Displaying publications 61 - 80 of 119 in total

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  1. Chilmi MZ, Desnantyo AT, Widhiyanto L, Wirashada BC
    Malays Orthop J, 2020 Jul;14(2):145-148.
    PMID: 32983392 DOI: 10.5704/MOJ.2007.025
    In Indonesia, arthrodesis becomes a choice of treatment in the absence of ankle arthroplasty implants for young adults. Arthrodesis on ankle osteoarthritis (OA) often leads to functional impairment. Low tibiofibular osteotomy is an alternative and it has been known to be the preferable option for those in the productive-ages. A 22-year-old male with a previous history of a motorbike accident, operated eight years ago, came with persistent pain on the left ankle that has worsened over the years. Plain radiography with a tibial-ankle surface angle (TAS) of 74o (normally 88o-93o) indicated varus deformity. Osteotomy was performed on distal tibia above the syndesmotic joint, as well as on the middle third of fibula. Open wedge osteotomy of the tibia was corrected until the normal TAS angle was reached by fluoroscopy. Cortical allograft was used to fill the osteotomy gap. Instrumentation was performed using a clover leaf® plate with 6 screws insertion for fixation stability. All results were satisfactory. Twelve weeks post-operatively, the patient was performing activities normally. Four-month post-operative radiological evaluation showed fusion of graft and the angle of TAS of 89°. Post-operative functional assessment using the American Academy of Orthopaedic Surgeon (AAOS) Foot and Ankle Measurement (FAM) questionnaires showed significant improvement (pre 89, post 38).
    Matched MeSH terms: Ankle; Ankle Joint
  2. Fazreena Othman N, Salleh Basaruddin K, Hanafi Mat Som M, Shukry Abdul Majid M, Razak Sulaiman A
    Acta Bioeng Biomech, 2019;21(1):55-62.
    PMID: 31197285
    PURPOSE: The aim of this study was to examine the joint contact forces (JCF) between each limb as the LLD magnitude increases during walking activity.

    METHODS: Eighteen male healthy subjects volunteered to participate in the experiment. Walking gait analysis was conducted with eight different levels of insole to simulate the LLD, starting from 0 cm until 4.0 cm with 0.5 cm increment. Qualisys Track Manager System and C-motion Visual 3D biomechanical tools were used to analyse the results. Four joints (ankle, knee, hip, and pelvis) of lower limb of two legs were investigated. The increment of insoles was placed on the right leg to represent the long leg.

    RESULTS: The results suggest that the mean contact forces for all joints in the short leg were increased as the increment level increased. On the contrary, the mean contact forces in the long leg decreased when the LLD level increased. Among these four joints, JCF in hip shows a positive increment based on the ASI value. Means that hip shows the most affected joint as the LLD level increase.

    CONCLUSIONS: The result obtained in this study might help clinicians treat patients with a structural LLD for treatment plan including surgical intervention.

    Matched MeSH terms: Ankle/physiopathology
  3. Ong HK, Chinna K, Khoo SK, Ng WL, Wong BY, Chow KL, et al.
    Zoo Biol, 2012 Mar-Apr;31(2):219-28.
    PMID: 21480370 DOI: 10.1002/zoo.20387
    Logistic regression was applied to develop a morphometric sexing method of two closely related stork species that were previously sexed through amplification of the CHD gene. Tarsus length (TL) and bill length (BL) measurements were recorded from captive populations of adult Milky Stork (Mycteria cinerea) (n = 60) and Painted Stork (Mycteria leucocephala) (n = 58) at Zoo Negara Malaysia. Despite having monomorphic plumages, both stork species exhibited normal sexual size dimorphism in which males were significantly larger than females in the tested variables. Based on logistic regression analysis, BL correctly classified the sex of sampled individuals from Painted and Milky stork with an overall predicted accuracy of 94.8 and 90.0%, respectively. However, TL measurements generated a lower predicted accuracy level of 86.2% and a same accuracy level of 90% on the sex classification of individuals from Painted and Milky stork, respectively. By comparing the measurements of both species, only the average BL measurements of the Milky storks were significantly lower than that of Painted storks (t-test, P80.001). The logistic regression equation in this study may serve as a simple and more practical option for sexing Milky and Painted storks for their breeding and conservation programmes.
    Matched MeSH terms: Ankle/anatomy & histology
  4. Singh N, Pandey CR, Tamang B, Singh R
    Malays Orthop J, 2020 Jul;14(2):64-71.
    PMID: 32983379 DOI: 10.5704/MOJ.2007.014
    Introduction: The study was conducted to evaluate the efficacy of arthroscopic debridement, microfracture and plasma rich in growth factor (PRGF) injection in the management of type V (Scranton) osteochondral lesions of talus and its role in healing the subchondral cyst and cessation of progression of ankle osteoarthritis.

