Displaying publications 61 - 80 of 105 in total

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  1. Fulltext The Role of Real Time Ultrasound in Differentiatingbetween Osteomyelitis and Tumour in Long Bones
    George, J., Teo, S.C., Adan, M.
    Malays Orthop J, 2008;2(1):33-37.
    MyJurnal
    Aim: This study was designed to evaluate the use of ultrasound in diagnosis of infection and tumour of long bones. Methodology: Patients referred from the orthopaedic unit with doubt regarding long bone clinical and/or radiological signs which could be tumour or infection were enrolled in this study. Analysis of ultrasound characteristics included presence of pericortical fluid over normal cortex well away from the primary lesion, wavy contour sign (fluid tracking in and out muscle planes), subperiosteal fluid and soft tissue mass displacing adjacent muscle planes. Results: Fourteen out of 15 patients with confirmed osteomyelitis were diagnosed by ultrasound examination. Ultrasound as a diagnostic tool has a sensitivity of 93% and specificity of 100%. The most accurate indicator was pericortical fluid noted up to several centimetres from the long bone abnormality seen on plain x-rays. Conclusion: Ultrasound is a safe, fast, cost-effective imaging modality that can play an important role in diagnosis of osteomyelitis as it then serves as a tool for ultrasound guided aspiration.
    Matched MeSH terms: Orthopedics
  2. Fulltext Giant sacral chondrosarcoma in an elderly male: a case report
    Chan, H. Z., Wang, C. S., Azuhairy, A., Hau, A., Zulkiflee, O.
    Malays Orthop J, 2014;8(1):79-81.
    MyJurnal
    Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm) in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.
    Matched MeSH terms: Orthopedics
  3. Fulltext Kajian analisa kos pembekal perkhidmatan kesihatan bagi rawatan diabetic foot wad ortopedik Pusat Perubatan Universiti Kebangsaan Malaysia dalam tahun 2006
    Amin, S.A., Ali, M., Aniza, I., Rizal, A.M., Saperi, S., Amrizal, M., et al.
    Malaysian Journal of Community Health, 2009;15(1):32-38.
    MyJurnal
    Introduction : Diabetes mellitus is recognized as a major public health problem worldwide. The burden of diabetes to society are morbidity, mortality and extensive usage of health care services.
    Methodology : This study aimed to determine the provider’s cost in treating diabetic foot patient per day in orthopaedic ward, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in year 2006. Result : A total of 54 patients fulfilled the inclusion and exclusion criteria, only 29 were eligible for analysis. The cost of health care providers derived from cost calculation on capital and recurrent costs. Results showed that the average cost for treating diabetic foot patient per day is RM 634.57. Recurrent costs contributed 75.3% of the total diabetic foot treatment and Intensive Care Unit costs was the biggest percentage (40.5%).
    Discussion : The results were comparable with findings by Case-Mix Unit of UKMMC. Treatment cost of diabetic foot is substantial and therefore avoidance of this complication must be emphasized to all diabetic patients.
    Matched MeSH terms: Orthopedics
  4. Osteomyelitis in childhood -the natural history documented by radiographs
    Singh, H.
    Malaysian Journal of Paediatrics and Child Health, 2000;12(1):74-76.
    MyJurnal
    It is very rare indeed in the practice of children's orthopaedics today in Malaysia that the natural history of long bone osteomyelitis is seen. A case is presented where a shoulder abscess in a 3-year-old child developed into septic arthritis of the shoulder and subsequently chronic osteomyelitis of the adjacent humerus. The parents refused active surgical debridement and sequestrectomies. Three years later the child had regenerated a new humerus over the sequestra. Radiographs are presented illustrating the entire natural history of osteomyelitis with the regeneration of a new humerus.
    Matched MeSH terms: Orthopedics
  5. Fulltext Review Article: Stem Cell Therapy in Orthopaedic Surgery:Current Status and Ethical Considerations
    Hui,J.H.P., Azura M., Lee, E.H.
    Malays Orthop J, 2009;3(1):4-12.
    MyJurnal
    Regenerative medicine using stem cell therapy has sparked much interest in this 21st century not only because of the controversies that surround the ethics involving pluripotent stem cells but their potential for use in the clinic. The ability of stem cells to repair and regenerate new tissues and organs holds tremendous promise for the treatment of many serious diseases and injuries. This review provides a brief summary of the current status of research in stem cells with special emphasis on where we are in terms of the possible clinical application of stem cell therapy in orthopaedic surgery. We look at the available evidence and examine the ethical issues and considerations associated with the clinical use of stem cells.
    Matched MeSH terms: Orthopedics
  6. Fulltext Tissue Diagnosis for Musculoskeletal Tumours
    Saw, A.
    Malays Orthop J, 2007;1(2):1-2.
    MyJurnal
