Displaying publications 41 - 60 of 147 in total

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  1. Khoo, S,M.
    Malays Orthop J, 2007;1(2):17-20.
    MyJurnal
    Traumatic hip dislocation in children is uncommon; when this condition is diagnosed in paediatric patients, it is most frequently seen as a unilateral posterior dislocation and is rarely associated with fracture. We report here a case involving a young girl who dislocated both hips in two separate incidents.
    Matched MeSH terms: Fractures, Bone
  2. Zainab Shakir Radif, Aidy Ali
    MyJurnal
    The fracture behaviour represents the most critical issue in the automotive and aerospace engine fields. Thus, the objective of this study was to estimate and analyze the crack criteria by using the
    Mathematical laws that were limited in E 1820 standard and the results affirmed by applying the numerical solutions of ANSYS to estimate the fracture toughness value KIC, besides the energy release rate of biomass composite. The specimens were prepared from different percentage of kenaf mat (KM) and unsaturated polyester resin (UP) 20% KM – 80% UP and 40% KM – 60% UP, respectively, as well the other composite properties which were calculated using the stress-strain data. The fracture characterizations of this composite were carried out using the compact tension (CT) specimen that was commonly used to determine Mode-I fracture properties. The fracture toughness has been found to be independent of pre-crack length. Meanwhile, the tests were performed at room temperature. The numerical simulations of the ANSYS model results demonstrated a good agreement between the experiments computed results of the fracture toughness. The fracture toughness KIC of 20% KM – 80% UP and 40% KM – 60% UP was equivalent to 0.76 MPa√m and 2.0 MPa√m, respectively. Thus, the fracture propagation is dependent on the fibre percentage of the composite. On the other hand, there are unlimited mechanisms of crack paths derived from randomly kenaf mat packs, particularly in the frontal process zone of crack tip.
    Matched MeSH terms: Fractures, Bone
  3. Zamzuri, Z., Nazri, M.Y., Amindudin, C.A., Azril, A., Shukrimi, A., Hafiz, A., et al.
    MyJurnal
    We report a case of a 14-year-old Malay male who fell at school and sustained bilateral olecranon fractures. He had undergone an open reduction and tension band wiring to stabilize the fracture. Three months after the surgery, the movement of both his elbows was satisfactory.
    Matched MeSH terms: Fractures, Bone
  4. Bajuri MY, Johan RR, Shukur H
    BMJ Case Rep, 2013;2013.
    PMID: 23576653 DOI: 10.1136/bcr-2013-008631
    Fat embolism syndrome (FES) is a continuum of fat emboli. Variants of FES: acute fulminant form and classic FES are postulated to represent two different pathomechanisms. Acute fulminant FES occurs during the first 24 h. It is attributed to massive mechanical blockage pulmonary vasculature by the fat emboli. The classic FES typically has a latency period of 24-36 h manifestation of respiratory failure and other signs of fat embolism. Progression of asymptomatic fat embolism with FES frequently represents inadequate treatment of hypovolaemic shock. We present a rare case of two variants of FES evolving in a patient with multiple fractures to emphasis the importance of adequate and appropriate treatment of shock in preventing the development of FES. Since supportive therapy which is a ventilatory support remains as the treatment of FES, it is appropriate to treat FES in the intensive care unit setting.
    Matched MeSH terms: Fractures, Bone/complications*; Fractures, Bone/radiography; Fractures, Bone/surgery
  5. Bajuri MY, Johan RR, Bahari SI
    BMJ Case Rep, 2013;2013.
    PMID: 23329712 DOI: 10.1136/bcr-2012-007697
    Chronic neglected subtalar dislocation associated with a non-union talar neck fracture is rare and never documented before. The lack of information from the literature on the optimal management prompted us to describe our experience in the management of this condition. We reported a case of a 57-year-old women presented with this injury. A satisfactory outcome was obtained using a tibio-talo-calcaneal arthrodesis through a plantar approach.
    Matched MeSH terms: Fractures, Bone/complications*; Fractures, Bone/diagnosis; Fractures, Bone/surgery
  6. Tan BB, Chan CY, Saw LB, Kwan MK
    Indian J Orthop, 2012 Nov;46(6):710-3.
    PMID: 23325978 DOI: 10.4103/0019-5413.104235
    Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS). We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery.
    Matched MeSH terms: Fractures, Bone
  7. Saravanan S, Zairul Anuar KB, Zulkefli A, Ramanathan R
    Med J Malaysia, 2014 Oct;69(5):216-8.
    PMID: 25638234 MyJurnal
    OBJECTIVE: The aim is to find rate of return to work of surgically treated thoracolumbar fracture patients and to know if back pain, compensation issues or neurological status influence this rate.

