Case Report: Case Report 1: Mrs P, a 27-year-old right-hand dominant female, was involved in a motor vehicle accident (MVA) and sustained an isolated Regan-Morrey type III ulnar coronoid process fracture. In view of the large coronoid process fragment causing elbow joint instability, she underwent an open reduction and internal fixation when the elbow swelling had subsided. An anterior approach was used to identify the fracture fragment and it was fixed with two half-threaded cancellous lag screws with washers to achieve an anatomical reduction. Postoperatively, she recovered with excellent outcome based on the Mayo elbow performance score (MEPS).Case Report 2: Mr M, a 23-year-old right-hand dominant gentleman, was involved in a MVA and sustained an isolated Regan-Morrey type III ulnar coronoid process fracture. During examination under general anesthesia, passive range of the movement of his right elbow was noted to be <90°due to the impaction of the fracture fragment. An open reduction through an anterior approach was performed and Kirschner wires were inserted to fix the coronoid process fracture. Kirschner wires were opted for the ease of post-operative removal as the patient was not keen to have a retained implant after recovery. He recovered with good outcome based on the MEPS.
Conclusion: Isolated fracture of the ulnar coronoid process is rare. Open reduction and internal fixation is mandatory for patients with coronoid process fracture and unstable elbow joint to achieve good functional outcomes.
OBJECTIVES: To determine the prevalence and severity of HAVS among tyre shop workers in Kelantan, Malaysia.
METHODS: A cross-sectional study involving 200 tyre shop workers from two districts in Kelantan was performed. Part one data were collected at the field using questionnaire, and hand-arm vibration was measured. Part two involved a set of hand clinical examinations. The workers were divided into high (≥5 m s-2 ) and low/moderate (<5 m s-2 ) exposure group according to their 8-hr time weighted average [A(8)] of vibration exposure. The differences between the two exposure group were then compared.
RESULTS: The prevalence of the vascular, neurological, and musculoskeletal symptoms was 12.5% (95% CI 10.16 to 14.84), 37.0% (95% CI 30.31 to 43.69), and 44.5% (95% CI 37.61 to 51.38) respectively. When divided according to their exposure statuses, there was a significant difference in the prevalence of HAVS for all three components of vascular, neurological, and musculoskeletal (22.68% vs 2.91%, 62.89% vs 12.62% and 50.52% and 38.83%) respectively. All the clinical examinations findings also significantly differed between the two groups with the high exposure group having a higher abnormal result.
CONCLUSION: Exposure to high A(8) of vibration exposure was associated with a higher prevalence of all three component of HAVS. There is a need for better control of vibration exposure in Malaysia.
DESIGN: Prospective, non-randomized trial.
SETTING: Naturalistic driving in Malaysia.
PARTICIPANTS: Heavy vehicle drivers in Malaysia were assigned to the Device (n = 25) or Control condition (n = 34).
INTERVENTION: Both conditions were monitored for driving events at work over 4-weeks in Phase 1, and 12-weeks in Phase 2. In Phase 1, the Device condition wore the device operated in the silent mode (i.e., no drowsiness alerts) to examine the accuracy of the device in predicting driving events. In Phase 2, the Device condition wore the device in the active mode to examine if drowsiness alerts from the device influenced the rate of driving events (compared to Phase 1).
MEASUREMENTS: All participants were monitored for harsh braking and harsh acceleration driving events and self-reported sleep duration and sleepiness daily.
RESULTS: There was a significant decrease in the rate of harsh braking events (Rate ratio = 0.48, p