Displaying publications 21 - 40 of 106 in total

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  1. Fulltext The Malaysian Orthopaedic Association humanitarian mission to Indonesia and Sri Lanka
    Sharaf I, Saw A, Hyzan Y, Sivananthan KS
    Med J Malaysia, 2005 Jul;60 Suppl C:3-7.
    PMID: 16381273
    The tsunami which occurred off the west coast of North Sumatra on December 26, 2004 devastated the coastal areas of North Sumatra, South-West Thailand, South-East India and Sri Lanka killing more than a quarter of a million people. The destruction was enormous with many coastal villages destroyed. The other countries affected were Malaysia, Myanmar, Maldives, Bangladesh, Somalia, Kenya, Tanzania and the Seychelles. In January 2005, volunteers went in weekly rotation to Banda Aceh in collaboration with Global Peace Mission. These were Dr Hyzan Yusof, Dr Suryasmi Duski, Dr Sharaf Ibrahim, Dr Saw Aik, Dr Kamariah Nor and Dr Nor Azlin. In Banda Aceh, the surgical procedures that we could do were limited to external fixation of open fractures and debriding infected wounds at the Indonesian Red Crescent field hospital. In February, a team comprising Dato Dr K S Sivananthan, Dr T Kumar and Dr S Vasan spent a week in Sri Lanka. In Sri Lanka, Dato Sivananthan and his team were able to perform elective orthopaedic operations in Dr Poonambalam Memorial Hospital. We appealed for national and international aid and received support from local hospitals and the orthopaedic industry. International aid bound for Banda Aceh arrived in Kuala Lumpur from the Philippine Orthopaedic Association, the Chiba Children's Hospital in Japan and the Chinese Orthopaedic Association. The COA donated 1.5 tons of orthopaedic equipments. A special handing over ceremony from the COA to the Indonesian Orthopaedic Association was held in Putrajaya in March. Malaysia Airlines flew in the donated equipment to Kuala Lumpur while the onward flight to Aceh was provided by the Royal Malaysian Air Force. In April, Dr Saw Aik and Dr Yong Su Mei joined the Tsu-Chi International Medical Association for volunteer services on Batam Island, Indonesia. The MOA acknowledges the many individuals and organizations, both governmental and non-governmental, for their contributions in the humanitarian efforts.
    Matched MeSH terms: Orthopedics*
  2. Machining of bone: Analysis of cutting force and surface roughness by turning process
    Noordin MY, Jiawkok N, Ndaruhadi PY, Kurniawan D
    Proc Inst Mech Eng H, 2015 Nov;229(11):761-8.
    PMID: 26399875 DOI: 10.1177/0954411915606169
    There are millions of orthopedic surgeries and dental implantation procedures performed every year globally. Most of them involve machining of bones and cartilage. However, theoretical and analytical study on bone machining is lagging behind its practice and implementation. This study views bone machining as a machining process with bovine bone as the workpiece material. Turning process which makes the basis of the actually used drilling process was experimented. The focus is on evaluating the effects of three machining parameters, that is, cutting speed, feed, and depth of cut, to machining responses, that is, cutting forces and surface roughness resulted by the turning process. Response surface methodology was used to quantify the relation between the machining parameters and the machining responses. The turning process was done at various cutting speeds (29-156 m/min), depths of cut (0.03 -0.37 mm), and feeds (0.023-0.11 mm/rev). Empirical models of the resulted cutting force and surface