    METHODOLOGY: A retrospective cohort study analysing the patients with thoracolumbar fractures treated surgically from January 2008 till December 2009.

    RESULTS: Neurological status is the main factor deciding return to work in this group. Back pain and compensation related issues were not statistically significant in influencing return to work. 74% of patients in this group return to work.

    CONCLUSION: Return to work among the patients with thoracolumbar fracture, treated surgically, is mainly dependent on neurological status and not the compensation related issues or back pain.
    Matched MeSH terms: Fractures, Bone
  8. 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: Fractures, Bone
  9. Pan KL, Masbah O, Razak M
    Med J Malaysia, 2001 Jun;56 Suppl C:73-5.
    PMID: 11814255
    A case of late reconstruction of the patellar tendon is reported. Besides partial loss of the tendon, the patient also had loss of the distal third of the patella. A rolled strip of fascia lata was used to reconstruct the tendon with tunnels through the patella. At the tenth month of follow-up, the result was deemed successful.
    Matched MeSH terms: Fractures, Bone/radiography; Fractures, Bone/surgery*
  10. Azmi I, Razak M, Hyzan Y
    Med J Malaysia, 1998 Sep;53 Suppl A:59-70.
    PMID: 10968184
    Forty-one patients with 42 elbow dislocations, of which 13 had acute simple dislocations, 21 had fracture-dislocations and 8 had neglected elbow dislocations, were evaluated with regard to limitation of motion, pain, instability and residual neurovascular deficit. All patients with acute simple dislocation were treated with closed reduction, but the duration of immobilization before commencement of active motion varied. Open-reduction was indicated for failed closed reduction and neglected-dislocations. Internal fixation as a primary procedure was only performed for displaced fracture-dislocation. Excision of radial head or tricepsplasty were performed if the reduction was impossible in neglected elbow dislocation. Despite a good results in acute simple dislocation, 33.07% had flexion contracture of between 5 to 30 degrees. In fracture dislocation, satisfactory results were seen in whom the elbow was immobilized for three weeks or less. Neglected-dislocation is associated with poor functional outcome, 37.5% were good and 62.5% were poor. Prolonged immobilization after injury was strongly associated with an unsatisfactory result. The results indicate that early properly supervised active motion is a key factor in the rehabilitation of elbow dislocation.
    Matched MeSH terms: Fractures, Bone/complications; Fractures, Bone/therapy
  11. Iqbal QM
    Med J Malaysia, 1977 Mar;31(3):252-5.
    PMID: 904523
    Matched MeSH terms: Fractures, Bone/etiology*; Fractures, Bone/prevention & control
  12. Park KS, Chan CK, Lee GW, Ahn HW, Yoon TR
    Injury, 2017 Feb;48(2):388-393.
    PMID: 27914663 DOI: 10.1016/j.injury.2016.11.029
    INTRODUCTION: Anatomical reduction of displaced acetabular fracture is not without its' limitations and complications. This study is conducted to assess clinical and radiological outcomes as well as complications of treating displaced acetabular fractures with emphasis on anatomical reduction in weight-bearing area, mainly the posterior column, and imperfect reduction of the anterior column is acceptable. However, stability of both columns is mandatory.