    Material and Methods: This is a prospective case series conducted on patients who were diagnosed with type V osteochondral lesions of talus. All the cases were treated with arthroscopic debridement, microfracture, and PRGF injections. The patients were evaluated for the healing of subchondral cysts and progression of osteoarthritis with radiography (plain radiographs and computerised tomography Scan). Also, the patients' outcome was evaluated with Quadruple Visual Analogue Scale, Ankle Range of Motion, Foot and Ankle Disability Index, Foot and Ankle Outcome Instrument and a Satisfaction Questionnaire.

    Results: Five male patients underwent arthroscopic debridement, microfracture and PRGF injection for type V osteochondral lesion of talus. The mean age of patients was 27.4 years (19-47 years). All the patients gave history of minor twisting injury. Subchondral cyst healing was achieved in all patients by six months post-surgery. However, four out of five patients had developed early osteoarthritic changes of the ankle by their last follow-up [mean follow-up 29 months (ranged 15-36 months)]. Despite arthritic changes, all the patients reported 'Good' to 'Excellent' results on satisfaction questionnaire and Foot and Ankle Disability Index and could perform their day to day activities including sports.

    Conclusion: Arthroscopic debridement, microfracture, and PRGF causes healing of the subchondral cyst but does not cause cessation of progression to osteoarthritis of ankle in type V osteochondral defects of talus. However, despite progress to osteoarthritis, patient satisfaction post-procedure is good to excellent at short-term follow-up.