roughness as the functions of cutting speed, depth of cut, and feed were developed. Observation using the developed empirical models found that within the range of machining parameters evaluated, the most influential machining parameter to the cutting force is depth of cut, followed by feed and cutting speed. The lowest cutting force was obtained at the lowest cutting speed, lowest depth of cut, and highest feed setting. For surface roughness, feed is the most significant machining condition, followed by cutting speed, and with depth of cut showed no effect. The finest surface finish was obtained at the lowest cutting speed and feed setting.
    Matched MeSH terms: Orthopedics/methods*
  3. Fulltext Predictive factors for success in surgery of the physically disabled
    Subramanian N
    Med J Malaysia, 1990 Sep;45(3):202-7.
    PMID: 2152081
    The following factors influencing vocational success or failure were selected and studied for their predictive value in a Rehabilitation Centre, age, family background, educational level, work history and work level, motivation, mental ability and physical disability. Graded numerical scores from 1 to 3 were assigned to these factors according to Lane et al. A cut-off score was tested and found to distinguish the successful from the unsuccessful groups. The individual factors found to differ significantly in the two groups were work history and skill, motivation, and physical disability. Mental ability, however, could not be tested adequately.
    Matched MeSH terms: Orthopedics*
  4. Fulltext Parametric evaluation of electrical discharge coatings on nickel-titanium shape memory alloy in deionized water
    Mansor AF, Azmi AI, Zain MZM, Jamaluddin R
    Heliyon, 2020 Aug;6(8):e04812.
    PMID: 32913911 DOI: 10.1016/j.heliyon.2020.e04812
    Nickel-titanium shape memory alloy (NiTi) has a unique capacity to restore its initial shape after deformation, which is highly applicable to orthopaedic implantations, especially for the minimization of invasive surgeries. The high nickel content of this alloy can lead to unfavourable effects on the human body upon dissolution; thus, a reliable barrier of coatings on the NiTi surface is required to alleviate the nickel migration and increase its biocompatibility. In this paper, analyses of a titanium oxide layer development on NiTi surface using electrical discharge coating (EDC) process is presented. The recast layer thickness, crater sizes, and surface roughness were characterized based on five parameters; polarity, discharge duration, pulse interval, peak current, and gap voltage. The results show that the discharge duration is the most significant parameter to influence all responses, followed by peak current. The surface characteristics of the EDC substrate is depending on the crater formations and is highly correlated with the discharge energy intensity. As a result, appropriate parametric conditions of the electrical discharge coating process can enhance the NiTi surface for future medical applications, without compromising the shape memory effect.
    Matched MeSH terms: Orthopedics
  5. Low-Cost Self-Made Arthroscopic Training Camera Is Equally as Effective as Commercial Camera: A Comparison Study
    Ling JL, Teo SH, Mohamed Al-Fayyadh MZ, Mohamed Ali MR, Ng WM
    Arthroscopy, 2019 02;35(2):596-604.
    PMID: 30611592 DOI: 10.1016/j.arthro.2018.08.038
    PURPOSE: To assess the effectiveness of a low-cost self-made arthroscopic camera (LAC) in basic arthroscopic skills training compared with a commercial arthroscopic camera (CAC).