    Musculoskeletal tumour is much less common compared to tumours of epithelial origin. Most of these tumours are benign, with only about 1% malignant in nature. A general orthopaedic surgeon may only come across a malignant primary bone or soft tissue tumour a few times in his entire medical career. The current recommendation is for these conditions to be investigated and treated in centres with musculoskeletal oncology service. Careful clinical evaluation with appropriate plain radiography can provide adequate information for definitive diagnosis and treatment for most cases, especially the benign tumours. For some other cases, further investigations will be necessary. Magnetic resonance imaging (MRI) can provide excellent details on anatomical location of a tumour and delineate vital structures that may have been distorted by the lesion. For primary malignant tumours, computerized tomography scanning is still the gold standard for evaluation of pulmonary metastasis, and bone scan can allow early detection of distant metastasis to other bones. Whole body MRI has recently been recommended for tumour staging but the potential benefit for musculoskeletal tumour is not that convincing. PET may be very helpful for follow up detection of tumour recurrence but its role in diagnosis and staging of musculoskeletal tumours is still being evaluated...
    Matched MeSH terms: Orthopedics
  7. Fulltext Transformation of surgical training through national transformation 2050 (TN50): a National agenda
    Razman, J.
    Journal of Surgical Academia, 2017;7(1):1-3.
    MyJurnal
    Surgical training worldwide has been reformed from
    the since 19th century until the present era. It started as
    a trade which eventually was transformed into a
    profession that acquires skills and knowledge. The
    apprenticeship model was introduced amongst the
    Western surgeons as the standard approached for
    surgical training. The surgery was learned through
    direct observation without any formal and structured
    education. William S Halstead had introduced the new
    approach of training the surgeons in America
    following his landmark lecture at Yale University in
    1904 (1). His principle was based on direct the
    German Surgical training which emphasized on basic
    sciences in the curriculum and Sir William Ossler
    concepts of bedside rounds. This has lead to the
    development of Halsted principals of surgical training
    which included intense and repetitive exposure in
    managing surgical patients under the supervision of
    skilled surgeons, acquiring the knowledge of scientific
    basis of surgical diseases and as the surgical trainee
    received enhanced responsibility and independence
    with each advancing year (2). Since then, Halsted
    principle of surgical training has become the
    foundation of most established surgical training
    worldwide. The principles have been expanded and
    upgraded and since then six cores competencies have
    been identified for the surgical residents to achieve
    and master during the training course (3). There were
    medical knowledge, patient care, interpersonal and
    communication skills, professionalism, practice-based
    learning and improvement and system based practice.
    From the Malaysia perspective, surgical training was
    done through the overseas Royal colleges after the
    independence in 1957. The local programme started in
    1982 through the initiative of local universities that
    initially offered surgical training programme in
    General surgery, Orthopedics and otorhinolaryngology
    (4). Since then through the collaborations of Ministry
    of Health and other professional bodies various
    surgical training programme has been established to
    provide training opportunities which will eventually
    serving the nation. The subcommittee of the National
    Conjoint Board for General Surgery was the
    consultative body to oversee and manage the
    implementation of the surgical training. Since the
    establishment, the subcommittee was responsible in
    streamlined the training curriculum for all the
    universities that offered the course, centralized and
    standardized the intake of the trainees, coordinating
    the national exit examination and advising new
    application for graduate training in general surgery.
    The important milestone of the subcommittee was the
    task given to develop the national surgical
    postgraduate curriculum for the doctors who are
    interested in becoming a surgeon in the country. The
    curriculum is being developed to create a pathway for
    surgical training from the internship until subspecialty
    training. The development encompasses the
    governance, the curriculum development, the training
    process and learning outcome according to the latest
    evidence based on post graduate training. The
    programme should be the foundation in producing well
    trained surgeons towards 2050 through TN50.
    Matched MeSH terms: Orthopedics
  8. Fulltext An approach for developing integrated undergraduate medical curriculum
    Akram A, Rizwan F, Sattar K, Hadi JIS, Meo SA
    Pak J Med Sci, 2018 9 8;34(4):804-810.
    PMID: 30190732 DOI: 10.12669/pjms.344.14565
    Background and Objectives: Medical schools are to develop integrated medical curricula because the term 'integrated curriculum' has grown up and flourished globally and it has become mandatory to align the medical education with the global concept in Pakistan. This paper aims to present a guideline to design an undergraduate integrated medical curriculum.