    Matched MeSH terms: Ankle; Ankle Joint
  5. Aimanan K, Chea CH, Lim KY, Damodaran A
    BMJ Case Rep, 2019 May 24;12(5).
    PMID: 31129637 DOI: 10.1136/bcr-2018-228255
    Pseudoaneurysm of the ankle involving the posterior tibial artery is a rare presentation with only four paediatric cases previously reported in English literature. We report a new case following blunt trauma with the clinical presentation and management strategy. A 6-year-old boy presented with a pulsatile swelling at the medial aspect of ankle following a history of blunt trauma 3 weeks ago. Imaging confirmed pseudoaneurysm involving the distal posterior tibial artery. Excision of the pseudoaneurysm was performed without any complication.
    Matched MeSH terms: Ankle Injuries/complications
  6. Al-Quraishi MS, Ishak AJ, Ahmad SA, Hasan MK, Al-Qurishi M, Ghapanchizadeh H, et al.
    Med Biol Eng Comput, 2017 May;55(5):747-758.
    PMID: 27484411 DOI: 10.1007/s11517-016-1551-4
    Electromyography (EMG)-based control is the core of prostheses, orthoses, and other rehabilitation devices in recent research. Nonetheless, EMG is difficult to use as a control signal given the complex nature of the signal. To overcome this problem, the researchers employed a pattern recognition technique. EMG pattern recognition mainly involves four stages: signal detection, preprocessing feature extraction, dimensionality reduction, and classification. In particular, the success of any pattern recognition technique depends on the feature extraction stage. In this study, a modified time-domain features set and logarithmic transferred time-domain features (LTD) were evaluated and compared with other traditional time-domain features set (TTD). Three classifiers were employed to assess the two feature sets, namely linear discriminant analysis (LDA), k nearest neighborhood, and Naïve Bayes. Results indicated the superiority of the new time-domain feature set LTD, on conventional time-domain features TTD with the average classification accuracy of 97.23 %. In addition, the LDA classifier outperformed the other two classifiers considered in this study.
    Matched MeSH terms: Ankle Joint/physiology*
  7. Thor JA, Mohamed Hanapi NH, Halil H, Suhaimi A
    Pain Med, 2017 10 01;18(10):2041-2045.
    PMID: 28460075 DOI: 10.1093/pm/pnx063
    Matched MeSH terms: Ankle/blood supply
  8. Norhamizan Hamzah, Muhammad Aizuddin Bahari, Saini Jeffery Freddy Abdullah, Mazlina Mazlan
    Neurology Asia, 2015;20(1):49-58.
    MyJurnal
    Objective: To determine the incidence and predictors of early ankle contracture in adults with acquired brain injury. Methods: A prospective cohort study of patients admitted to Neurosurgical Intensive Care Unit (NICU), University Malaya Medical Centre and referred for rehabilitation within a period of 12 months. Adult patients with newly diagnosed acquired brain injury with no prior deformity to lower limbs, Glasgow Coma Scale ≤ 12, no concomitant spinal or lower limb injuries, medical stability at inclusion into the study and agreed to participate for the total duration of assessment (3 months) were recruited. We conducted weekly review of ankle muscle tone and measurement of ankle maximum passive dorsiflexion motion. The end point is reached if ankle contracture developed or completed 3 months post injury assessment. Results: The cohort included 70 patients, of which only 46 patients completed the study. Twenty-eight patients suffered from severe brain injury whilst 18 from moderate brain injury. Out of the 46 patients, 13 (28%) developed ankle contracture at the end of the study period. Abnormal motor pattern was significantly associated with incidence of ankle contracture, which included spasticity (p
    Matched MeSH terms: Ankle; Ankle Joint
  9. Sulaiman AR, Munajat I, Mohd EF
    Foot (Edinb), 2018 Sep;36:6-9.
    PMID: 30041040 DOI: 10.1016/j.foot.2018.01.001
    Limb lengthening of fibular hemimelia is associated with progressive ankle valgus deformity. We reported a successful tibial lengthening in fibular hemimelia without recurrence of ankle valgus in 2 cases. The procedure involved 2 stages. First stage was a resection of the fibular remnant followed by a bending osteotomy through the distal tibial physis before the age of 2 years old. The second stage was a tibia lengthening up to 25% of its original segmental length performed at the age of 5 years old. There was neither progressive ankle valgus nor distal tibial growth arrest observed at 4 years follow-up.
    Matched MeSH terms: Ankle Joint/surgery*
  10. Samal P, Mohapatra NC, Mishra J, Mylarappa A, Das P
    Malays Orthop J, 2020 Mar;14(1):84-87.
    PMID: 32296488 DOI: 10.5704/MOJ.2003.014
    Giant cell tumour of tendon sheath is a benign soft tissue lesion most commonly found in the flexor aspect of hand and wrist. However, it is uncommon in foot and ankle and rare in bilateral achilles tendon. We report a case of 17-year-old female who presented with progressive enlargement of bilateral achilles tendon for six months. MRI findings showed that most of the tumour had intermediate to low signal intensity. Histopathology confirmed the diagnosis of giant cell tumour of tendon sheath. To help the patient regain the strength of the achilles tendon and walking abilities, a large area of tendon tumour was excised, followed by reconstruction with transfer of the peroneus brevis (PB) and posterior tibial (PT) tendon autograft. At two years follow-up, functional result was satisfactory.
    Matched MeSH terms: Ankle; Ankle Joint
  11. Yusof NM, Fadzli AS, Azman WS, Azril MA
    Med J Malaysia, 2016 04;71(2):47-52.
    PMID: 27326940 MyJurnal
    INTRODUCTION: The understanding of the skin's vascular anatomy has improved in the last decade. It has lead to technique modification such as the staged procedure in performing sural flaps and improvement in the flap survival rate. The aim of this study was to evaluate the acute vascular complications (flap necrosis or congestion) of 29 patients who underwent distal base sural flap for coverage of wound around the ankle.