    METHODS: One hundred fifty-three orthopaedic residents were recruited and randomly assigned to either the LAC or CAC. They were allocated 2 practice sessions, with 20 minutes each, to practice 4 given arthroscopic tasks: task 1, transferring objects; task 2, stacking objects; task 3, probing numbers; and task 4, stretching rubber bands. The time taken for participants to complete the given tasks was recorded in 3 separate tests; before practice, immediately after practice, and after a period of 3 months. A comparison of the time taken between both groups to complete the given tasks in each test was measured as the primary outcome.

    RESULTS: Significant improvements in time completion were seen in the post-practice test for both groups in all given arthroscopic tasks, each with P < .001. However, there was no significant difference between the groups for task 1 (P = .743), task 2 (P = .940), task 3 (P = .932), task 4 (P = .929), and total (P = .944). The outcomes of the tests (before practice, after practice, and at 3 months) according to repeated measures analysis of variance did not differ significantly between the groups in task 1 (P = .475), task 2 (P = .558), task 3 (P = .850), task 4 (P = .965), and total (P = .865).

    CONCLUSIONS: The LAC is equally as effective as the CAC in basic arthroscopic skills training with the advantage of being cost-effective.

    CLINICAL RELEVANCE: In view of the scarcity in commercial arthroscopic devices for trainees, this low-cost device, which trainees can personally own and use, may provide a less expensive and easily available way for trainees to improve their arthroscopic skills. This might also cultivate more interest in arthroscopic surgery among junior surgeons.

    Matched MeSH terms: Orthopedics
  6. Fulltext Operative internal fixation of isolated femoral diaphyseal fractures - is interlocking nail the best option?
    Zairul-Nizam, Z.F.
    International Medical Journal Malaysia, 2008;7(2):25-30.
    MyJurnal
    Femoral fractures are one of the commonest fractures encountered in orthopaedic practice. Over the years, treatment of this injury has evolved tremendously. The initial non-operative methods of reduction and stabilization have largely been replaced by operative fixation. There are currently three basic modes of internal fixation of femoral diaphyseal fractures in the adult age group: plate and screws, intramedullary Kuntscher nailing, and interlocking nailing. The objective of this study is to determine whether the so-called more ‘technologically advanced’ interlocking nailing results in better outcome compared to the more ‘traditional’ plate and screws, and Kuntscher nailing. It is found that, in terms of time to union and final function after an average of just under 2 years post-operative period, the group of patients who had interlocking nailing fared poorer. A review of relevant literature will then be presented.
    Matched MeSH terms: Orthopedics
  7. Fulltext In vitro Analysis of Antimicrobial Properties of CefuroximeImpregnated Bone Cement
    Suhail,A., Gunalan, Sabarul, A ., Shahril, Y., Salasawati, H., Masbah, O.
    Malays Orthop J, 2008;2(2):1-5.
    MyJurnal
    Infection after joint replacement surgery is problematic and difficult to treat. The utility of antibiotic laden bone cement for reduction of risk of infection in primary and revision joint replacement surgery has already been established in many studies. In this study, we examined the efficacy of bone cement containing cefuroxime, employing a modified in vitro Kirby-Bauer susceptibility model for investigation of 13 strains of organisms that are found in orthopaedic infections. Organisms investigated were broad spectrum and effective for Gram-positive, Gram-negative, aerobic organisms and anaerobes. Simplex P with added cefuroxime was effective against 8 out of 13 strains. Cefuroxime is stable during exothermic polymerisation of the cement, and is released from the cement at concentrations high enough to inhibit the growth of most organisms encountered after joint arthroplasty.