    METHODS: It was a retrospective study carried out in a Level 1 arthroplasty and trauma centre. 23 patients (17 males, 6 females) with average age of 50.1 years (range, 36-68 years) with displaced acetabular fracture treated with combined incisions and plate-cable systems were included. There were 3 elementary and 18 associated fractures according to Letournel classification. Average follow-up was 23.5 months (range, 12-38.7 months). Mean operation time was 160min (range: 75-320min). Functional scores were evaluated using Harris Hip Score (HHS) whilst reduction was assessed by Matta criteria. Any displacement of reduction, osteoarthritis, heterotopic ossification, and other complications was recorded.

    RESULT: 65.2% (15/23) of the patients obtained excellent HHS and 21.7% (5/23) had good HHS. There were 12 anatomical, 6 imperfect, and 5 poor reductions. No displacement was recorded in final follow-up. Complications documented: three lateral femoral cutaneous nerve injuries, two conversions to total hip arthroplasty, three Brooker stage 1 heterotrophic ossification, one pulmonary embolism and one screw irritation. No incidence of wound breakdown, infection and radiological osteoarthritis was reported.

    CONCLUSIONS: Imperfect reduction of the anterior column provided clinical outcomes that are as good as total anatomical reduction. This approach minimizes soft tissue damage and reduces perioperative morbidities.

    Matched MeSH terms: Fractures, Bone/pathology; Fractures, Bone/surgery*
  13. Afshar R, Fong TS, Latifi MH, Kanthan SR, Kamarul T
    J Hand Surg Eur Vol, 2012 Jun;37(5):396-401.
    PMID: 22019989 DOI: 10.1177/1753193411424557
    The use of bicortical screws to fix metacarpal fractures has been suggested to provide no added biomechanical advantage over unicortical screw fixation. However, this was only demonstrated in static loading regimes, which may not be representative of biological conditions. The present study was done to determine whether similar outcomes are obtained when cyclic loading is applied. Transverse midshaft osteotomies were created in 20 metacarpals harvested from three cadavers. Fractures were stabilised using 2.0 mm mini fragment plates fixed with either bicortical or unicortical screw fixation. These fixations were tested to failure with a three-point bending cyclic loading protocol using an electromechanical microtester and a 1 kN load cell. The mean load to failure was 370 N (SD 116) for unicortical fixation and 450 N (SD 135) for bicortical fixation. Significant differences between these two constructs were observed. A biomechanical advantage was found when using bicortical screws in metacarpal fracture plating.
    Matched MeSH terms: Fractures, Bone/physiopathology; Fractures, Bone/surgery*
  14. Mohd Fozi NF, Mazlan M, Shuid AN, Isa Naina M
    Curr Drug Targets, 2013 Dec;14(14):1659-66.
    PMID: 24093748
    Osteoporosis is a progressive disease of the skeleton characterised by bone fragility due to a reduction in bone mass and possibly to alteration in bone architecture that lead to a propensity to fracture with minimum trauma. Most osteoporotic fractures occur at locations rich in trabecular or cancellous bone and usually related to post menopausal women. Recently, silymarin received attention due to its alternative beneficial effect on bone formation. It is a mixture of flavonoids with powerful antioxidant properties. This review focuses on the use of milk thistle or silymarin for the treatment of osteoporosis that may be related to fracture bone. Silymarin shows potent antioxidant herb that may modulate multiple genes in favour of helping to build bone and prevent bone loss. In the mouse fracture healing model, silymarin supplementation improved tibial healing with elevated BMD and serum levels of ALP and osteocalcin. Silymarin also demonstrated clear estrogenic antiosteoporotic effects in bone structure. Silymarin appears to play a crucial role to prevent bone loss and might regulate osteogenesis and may be beneficial for fracture healing. If silymarin is considered for the use of post menopausal women, it may be used for the treatment of osteoporosis. It would be of great benefit to postmenopausal women to develop an oestrogen antagonist that is as potent and efficacious as oestrogen in preventing bone loss without the major side effect associated with HRT.
    Matched MeSH terms: Fractures, Bone/drug therapy*; Fractures, Bone/etiology; Fractures, Bone/metabolism; Fractures, Bone/pathology
  15. Labens R, Khairuddin NH, Murray M, Jermyn K, Ahmad RS
    Vet Surg, 2019 Jan;48(1):96-104.
    PMID: 30403407 DOI: 10.1111/vsu.13123
    OBJECTIVE: To assess fracture gap reduction and stability of linear vs triangular 4.5-mm lag screw repair of experimental, uniarticular, and complete forelimb proximal phalanx (P1) fractures.

