MyMedR

Fulltext Knowledge on Bone Banking among Participants in an Orthopaedic Conference: A Preliminary Survey

Mohd S, Yusof N, Ramalingam S, Ng WM, Mansor A

Malays Orthop J, 2017 Jul;11(2):1-6.

PMID: 29021871 MyJurnal DOI: 10.5704/MOJ.1707.004

Despite increasing use of bone graft in Malaysia, there was still lack of data to quantify knowledge level on bone banking among orthopaedic community who are involved in transplantation related work. Therefore, a survey on awareness in tissue banking specifically bone banking, usage and choice of bone grafts was conducted. From 80 respondents, 82.5% were aware about tissue banking however only 12.5% knew of the existence of tissue banks in Malaysia. Femoral head was the bone allograft most often used as a substitute to autograft. Only 34.8% respondents preferred irradiated bone grafts whilst 46.9% preferred nonirradiated, indicating the need to educate the importance of radiation for sterilising tissues. Exhibition was the most preferred medium for awareness programme to disseminate information about bone banking in the orthopaedic community. The professional awareness is necessary to increase the knowledge on the use of bone graft, hence to increase bone transplantation for musculoskeletal surgeries in the country.

Matched MeSH terms: Orthopedics

Fulltext Multiple variations of the tendons of the anatomical snuffbox

Thwin SS, Fazlin F, Than M

Singapore Med J, 2014 Jan;55(1):37-40.

PMID: 24452976

Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis.

Matched MeSH terms: Orthopedics

Orthopaedic surgeons and the device industry: skeletons in the closet

Poduval M

Indian J Med Ethics, 2011 Apr-Jun;8(2):97-102.

PMID: 22106619

The relationship between orthopaedic surgeons and the device industry is one that is mutually beneficial and productive. However there are skeletons in the closet. The financial implications of this relationship have come under intense scrutiny. The sponsorships and the financial benefits of this symbiotic relationship have been found to cross the boundaries considered acceptable to ethical practice of the profession. In India, the ethical transgressions resulting from unhealthy associations between the orthopaedic surgeon and the industry have yet to be given due importance. Adequate rules and regulations are yet to be enforced and self-regulation is practically non-existent. It is essential to deal with the problem and potential implications that can arise from this kind of misconduct at the organisational level and enforce them for compliance.

Matched MeSH terms: Orthopedics/ethics*

Fulltext Radiation exposure to the surgeon during femoral interlocking nailing under fluoroscopic imaging

Muzaffar TST, Imran Y, Iskandar MA, Zakaria A

Med J Malaysia, 2005 Jul;60 Suppl C:26-9.

PMID: 16381279

Femoral interlocking nailing requires fluoroscopic assistance for insertion of the nail and distal screws. In this study, scattered radiation to the eye and hand of the operating surgeon was measured during the procedure. Thermo-luminescent dosimeter (TLD) was used to quantify the dose received by the surgeon. The mean radiation exposure time during the procedure was 3.89 minutes. The mean scattered radiation doses to the hand and eye were 0.27 mSv and 0.09 mSv per procedure respectively. These very low doses have made a surgeon very unlikely to receive more than the recommended annual dose limit set by the National Council on Radiological Protection.

Matched MeSH terms: Orthopedics*

Skills assessment for undergraduate orthopaedic education

Harwant S, Pravin D, Teng EM

Med J Malaysia, 2005 Aug;60 Suppl D:69-70.

PMID: 16315628

Matched MeSH terms: Orthopedics/education*

Fulltext The incidence of post-operative wound infection in orthopaedic surgery

Dhillon KS, Kok CS

Med J Malaysia, 1995 Sep;50(3):237-40.

PMID: 8926901

With the increase in the number of orthopaedic surgeons and the aggressive marketing by manufacturing companies, high technology orthopaedic surgery is being more frequently carried out in Malaysia. Post-operative sepsis complicating this type of surgery can have disastrous consequences. No data is available in this country on the incidence of post-operative infection in Orthopaedic Surgery. The aim of this study was to determine the incidence of post-operative infection. A retrospective survey of 703 patients undergoing elective Orthopaedic Surgery in the year 1991 was carried out. We found an overall post-operative infection rate of 6.8% and a deep infection rate of 3.3%. This figure of 3.3% is higher than the internationally accepted figure of less than 2%. A need for ongoing surveillance and concerned effort to reduce the infection rate is stressed.

Matched MeSH terms: Orthopedics/statistics & numerical data*

Fulltext A new clinical test for radial tunnel syndrome--the Rule-of-Nine test: a cadaveric study

Loh YC, Lam WL, Stanley JK, Soames RW

J Orthop Surg (Hong Kong), 2004 Jun;12(1):83-6.