    METHODS: Twenty-four males and five females with a mean age of 37.1 years old underwent sural flap surgery to cover wounds at around the ankle. There were 12 cases of open fracture, five infected fractures, four spoke injuries, four degloving injuries and four diabetic foot ulcers. Twentythree cases were done as a single stage procedure while six as a two-stage procedure. The flaps were tunnelled under the skin in three cases.

    RESULTS: Twenty one flaps healed uneventfully, seven acute vascular complications occur in a single stage group: five developed partial necrosis, one had congestion with epidermolysis, and one had complete flap necrosis. Complications were treated by dressing or skin grafting and only one required a repeat flap surgery.

    CONCLUSIONS: Acute vascular complications may be minimised when sural flap is done in stages for elderly, diabetic, smokers and/or patients with large wound around the ankle. Even if the flap appears necrotic, the underlying structure may still be covered as the fasciosubcutaneous layer of the flap may still survive.
    Matched MeSH terms: Ankle/surgery*
  12. Raja NS
    J Microbiol Immunol Infect, 2007 Apr;40(2):178-82.
    PMID: 17446969
    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in southeast Asia and northern Australia. In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare but well-recognized manifestation of melioidosis. Patients with underlying medical conditions, such as diabetes mellitus, renal impairment, cirrhosis, and malignancy are at greater risk. The presentations of melioidotic septic arthritis often mimic other disease processes and patients may not always be clinically septic. We present a case of septic arthritis due to B. pseudomallei in a 66-year-old male with diabetes mellitus presenting with a history of fever and ankle swelling. Follow-up ankle X-ray showed soft tissue swelling. Synovial fluid and blood samples grew B. pseudomallei. The patient improved gradually after parenteral administration of ceftazidime (2 g 8-hourly) and cotrimoxazole (1440 mg 8-hourly). He was discharged on oral cotrimoxazole (1440 mg 12-hourly), doxycycline (100 mg 12-hourly), and chloramphenicol (500 mg 6-hourly) for 6 months. This case highlights the possible occurrence of melioidotic septic arthritis, and the importance of prompt initiation of appropriate antimicrobials to achieve good outcomes.
    Study site: Emergency department, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Ankle Joint/microbiology; Ankle Joint/pathology
  13. Amin NA, Nordin R, Fatt QK, Noah RM, Oxley J
    PMID: 25852937 DOI: 10.1186/s40557-014-0023-2
    OBJECTIVE: This study examined the relationships between psychosocial work factors and risk of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.

    METHODS: We conducted a cross-sectional study among 660 public hospital nurses. A self-administered questionnaire was used to collect data on the occurrence of WRMSDs according to body regions, socio-demographic profiles, occupational information and psychosocial risk factors. 468 questionnaires were returned (response rate of 71%), and 376 questionnaires qualified for subsequent analysis. Univariate analyses were applied to test for mean and categorical differences across the WRMSDs; multiple logistic regression was applied to predict WRMSDs based on the Job Strain Model's psychosocial risk factors.

    RESULTS: Over two thirds of the sample of nurses experienced discomfort or pain in at least one site of the musculoskeletal system within the last year. The neck was the most prevalent site (48.94%), followed by the feet (47.20%), the upper back (40.69%) and the lower back (35.28%). More than 50% of the nurses complained of having discomfort in region one (neck, shoulders and upperback) and region four (hips, knees, ankles, and feet). The results also revealed that psychological job demands, job strain and iso-strain ratio demonstrated statistically significant mean differences (p