    STUDY DESIGN: Experimental.

    SAMPLE POPULATION: Fourteen equine cadaver limbs/horses.

    METHODS: Simulated fractures were repaired with 2 lag screws under 4-Nm insertion torque (linear repair). Computed tomography (CT) imaging was performed with the leg unloaded and loaded to forces generated while walking. The fracture repair was revised to include 3 lag screws placed with the same insertion torque (triangular repair) prior to CT. The width of the fracture gap was assessed qualitatively by 2 observers and graded on the basis of gap measurements relative to the average voxel size at dorsal, mid, and palmar P1 sites. Interobserver agreement was assessed with Cohen's κ. The effect of repair type, loading condition, and measurement site on fracture gap grades was evaluated by using Kendall's τ-b correlation coefficients and paired nonparametric tests. Significance was set at P ≤ .05.

    RESULTS: Agreement between loading and fracture gap widening was fair in triangular (κ = 0.53) and excellent in linear (κ = 0.81) repairs. Loading resulted in fracture gap distraction in linear repairs (Plinear  = .008). Triangular repairs reduced fractures better irrespective of loading (Punloaded  = .003; Ploaded  

    Matched MeSH terms: Fractures, Bone/surgery; Fractures, Bone/veterinary*
  16. Hilmi I, Sunderesvaran K, Ananda V, Sarji SA, Arumugam K, Goh KL
    J Clin Endocrinol Metab, 2013 Jun;98(6):2415-21.
    PMID: 23553858 DOI: 10.1210/jc.2013-1147
    INTRODUCTION: Osteoporosis and osteopenia are well-recognized complications of inflammatory bowel disease. Previous studies have suggested that vitamin D deficiency is an important risk factor for the development of osteoporosis. We hypothesized that low vitamin D levels is the main reason for reduced bone mineral density in patients with inflammatory bowel disease. We aimed to study its potential role in Malaysia, which is a tropical country with 3 large ethnic groups. We also sought to examine the relationship between fracture risk and bone mineral density in this group.
    METHODOLOGY: Relevant history as well as 25-hydroxycholecalciferol (vitamin D) levels and bone mineral density were obtained. Normal, inadequate, and low vitamin D levels were defined as 61-160 nmol/L (24-64 ng/mL), 30-60 nmol/L (12-24 ng/mL), and less than 30 nmol/L (<12 ng/mL), respectively.
    RESULTS: Seventy-two patients were recruited. The prevalence of osteopenia and osteoporosis, respectively, were 58% and 17% in the spine and 51% and 14% in the hip. Mean vitamin D level in the group was low at 45.12 ± 17.4 nmol/L (18.05 ± 6.96 ng/mL), but there was no significant association between bone mineral density and vitamin D level. Twelve patients (16.7%) had a fragility fracture after the diagnosis of inflammatory bowel disease. The cumulative fracture incidence was 10% at 5 years and 35% at 10 years. There was a statistically significant association between osteoporosis of hip and a history of fracture (odds ratio 5.889; 95% confidence interval 1.41-24.53, P = .009).
    CONCLUSION: Osteoporosis is prevalent among Malaysian patients with inflammatory bowel disease and is associated with a 6-fold increased risk of fractures. Most inflammatory bowel disease patients had inadequate or low vitamin D levels, but there was no association between vitamin D levels and BMD.
    Matched MeSH terms: Fractures, Bone/etiology*; Fractures, Bone/epidemiology
  17. Saw A, Sallehuddin AY, Chuah UC, Ismail MS, Yoga R, Hossain MG
    Singapore Med J, 2010 Sep;51(9):702-8.
    PMID: 20938610
    The pattern of fracture, including the anatomical location and age distribution, may differ among urban and rural populations due to various factors such as the inhabitants' occupation and living environment.
    Matched MeSH terms: Fractures, Bone/diagnosis*; Fractures, Bone/pathology
  18. Abilash K, Mohd Q, Ahmad Z, Towil B
