    Study site: Melaka General Hospital, Malaysia
    Matched MeSH terms: Retrospective Studies
  13. Fulltext Physical and Clinical Evaluation of Hip Spica Cast applied with Three-slab Technique using Fibreglass Material
    Bitar KM, Ferdhany ME, Ashraf EI, Saw A
    Malays Orthop J, 2016 Nov;10(3):17-20.
    PMID: 28553442 MyJurnal DOI: 10.5704/MOJ.1611.008
    Introduction: Hip spica casting is an important component of treatment for developmental dysplasia of the hip (DDH) and popular treatment method for femur fractures in children. Breakage at the hip region is a relatively common problem of this cast. We have developed a three-slab technique of hip spica application using fibreglass as the cast material. The purpose of this review was to evaluate the physical durability of the spica cast and skin complications with its use. Methodology: A retrospective review of children with various conditions requiring hip spica immobilisation which was applied using our method. Study duration was from 1st of January 2014 until 31st December 2015. Our main outcomes were cast breakage and skin complications. For children with hip instability, the first cast would be changed after one month, and the second cast about two months later. Results: Twenty-one children were included, with an average age of 2.2 years. The most common indication for spica immobilisation was developmental dysplasia of the hip. One child had skin irritation after spica application. No spica breakage was noted. Conclusion: This study showed that the three-slab method of hip spica cast application using fibreglass material was durable and safe with low risk of skin complications.
    Matched MeSH terms: Retrospective Studies
  14. High burden of Carbapenem-resistant Enterobacteriaceae (CRE) fecal carriage at a teaching hospital: cost-effectiveness of screening in low-resource setting
    Zaidah AR, Mohammad NI, Suraiya S, Harun A
    Antimicrob Resist Infect Control, 2017;6:42.
    PMID: 28473912 DOI: 10.1186/s13756-017-0200-5
    BACKGROUND: Infections by multidrug-resistant gram-negative bacteria (MDR-GNB) have been continuously growing and pose challenge to health institution globally. Carbapenem-resistant Enterobacteriacea (CRE) was identified as one of the MDR-GNB which has limited treatment options and higher mortality compared to those of sensitive strains. We report an increased burden of CRE fecal carriage at a hospital in the North-eastern region of Malaysia.

    METHODS: A retrospective descriptive study from August 2013 to December 2015 was conducted in the Medical Microbiology & Parasitology laboratory of Hospital Universiti Sains Malaysia, which is a tertiary teaching hospital with more than 700 beds. This hospital treats patients with various medical and surgical conditions. Suspected CRE from any clinical specimens received by the laboratory was identified and confirmed using standard protocols. Polymerase chain reaction (PCR) assay was performed to determine the genotype.

    RESULTS: Altogether, 8306 Enterobacteriaceae was isolated from various clinical specimens during the study period and 477/8306 (5.74%) were CRE. Majority of the isolated CRE were Klebsiella [408/477, (85.5%)], of which Klebsiella pneumoniae was the predominant species, 388/408 (95%). CRE were mainly isolated from rectal swab (screening), 235/477 (49.3%); urine, 76/477 (15.9%); blood, 46/477 (9.6%) and about 7.1% from tracheal aspirate. One hundred and thirty-six isolates were subjected to genotype determination and., 112/136 (82.4%) showed positive detection of New Delhi metallo-β-lactamase 1 (NDM-1) gene (blaNDM1).

    CONCLUSION: The study noted a high numbers of CRE isolated especially from rectal swabs. Active screening results in significant cost pressures and therefore should be revisited and revised, especially in low resource settings.

    Matched MeSH terms: Retrospective Studies
  15. Total percutaneous endovascular aneurysm repair (pEVAR): the initial experience in Hospital Kuala Lumpur
    Leong BDK, Govindarajanthran N, Hafizan TM, Tan KL, Hanif H, Zainal AA
    Med J Malaysia, 2017 04;72(2):91-93.
    PMID: 28473670 MyJurnal
    INTRODUCTION: There has been a paradigm shift in the treatment of AAA with the advent of endovascular aneurysm repair (EVAR). Rapid progress and evolution of endovascular technology has brought forth smaller profile devices and closure devices. Total percutaneous endovascular aneurysm repair (pEVAR) involves the usage of suture-mediated closure devices (SMCDs) at vascular access sites to avoid a traditional surgical cutdown.

    MATERIALS AND METHODS: We retrospectively reviewed our experience of pEVAR between April 2013 and July 2014. Primary success of the procedure was defined as closure of a common femoral artery (CFA) arteriotomy without the need for any secondary surgical or endovascular procedure within 30 days.

    RESULTS: In total there were 10 pEVAR cases performed in the study period, one case in Queen Elizabeth Hospital during visiting vascular service. Patients have a mean age of 73.4 year old (66-77 year old) The mean abdominal aortic size was 7.2 cm (5.6-10.0cm). Mean femoral artery diameter was 9.0 mm on the right and 8.9 mm on the left. Mean duration of surgery was 119 minutes (98- 153 minutes). 50% of patients were discharged at post-operative day one, 30%- day two and 20%- day three. Primary success was achieved in 9 patients (90%) or in 19 CFA closures (95%). No major complication was reported.

    DISCUSSION: We believe that with proper selection of patients undergoing EVAR, pEVAR offers a better option of vascular access with shorter operative time, less post- operative pain, shorter hospital stay and minimises the potential complications of a conventional femoral cutdown.