    Matched MeSH terms: Ankle
  14. Khoo S, Felix L, Azura L, Manmohan S, Jeffry A
    Malays Orthop J, 2012 Nov;6(3):48-50.
    PMID: 25279058 MyJurnal DOI: 10.5704/MOJ.1207.006
    Heterotopic ossification (HO) is the growth of bone in soft tissue, and can be broadly classified into neurogenic, genetic and traumatic causes. The pathophysiology of HO remains unknown. This disorder is extremely rare in infants and can mimic or coexist with thrombophlebitis, cellulitis or osteomyelitis. Most importantly, HO has to be differentiated from bone-forming tumours such as osteosarcoma and osteochondroma. We report a case of traumatic HO in a fiveday- old newborn following intravenous cannulation of the right wrist and left ankle, with the latter complicated with osteomyelitis. We highlight the clinical and radiological features of HO and differential diagnoses of soft tissue ossification in early childhood.
    Matched MeSH terms: Ankle
  15. Barman P, Sidhwa H, Shirkhande PA
    J Glob Infect Dis, 2011 Apr;3(2):183-6.
    PMID: 21731307 DOI: 10.4103/0974-777X.81697
    Burkhloderia pseudomallei has recently gained importance as an emerging pathogen in India. It causes various clinical manifestations like pneumoniae, septicaemia, arthritis, abscess etc. Cases have been reported from Southeast Asia mainly Thailand, Malaysia, Vietnam, etc. In India, few cases have been reported mainly from the southern part of the country. Patient was a 65-year-old male and presented with fever 1 month back, cough and breathlessness for same period, swelling on both ankles from 7 days. B. pseudomallei was isolated from endotracheal secretions, blood cultures, leg wound. He was successfully treated with Imipenem and Doxycycline and put on maintenance therapy now, and is currently doing well.
    Matched MeSH terms: Ankle
  16. Anwar S, Hishamuddin A, Khairul AJ, Shamsul AJ, Razlan H, Said MS
    BMJ Case Rep, 2009;2009.
    PMID: 21687021 DOI: 10.1136/bcr.01.2009.1438
    We would like to report a case involving a 38-year-old woman who presented with knee and ankle swellings 2 weeks prior to admission. There were also multiple painful oral ulcers and a few skin sores on the wrist. She also had associated diarrhoea for 2 weeks. There was also marked loss of weight (6 kg in 2 weeks). Colonoscopy examination showed macroscopic and histopathological findings of Crohn's disease; however, skin histology showed extensive neutrophilic infiltration in the dermis, predominantly in the perivascular region. Her final diagnosis was Sweet's syndrome with Crohn's disease.
    Matched MeSH terms: Ankle
  17. Leong BDK, Ariffin AZ, Chuah JA, Voo SY
    Med J Malaysia, 2013;68(1):10-2.
    PMID: 23466759 MyJurnal
    INTRODUCTION: Peripheral arterial disease(PAD) and abdominal aortic aneurysm(AAA) are two important underdiagnosed vascular pathologies. As they share common risk factors with coronary arterial disease, we conducted a study to look at their prevalence among patients with acute coronary syndrome(ACS).
    MATERIALS AND METHODS: Patients with ACS admitted to Queen Elizabeth Hospital, Malaysia, from February 2009 till August 2009 were screened prospectively for PVD and AAA. Patients' data and clinical findings were gathered and analyzed. Measurements of ankle brachial index (ABI) and abdominal aortic diameter were performed by a single assessor. PAD was defined as ABI ≤ 0.9 or diabetic patients with signs and symptoms of PAD and absence of pedal pulses. AAA was defined as abdominal aortic diameter ≥ 3cm.
    RESULTS: 102 patients were recruited with mean age of 59.5 years old. Male: female ratio was 6:1. 40.2% of patients had NSTEMI; 45.1%, STEMI and 14.7%, unstable angina. Risk factors profile is as follows: hypertension- 68.6%, smoking- 56.9%, hypercholesterolemia- 52.9%, diabetes mellitus- 35.3% and history of stroke- 5.9%. Median ABI was 1.1 with lowest reading of 0.4. Mean abdominal aortic size was 2.0cm with largest diameter of 3.3cm. PAD was present in 24.5% of patients and AAA in 2.0%. 68.0% of patients with PAD were asymptomatic. Smoking and age more than 60 years were independent predictors for PAD among ACS patients.
    CONCLUSIONS: PAD is strongly correlated with CAD with old age and smoker as independent predictors. However, association between AAA and ACS could not be established.
    Study site: Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
    Matched MeSH terms: Ankle Brachial Index
  18. Salleh Hudin N, De Neve L, Strubbe D, Fairhurst GD, Vangestel C, Peach WJ, et al.
    Ecol Evol, 2017 08;7(16):6163-6171.
    PMID: 28861222 DOI: 10.1002/ece3.3114
    Several studies on birds have proposed that a lack of invertebrate prey in urbanized areas could be the main cause for generally lower levels of breeding success compared to rural habitats. Previous work on house sparrows Passer domesticus found that supplemental feeding in urbanized areas increased breeding success but did not contribute to population growth. Here, we hypothesize that supplementary feeding allows house sparrows to achieve higher breeding success but at the cost of lower nestling quality. As abundant food supplies may permit both high- and low-quality nestlings to survive, we also predict that within-brood variation in proxies of nestling quality would be larger for supplemental food broods than for unfed broods. As proxies of nestling quality, we considered feather corticosterone (CORT f), body condition (scaled mass index, SMI), and tarsus-based fluctuating asymmetry (FA). Our hypothesis was only partially supported as we did not find an overall effect of food supplementation on FA or SMI. Rather, food supplementation affected nestling phenotype only early in the breeding season in terms of elevated CORT f levels and a tendency for more variable within-brood CORT f and FA. Early food supplemented nests therefore seemed to include at least some nestlings that faced increased stressors during development, possibly due to harsher environmental (e.g., related to food and temperature) conditions early in the breeding season that would increase sibling competition, especially in larger broods. The fact that CORT f was positively, rather than inversely, related to nestling SMI further suggests that factors influencing CORT f and SMI are likely operating over different periods or, alternatively, that nestlings in good nutritional condition also invest in high-quality feathers.
    Matched MeSH terms: Ankle
  19. Sobhani-Eraghi A, Panahi M, Shirani A, Pazoki-Toroudi H
    Malays Orthop J, 2020 Nov;14(3):155-160.
    PMID: 33403077 DOI: 10.5704/MOJ.2011.024
    Introduction: Doxycycline is a commonly used antibiotic that is also a potent inhibitor of matrix metalloproteinase (MMPs). The use of doxycycline in repairing tendon lesions has been previously investigated and conflicting findings have been reported on its effectiveness. In this study, we sought to evaluate the effects of exposure to doxycycline on Achilles tendon repair.