    Matched MeSH terms: Orthopedics
  8. Fulltext Conflicts of interest in orthopaedic surgery: The intertwining of orthopaedic surgery, peer review publications and corporate sponsorship
    Dhillon KS
    Malays Orthop J, 2015;9(1):47-59.
    MyJurnal
    Conflicts of interest in medicine has created deep concerns about the integrity of medicine and raised doubts about the trustworthiness of the medical professional. New stories of conflict of interest in medicine have become a commonplace. The interactions between the medical professional and the biomedical device as well as the pharmaceutical industry has become so pervasive that the primary interest of the medical professional in protecting and promoting the welfare of the patient has been compromised. The professional judgement and actions have been influenced by secondary interests, the major fungible and quantifiable being financial interest. The industry influence not only affects the way we practice orthopaedics but also affects medical education and peer review publications. Peer review publications have been shown to exaggerate benefits of the industry products while at the same time downplaying the risks. These conflicts of interest in orthopaedic surgery are particularly common in spinal and joint replacement surgery where joint replacement has been described as a ‘fashion trade’. The introduction of new products appears to be an uncontrolled experiment which has been hijacked by large corporations. This article explores the unhealthy pervasive interaction between the orthopaedic surgeon and the medical devices as well as the pharmaceutical industry. It highlights how the biomedical and the pharmaceutical industry dominate all aspects of the healthcare system. With its wealth and political clout, its influence is present everywhere, from the use of devices and drugs, research, publications, trials, education and even formulation of CGPs.
    Matched MeSH terms: Orthopedics
  9. Fulltext Preliminary in Vivo evaluation of bone healing in critical size bone defects implanted with an injectable calcium phospate bone cement (Osteopaste)
    Che Nor Zarida Che Seman, Zamzuri Zakaria, Zunariah Buyong, Mohd Shukrimi Awang, Ahmad Razali Md Ralib @ Md Raghib
    International Medical Journal Malaysia, 2017;16(11):23-23.
    MyJurnal
    A novel injectable calcium phosphate bone cement (osteopaste) has been
    developed. Its potential application in orthopaedics as a filler of bone defects has been
    studied. The biomaterial was composed of tetra-calcium phosphate (TTCP) and tricalcium
    phosphate (TCP) powder. The aim of the present study was to evaluate the
    healing process of osteopaste in rabbit tibia.(Copied from article).
    Matched MeSH terms: Orthopedics
  10. Dataset on optimization of EDM machining parameters by using central composite design
    Soundhar A, Zubar HA, Sultan MTBHH, Kandasamy J
    Data Brief, 2019 Apr;23:103671.
    PMID: 30788395 DOI: 10.1016/j.dib.2019.01.019
    Newly prepared titanium alloy (Ti-13Zr-13Nb (TZN)) using powder metallurgy is considered in this investigation. Titanium alloys (TZN) are used in hip and knee replacement for orthopedic implants. Conventional machining, TZN alloys produce higher tool wear rate and poor surface quality, but this can be reduced by Electrical Discharge Machining (EDM) method. Moreover, EDM produce good biological and corrosion resistant surface. In this research, experiments were conducted by considering the influential process factors such as pulse on time, pulse off time, voltage, and current. The experiments were designed based on Response Surface Methodology (RSM) of face centered central composite design. Analysis of Variance (ANOVA) was conducted to identify the significance process factors and their relation to output responses such as Electrode Wear Rate (EWR), Surface Roughness (SR) and Material Removal Rate (MRR). Further, an empirical model was developed by RSM in order to predict the output responses.
    Matched MeSH terms: Orthopedics
  11. Fulltext COVID-19 in Singapore and Malaysia: Rising to the Challenges of Orthopaedic Practice in an Evolving Pandemic
    Tay K, Kamarul T, Lok WY, Mansor M, Li X, Wong J, et al.
    Malays Orthop J, 2020 Jul;14(2).
    PMID: 32313613 DOI: 10.5704/MOJ.2007.001
    With the increasing number of COVID-19 cases and related deaths worldwide, we decided to share the development of this condition in Singapore and Malaysia. First few cases were diagnosed in the two countries at the end of January 2020, and the numbers have surged to thousands by end of March 2020. We will focus on strategies adopted by the government and also the Orthopaedic community of the two countries up till the beginning of April 2020. We hope that by sharing of relevant information and knowledge on how we are managing the COVID-19 condition, we can help other communities, and health care workers to more effectively overcome this pandemic.
    Matched MeSH terms: Orthopedics
  12. Can we safely deform a plate to fit every bone? Population-based fit assessment and finite element deformation of a distal tibial plate
    Harith H, Schmutz B, Malekani J, Schuetz MA, Yarlagadda PK
    Med Eng Phys, 2016 Mar;38(3):280-5.
    PMID: 26739124 DOI: 10.1016/j.medengphy.2015.11.012