    Matched MeSH terms: Retrospective Studies
  16. Bell's Palsy--a restrospective study
    Ing DK
    Med J Malaysia, 1974 Jun;28(4):248-50.
    PMID: 4278422
    Matched MeSH terms: Retrospective Studies
  17. Fulltext Retrospective review of facial nerve schwannomas: the universiti kebangsaan malaysia medical centre experience
    Mazita, A., Zahirrudin, Z., Saim, L., Asma, A.
    Medicine & Health, 2010;5(2):86-92.
    MyJurnal
    Facial nerve schwannoma is a rare slow growing benign tumour which arises from the Schwann cell of the neurilemma. A retrospective review of 6 patients who had been diagnosed with facial nerve schwannoma between 1998 and 2008 was conducted. There was equal distribution of male and female patients. The mean age was 42 years (range 19 to 66 years). The tumour originated in the internal auditory canal (2 patients), intra-temporal (3 patients) and intraparotid (1 patient) segments of the facial nerve. All tumours were successfully removed and facial nerve continuity was pre-served in 2 cases. The presenting symptoms of facial nerve schwannoma are non specific and dependent on the site of tumour origin. It is a great mimicker of other lesions that can present at the same location. The surgeon should have a high index of suspicion when patients present with progressive facial nerve palsy. Patients should always be counselled regarding risk of facial paralysis because the diagnosis of facial nerve schwannoma is often confirmed intra-operatively.
    Matched MeSH terms: Retrospective Studies
  18. Fulltext Treatment of Developmental Dysplasia of the Hip: Short and Mid-term Outcome
    Malays Orthop J, 2011;5(1):17-20.
    MyJurnal
    Objective: To review the presentation and outcome of developmental dysplasia of the hip (DDH) cases in the last 6 years. Methodology:We retrospectively reviewed the presentation as well as short and mid-term outcome of 17children (18 hips) with DDH seen and treated from 2004 to 2010. Treatment was either splinting with Pavlik harness,closed or open reduction depending on age at presentation and the individual needs of each patient. Results:Theaverage age at presentation was 31.1 months, and the male to female ratio was 1:4.6. Six patients (35%) presented early(less than 6 months old) while 7 patients (41%) presented between 6 -24 months. In these 2 groups splinting or closed reduction under anaesthesia was initially utilized for treatment depending on age, and open reduction was use dafter failure of closed reduction and for those presented late.Average age at the time of closed reduction was 11 months,and 6 years for those underwent open reduction. The average period of follow up for all patients was 29.4 months. The final outcome was successful in 12 hips (66%) in 11 patients.Ten of these presented at less than 2 years old, in the other 6 hips in which there was failure, 50% presented after 3 years of age. Conclusion:Late presentation of DDH is still common in Malaysia, which necessitates more complex management and more frequent occurrences of unfavourable results.
    Matched MeSH terms: Retrospective Studies
  19. Fulltext Use of the Tip-Apex Distance in predicting Dynamic Hip Screw Cut Out in Intertrochanteric Fracture of the Femur in Asian Population
    Malays Orthop J, 2011;5(2):24-27.
    MyJurnal
    The objective of this study was to assess the rate of screw cut out in elderly patients treated with the dynamic hip screw and the relationship to the Tip Apex Distance (TAD). This is a retrospective radiological evaluation of 100 cases of elderly patients with intertrochanteric fracture treated with dynamic hip screw fixation surgically treated between 1998 and 2002. The incidence of screw cut out was assessed and correlation of risk of cut out with the TAD was assessed. The rate of screw cut out was 9.0% and the average length of time to screw cut out was 3.8 months (range, 1 to 6 months) postoperatively. The incidence of screw cut out increased significantly when the TAD was 20 mm or more. The screw cut out rates were 2.9%, 20.0%, 30.8%, 50% and 100% for TAD of 20-24 mm, 25-29 mm, 30-34 mm, 35-44 mm and > 45 mm respectively. Overall, a TAD of 20mm or more was associated with a statistically significant screw cut out risk in this Malaysian population
    Matched MeSH terms: Retrospective Studies
  20. Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation
    Lee W, Kyaw MO
    Malays Orthop J, 2015 Jul;9(2):26-32.
    PMID: 28435606 MyJurnal DOI: 10.5704/MOJ.1507.008
    The optimal treatment for thoracolumbar fractures (TLF) without neurological deficit remains controversial. Majority of the systematic reviews and meta-analyses have evaluated open operative approaches but have yet to compare the outcomes of minimally invasive percutaneous pedicle fixation (MIPPF) versus non-operative treatment. A retrospective cohort study was performed to compare clinical and radiological outcomes between MIPPF and conservative groups for TLF AO Type A1 to Type B2 during a 2-year follow-up period. Pre-operative plain and CT films were evaluated and decision made for short segment (non-fusion) MIPPF. Patients who refused operation were treated conservatively with three months of body cast, brace, or corset. MIPPF group showed earlier Visual Analog Score(VAS) improvement at six months post-injury (0 vs 6.0- p<0.001), as well as better functional and radiological outcomes (p<0.050) at final follow-up. Progressions of regional kyphosis (RK) were noted in both groups but there was no significant difference within and between them(p>0.050). MIPPF as a method of internal bracing can be pursued in the treatment of TLF, with larger future cohorts and RCTs being called for to support and explore new findings.
    Matched MeSH terms: Retrospective Studies
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