PMID: 15237127 DOI: 10.1177/230949900401200115

Radial tunnel syndrome refers to pain on the lateral aspect of the forearm as a result of compression of the posterior interosseous nerve within a tunnel with specific anatomical boundaries. Diagnosis of the condition is difficult because of its close association with lateral epicondylitis, which warrants different methods of treatment. Based on a cadaveric study, a new clinical test, the Rule-of-Nine test, is proposed to improve the diagnostic accuracy in radial tunnel syndrome. The test involves constructing 9 equal squares on the anterior aspect of the forearm and noting those squares where tenderness can be elicited.

Matched MeSH terms: Orthopedics/methods*

Malaysian orthopaedic surgeons' approach to venous thromboembolic disease prophylaxis: attitudes and practice

Zairul-Nizam ZF, Gul YA

J Orthop Surg (Hong Kong), 2003 Dec;11(2):178-83.

PMID: 14676344

To survey Malaysian orthopaedic surgeons' attitudes to and use of venous thromboembolic disease prophylaxis.

Matched MeSH terms: Orthopedics*

Fulltext Personal protective equipment usage, recycling and disposal among spine surgeons: An Asia Pacific Spine Society survey

Chiu CK, Chan CYW, Cheung JPY, Cheung PWH, Gani SMA, Kwan MK

J Orthop Surg (Hong Kong), 2021 2 12;29(1):2309499020988176.

PMID: 33569998 DOI: 10.1177/2309499020988176

PURPOSE: In this study we investigated on the personal protective equipment (PPE) usage, recycling, and disposal among spine surgeons in the Asia Pacific region.

METHODS: A cross-sectional survey was carried out among spine surgeons in Asia Pacific. The questionnaires were focused on the usage, recycling and disposal of PPE.

RESULTS: Two hundred and twenty-two surgeons from 19 countries participated in the survey. When we sub-analysed the differences between countries, the provision of adequate PPE by hospitals ranged from 37.5% to 100%. The usage of PPE was generally high. The most used PPE were surgical face masks (88.7%), followed by surgical caps (88.3%), gowns (85.6%), sterile gloves (83.3%) and face shields (82.0%). The least used PPE were powered air-purifying respirators (PAPR) (23.0%) and shoes/boots (45.0%). The commonly used PPE for surgeries involving COVID-19 positive patients were N95 masks (74.8%), sterile gloves (73.0%), gowns (72.1%), surgical caps (71.6%), face shields (64.4%), goggles (64.0%), shoe covers (58.6%), plastic aprons (45.9%), shoes/boots (45.9%), surgical face masks (36.5%) and PAPRs (21.2%). Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE items compared to general waste.

CONCLUSIONS: The usage of PPE was generally high among most countries especially for surgeries involving COVID-19 positive patients except for Myanmar and Nepal. Overall, the most used PPE were surgical face masks. For surgeries involving COVID-19 positive patients, the most used PPE were N95 masks. Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE.

Matched MeSH terms: Orthopedics*

Clinical trials of intravenous tetracycline in traumatic and orthopaedic cases from the orthopaedic unit, General Hospital, Kuala Lumpur

Ismail AM

Med J Malaysia, 1963 Sep;18:59-63.

PMID: 14064300

Matched MeSH terms: Orthopedics*

Fulltext Development of decellularized meniscus using closed sonication treatment system: potential scaffolds for orthopedics tissue engineering applications

Yusof F, Sha'ban M, Azhim A

Int J Nanomedicine, 2019;14:5491-5502.

PMID: 31410000 DOI: 10.2147/IJN.S207270

PURPOSE: Meniscus is a fibrocartilagenous tissue that cannot effectively heal due to its complex structure and presence of avascular zone. Thus, tissue engineering and regenerative medicine offer an alternative for the regeneration of meniscus tissues using bioscaffolds as a replacement for the damaged one. The aim of this study was to prepare an ideal meniscus bioscaffold with minimal adverse effect on extracellular matrix components (ECMs) using a sonication treatment system.

METHODS: The decellularization was achieved using a developed closed sonication treatment system for 10 hrs, and continued with a washing process for 5 days. For the control, a simple immersion treatment was set as a benchmark to compare the decellularization efficiency. Histological and biochemical assays were conducted to investigate the cell removal and retention of the vital extracellular matrix. Surface ultrastructure of the prepared scaffolds was evaluated using scanning electron microscope at 5,000× magnification viewed from cross and longitudinal sections. In addition, the biomechanical properties were investigated through ball indentation testing to study the stiffness, residual forces and compression characteristics. Statistical significance between the samples was determined with p-value =0.05.