    Anatomically precontoured plates are commonly used to treat periarticular fractures. A well-fitting plate can be used as a tool for anatomical reduction of the fractured bone. Recent studies highlighted that some plates fit poorly for many patients due to considerable shape variations between bones of the same anatomical site. While it is impossible to design one shape that fits all, it is also burdensome for the manufacturers and hospitals to produce, store and manage multiple plate shapes without the certainty of utilization by a patient population. In this study, we investigated the number of shapes required for maximum fit within a given dataset, and if they could be obtained by manually deforming the original plate. A distal medial tibial plate was automatically positioned on 45 individual tibiae, and the optimal deformation was determined iteratively using finite element analysis simulation. Within the studied dataset, we found that: (i) 89% fit could be achieved with four shapes, (ii) 100% fit was impossible through mechanical deformation, and (iii) the deformations required to obtain the four plate shapes were safe for the stainless steel plate for further clinical use. The proposed framework is easily transferable to other orthopaedic plates.
    Matched MeSH terms: Orthopedics
  13. Tribute to a pioneer and leader in orthopaedic surgery
    J Orthop Surg (Hong Kong), 2011 Apr;19(1):1-2.
    PMID: 21519066
    Matched MeSH terms: Orthopedics/education; Orthopedics/history*
  14. Fulltext Radiation exposure to operating theatre personnel during fluoroscopic-assisted orthopaedic surgery
    Radhi AM, Masbah O, Shukur MH, Shahril Y, Taiman K
    Med J Malaysia, 2006 Feb;61 Suppl A:50-2.
    PMID: 17042230
    Orthopaedic procedures especially dynamic hip screw (DHS) fixation, interlocking nailing (ILN) of the tibia and femur require fluoroscopic assistance. Frequent exposure to radiation is a major concern to members of the orthopaedic surgical team. This study was undertaken to measure shallow (skin) dose to the operating team personnel and deep (whole body) dose to the surgeon during such procedures in view to provide guidelines to the operating team members regarding the number of procedures allowable for them to perform or assist annually. Skin dose for the operating personnel and whole body dose for the operating surgeon during 25 procedures; ten cases of DHS, seven and six cases of ILN of the tibia and femur respectively, was measured using Thermoluminescent Dosimeter (TLD) chips. The shallow radiation dose for theatre personnel ranged from 0.19 mSy to 0.61 per case while the deep dose for the surgeon was 0.28, 0.55 and 0.81 mSy for seven cases of tibial ILN, ten cases of DHS and six cases of femur ILN respectively. The surgeon has the highest radiation exposure than other theatre personnel and the whole body exposure for DHS was higher than that of for ILN. However, the estimated cumulative dose was still far below the permissible annual dose limit.
    Matched MeSH terms: Orthopedics/manpower*; Orthopedics/methods
  15. Fulltext Musculoskeletal MRI protocol
    Tan S, Suraya A, Sa'don S, Ruzi A, Zahiah M
    Biomed Imaging Interv J, 2010 Apr-Jun;6(2):e16.
    PMID: 21611037 MyJurnal DOI: 10.2349/biij.6.2.e16
    The authors propose a musculoskeletal (MSK) magnetic resonance imaging (MRI) protocol using selected sequences for common orthopaedic indications. Selected sequences allow optimal visualisation of the indicated pathology while screening for other common conditions. The authors emphasise the need for standard positioning of the patient and standard orientation of scan planes to facilitate comparison with follow-up scans.
    Matched MeSH terms: Orthopedics
  16. Fulltext Fighting from the COVID-19 Frontline: A Junior Doctor's Perspective on Fear, Duty and Calling
    Rasappan K, Oh J
    Malays Orthop J, 2020 Nov;14(3):1-3.
    PMID: 33403055 DOI: 10.5704/MOJ.2011.001
    As the COVID-19 pandemic ravages the whole world, the frontline clinicians are tirelessly fighting to contain and manage the disastrous effects of the virus from their communities. Stress, despair, fear, physical and psychological burn out, decreased work out put and lowered morale are some side effects this endless battle has had on the frontline healthcare worker. Although there have been many accounts of surgeons working in the frontline, there have only been few reflections on this ongoing battle from the junior clinician's point of view. In this article, we feature the perspectives of young residents from the orthopaedic unit at the epicenter of the COVID-19 fight in Singapore. We highlight the thoughts, fears, emotions, morale, motivating factors and reflections of junior clinicians while they work at frontlines. Fear in a dangerous new environment and amidst uncertainty is natural. However, a doctor's call of duty goes far above fear.
    Matched MeSH terms: Orthopedics
  17. Fulltext Surgical Management of Freiberg Disease by Dorsal Closing Wedge Osteotomy
    Dhar SA, Mir NA, Dar TA
    Malays Orthop J, 2020 Nov;14(3):161-165.
    PMID: 33403078 DOI: 10.5704/MOJ.2011.025
    Introduction: The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg's infraction.