    Materials and Methods: Twenty healthy rats of the same breed and gender were randomly assigned to two groups of sham, and Doxycycline group therapy. The rats underwent a surgical intervention in which a 2mm incision was performed on the lateral sides of the right Achilles tendons. The treatment group received oral gavage administrations of 50mg/kg/day of doxycycline for 30 days. After this duration, tissue samples were taken from the site of the injuries, which were then histologically evaluated for alignment of the collagen fibres, inflammation reaction, cellular density, and fibroblastic activity.

    Results: The histological assessment of the tissue samples, revealed significant changes in the repaired tissues of the treatment group in comparison to the sham group; namely more irregularity in the alignment of the collagen fibres, increased cellular density, and increased fibroblastic activity. However, only the alignment of the collagen fibres reached the statistical significance.

    Conclusion: The results of this study indicate that exposure to doxycycline may result in the improvement of repair of the Achilles tendon injuries, especially collagen filament integrity.

    Matched MeSH terms: Ankle Injuries
  20. Lui, Sze Yee, Noor Zuraini Abu Bakar, Ida Zaliza Zainol Abidin
    MyJurnal
    The clinical diagnosis of snakebite is critical, particularly in Southeast Asia where venomous snakebites are a public health concern. Additionally, cases involving unwitnessed snakebite with no species identification, especially in non-verbal children posed a challenge in the emergency setting. A 2-year-2-month-old boy presented to our emergency department with signs of neurotoxicity. He was restless and mildly bradypnoeic with the respiratory rate of 24 to 28 breaths per minute. He also had bilateral ptosis with absent gag reflex. There were faint fang marks noted over the medial aspect of his left ankle with local swelling and bruises, despite no history of animal bite and no eyewitness. A high index of suspicion of neurotoxic envenomation was prompted and a total of 6 vials of neuro-polyvalent anti-venom were administered in scheduled batches. Progressive clinical recovery was subsequently observed after the first batch of anti-venom administration. The case illustrated the importance of clinical recognition of neurotoxic envenomation in the absence of snake bite history or species identification. Early administration of anti-venom may potentially reverse the neurotoxic effects of systemic envenomation and saves lives.
    Matched MeSH terms: Ankle
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