    Malays Orthop J, 2017 Jul;11(2):75-77.
    PMID: 29021885 MyJurnal DOI: 10.5704/MOJ.1707.013
    Ankylosing spinal disorders (ASD) tend to result in fractures and/or dislocations after minor trauma because of the altered biomechanical properties. The relative risk of traumatic vertebral fractures in patients with ankylosing spondylitis has been estimated as three times higher than in the general population. These spine traumas, which are located at cervical level in 81% of patients with ankylosing spondylitis, are complicated by neurological lesions in 65% of patients, due to the high inherent instability of these fractures. Traditional massage is an ancient practice in many parts of Asia. It has many benefits that are currently recognized world-wide. However, it can be dangerous and even lethal if practised without adequate knowledge and skill. We report a case of C6-C7 fracture-dislocation with complete neurology and neurogenic shock in a middle aged man with undiagnosed ankylosing spondylitis.
    Matched MeSH terms: Fractures, Bone
  19. Gaaz TS, Sulong AB, Ansari MNM, Kadhum AAH, Al-Amiery AA, Nassir MH
    Materials (Basel), 2017 Jul 10;10(7).
    PMID: 28773134 DOI: 10.3390/ma10070777
    The advancements in material science and technology have made polyurethane (PU) one of the most important renewable polymers. Enhancing the physio-chemical and mechanical properties of PU has become the theme of this and many other studies. One of these enhancements was carried out by adding starch to PU to form new renewable materials called polyurethane-starch composites (PUS). In this study, PUS composites are prepared by adding starch at 0.5, 1.0, 1.5, and 2.0 wt.% to a PU matrix. The mechanical, thermal, and morphological properties of PU and PUS composites were investigated. Scanning electron microscope (SEM) images of PU and PUS fractured surfaces show cracks and agglomeration in PUS at 1.5 wt.% starch. The thermo-mechanical properties of the PUS composites were improved as starch content increased to 1.5 wt.% and declined by more starch loading. Despite this reduction, the mechanical properties were still better than that of neat PU. The mechanical strength increased as starch content increased to 1.5 wt.%. The tensile, flexural, and impact strengths of the PUS composites were found to be 9.62 MPa, 126.04 MPa, and 12.87 × 10(-3) J/mm², respectively, at 1.5 wt.% starch. Thermal studies showed that the thermal stability and crystallization temperature of the PUS composites increased compared to that of PU. The loss modulus curves showed that neat PU crystallizes at 124 °C and at 127 °C for PUS-0.5 wt.% and rises with increasing loading from 0.5 to 2 wt.%.
    Matched MeSH terms: Fractures, Bone
  20. Hassan, N.H., Nik Muhamad, N.A.
    MyJurnal
    This study is a descriptive epidemiology on the frequency of injuries, characteristics, and type of injuries incurred during the 16th National SilatChampionships 2012 competitions. This was a retrospective study by using a Pre Hospital Care Emergency Medicine PPUKM Form. All injuries sustained during the competition days were documented. The total number of participants involved in this tournament was 158 (114 males and 44 females). 51.6% participants sustained various injuries during the competition. The common sites of injuries involved the upper and lower extremities. The injuries sustained consist of swelling, fracture, dislocation, muscle sprain, strain and others. Most of the injuries were minor and did not require hospitalization. This study identified that soft tissue injuries due to blunt trauma were common among the silatparticipants. Strict observation of the tournament regulations, vigorous training and protective measures or equipments may contribute to the absence of severe or serious injury.
    Matched MeSH terms: Fractures, Bone
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