    Material and Methods: Twenty patients with Freiburg's infraction were admitted at our hospital over a period of six years. Patients with a normal plantar contour of the metatarsal head were included. All patients underwent a dorsal closing wedge osteotomy of the metatarsal.

    Results: The mean Leeds Movement Performance Index (LMPI) score was 84 (range 70-86). The mean metatarsal shortening was 2mm. the passive flexion restriction was 16° and extension restriction was 10°. Also, a strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r's = -0.85, P < .001).

    Conclusion: The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg's infraction.

    Matched MeSH terms: Orthopedics
  18. Fracture Non-Union: A Review of Clinical Challenges and Future Research Needs
    Stewart SK
    Malays Orthop J, 2019 Jul;13(2):1-10.
    PMID: 31467644 DOI: 10.5704/MOJ.1907.001
    Non-union of bone following fracture is an orthopaedic condition with a high morbidity and clinical burden. Despite its estimated global prevalence of nine million annually, the limit of bone regeneration therapy still results in patients living with pain, a reduced quality of life and associated psychological, social and financial repercussions. This review provides an overview of the current epidemiological and aetiological data, and highlights where the clinical challenges in treating non-union lie. Current treatment strategies are discussed as well as promising future research foci. Development in biotechnologies to treat non-union provides exciting scope for more effective treatment for this debilitating condition.
    Matched MeSH terms: Orthopedics
  19. Integration and Vascular Ingrowth of a Collagen Meniscal Implant: A Case Report
    Duarte-Silva M, Guerra-Pinto F, Camelo-Barbosa N, Beja-da-Costa P
    Malays Orthop J, 2019 Jul;13(2):38-41.
    PMID: 31467650 DOI: 10.5704/MOJ.1907.007
    Meniscectomy is the most common surgery in orthopaedics. The absence of meniscal tissue might be related to irreversible damage to the articular cartilage. Meniscal replacement is a tissue-engineering technique for post-meniscectomy syndrome. Its success depends on the implant integration which was vastly proven in animal model studies. Histological evidence is hard to obtain in humans due to ethical issues. We report a clinical case in which a collagen scaffold meniscal implant was harvested six months after implantation due to mechanical failure. Histological analysis was performed revealing vascularisation not only of the peripheral attachment of the implant but also on the anterior horn. These morphologic findings demonstrate that this implant allows the colonisation by precursor cells and vessels, leading to the formation of a fully functional tissue. This present report is one of the few independent reports of scaffold biological integration in the literature.
    Matched MeSH terms: Orthopedics
  20. Thermomechanical investigations of PEKK-HAp-CS composites
    Singh R, Singh G, Singh J, Kumar R, Rahman MM, Ramakrishna S
    Proc Inst Mech Eng H, 2019 Nov;233(11):1196-1203.
    PMID: 31545132 DOI: 10.1177/0954411919877979
    In this experimental study, a composite of poly-ether-ketone-ketone by reinforcement of hydroxyapatite and chitosan has been prepared for possible applications as orthopaedic scaffolds. Initially, different weight percentages of hydroxyapatite and chitosan were reinforced in the poly-ether-ketone-ketone matrix and tested for melt flow index in order to check the flowability of different compositions/proportions. Suitable compositions revealed by the melt flow index test were then taken forward for the extrusion of filament required for fused deposition modelling. For thermomechanical investigations, Taguchi-based design of experiments has been used with input variables in the extrusion process as follows: temperature, load applied and different composition/proportions. The specimens in the form of feedstock filament produced by the extrusion process were made to undergo tensile testing. The specimens were also inspected by differential scanning calorimetry and photomicrographs. Finally, the specimen showing the best performance from the thermomechanical viewpoint has been selected to extrude the filament for the fused deposition modelling process.
    Matched MeSH terms: Orthopedics
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