RESULTS: Histological and biochemical assays confirmed the elimination of antigenic cellular components with the retention of the vital extracellular matrix within the sonicated scaffolds. However, there was a significant removal of sulfated glycosaminoglycans. The surface histoarchitecture portrayed the preserved collagen fibril orientation and arrangement. However, there were minor disruptions on the structure, with few empty micropores formed which represented cell lacunae. The biomechanical properties of bioscaffolds showed the retention of viscoelastic behavior of the scaffolds which mimic native tissues. After immersion treatment, those scaffolds had poor results compared to the sonicated scaffolds due to the inefficiency of the treatment.

CONCLUSION: In conclusion, this study reported that the closed sonication treatment system had high capabilities to prepare ideal bioscaffolds with excellent removal of cellular components, and retained extracellular matrix and biomechanical properties.

Matched MeSH terms: Orthopedics*

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

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

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

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

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

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

Fulltext Fat Embolism Syndrome - A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management

Timon C, Keady C, Murphy CG

Malays Orthop J, 2021 Mar;15(1):1-11.

PMID: 33880141 DOI: 10.5704/MOJ.2103.001

Fat Embolism Syndrome (FES) is a poorly defined clinical phenomenon which has been attributed to fat emboli entering the circulation. It is common, and its clinical presentation may be either subtle or dramatic and life threatening. This is a review of the history, causes, pathophysiology, presentation, diagnosis and management of FES. FES mostly occurs secondary to orthopaedic trauma; it is less frequently associated with other traumatic and atraumatic conditions. There is no single test for diagnosing FES. Diagnosis of FES is often missed due to its subclinical presentation and/or confounding injuries in more severely injured patients. FES is most frequently diagnosed using the Gurd and Wilson criteria, like its rivals it is not clinically validated. Although FES is a multi-system condition, its effects in the lung, brain, cardiovascular system and skin cause most morbidity. FES is mostly a self-limiting condition and treatment is supportive in nature. Many treatments have been trialled, most notably corticosteroids and heparin, however no validated treatment has been established.

Matched MeSH terms: Orthopedics

Fulltext Coordinating a Postgraduate Orthopaedic Exam During the COVID-19 Pandemic

Mohamed-Haflah NH, Abdullah S, Abdul-Rani R

Malays Orthop J, 2021 Mar;15(1):16-20.

PMID: 33880143 DOI: 10.5704/MOJ.2103.003

The Coronavirus (COVID-19) pandemic and institution of the Movement Control Order (MCO) had resulted in the cancellation of a major orthopaedic exam in April 2020. The exam is known as the Malaysian Orthopaedic Specialist Committee (OSC) Part I Examinations. It is similar to the British Royal Colleges of Surgeons Membership (MRCS) exams and held twice annually in April and October. There are up to 200 candidates involved. With implementation of new guidelines and standard operating procedures (SOP), the OSC Part I exam was successfully held by Universiti Kebangsaan Malaysia (UKM) from 5th-9th October 2020. Here we highlight the challenges we faced whilst coordinating a major exam at a national level during the COVID-19 pandemic with recommendations for future exams.

Matched MeSH terms: Orthopedics

Fulltext Systemic Absorption of Gentamicin Irrigation in JointReplacement Surgery: A cause of concern

Lee, K.H., Ng, A.B.Y., Tan, T.B., Mossinac, K., To, B.C. Se

Malays Orthop J, 2008;2(2):11-15.

MyJurnal

Gentamicin, whether administered either intravenously, incorporated into bone cement or for local intra-operative irrigation, is a commonly used antibiotic in orthopaedic practice. The former two have been well studied, however the literature on the therapeutic efficacy and safety of gentamicin irrigation is sparse. The objective of this study was to assess systemic absorption of gentamicin irrigation in joint replacement surgery. This was a non-randomised, prospective study. Ninety-eight patients (group A) who underwent total joint replacement and 40 patients (group B) who underwent hemi-arthroplasty were treated traoperatively with gentamicin irrigation. Serum gentamicin levels were assayed at 4 hours and 24 hours post-surgery. Sixteen of 98 patients in group A (16%) and 12 out of 40 patients in group B (30%) were found to have serum gentamicin level above 2mcg/ml at 4 hours post-surgery. We conclude that intra-articular gentamicin irrigation is systemically absorbed at substantial levels.

Matched MeSH terms: Orthopedics

Displaying publications 41 - 60 of 105 in total