    Methods: Various themes are used to develop integrated curriculum which are basic medical science, simulation skills, clinical science, personality development, research, entrepreneurship and pre specialization. Each theme is subdivided, termed a module and its contents primarily focus on particular aspect.

    Results: Knowledge, skill and attitude, embodied in themes or modules, are planted in specific way that they have horizontal as well as vertical integration. There is no boundary of various traditional disciplines in template of five years curriculum. For example, diagnosis is a theme which carries contents from medicine, surgery, orthopedics etc.

    Conclusion: The blueprint introduced in this paper would help medical educators to draft integrated medical curricula for those institutions which intend to switch their medical programs from traditional to integrated one.

    Matched MeSH terms: Orthopedics
  9. Fulltext Incidence of phlebitis among adult patients with peripheral intravenous catheter in an east coast hospital Malaysia
    Azlina Daud, Fatimah Mohamad, Siti Noorkhairina Sowtali
    International Journal of Care Scholars, 2018;1(2):5-8.
    MyJurnal
    Objective: This study aims to determine the incidence rate of phlebitis among patients with peripheral intravenous catheter. Methods: An observational study was conducted in one of the hospitals in East Coast Malaysia. There were 321 data collected among patients who had peripheral intravenous catheter in medical, gynecology and orthopedic wards. The incidence of phlebitis was evaluated using modified Visual Infusion Phlebitis score checklist. Results: The incidence of phlebitis, was found out to be 36.1% (n=116/321). Most patients who developed phlebitis had visual infusion phlebitis, with a score of two (34.9%) and the rest developed phlebitis with a score of three (1.2%). Conclusion: This high incidence of phlebitis indicated a worrying outcome. Therefore, the study findings suggested that a specific guideline on post insertion management of peripheral intravenous catheter should be revised which may help in reducing more incidence of phlebitis, subsequently reduce infection in ward, and provide more safety environment in hospital and reducing cost in managing infection control.
    Matched MeSH terms: Orthopedics
  10. Fulltext Brachial Artery Injury in a Child following Closed Elbow Dislocation: Case Report of a Rare Injury
    Vickash K, Amer A, Naeem A, Falak S
    Malays Orthop J, 2016 Nov;10(3):36-38.
    PMID: 28553446 DOI: 10.5704/MOJ.1611.001
    Elbow dislocation, though a common orthopaedic emergency is rare with brachial artery injury and is even more uncommon in the paediatric age group. We present the case of a child who sustained trauma resulting in closed elbow dislocation with brachial artery injury. Elbow dislocation with brachial artery injury can present with palpable distal pulses and good capillary refill because of rich collaterals at the elbow. But this patient presented with signs of frank ischemia distally, and was managed with ipsilateral reverse cephalic vein graft. He had good volume pulses at one year follow-up. Patients with such presentation should have careful clinical and radiological assessment to exclude complicated elbow dislocation.
    Matched MeSH terms: Orthopedics
  11. The incidence of post-operative deep vein thrombosis in general surgical patients of hospital universiti sains malaysia
    Tun M, Shuaib IL, Muhamad M, Mat Sain AH, Ressang AS
    Malays J Med Sci, 2004 Jan;11(1):75-80.
    PMID: 22977363
    The incidence of deep vein thrombosis is believed to be rare in Asians. During recent years, a few reports have appeared with high incidence in orthopaedic patients comparable to Western studies. This study was carried out to find out the incidence of post-operative deep vein thrombosis (DVT) after major surgical procedures in general surgical patients in an Asian population. In a prospective study of 45 consecutive Asian patients after major general surgery, colour-flow duplex scan of the legs as an initial screening was done twice within two weeks. Mean age of the patients was 54 years 5 months and 87% of patients were included in the moderate and high risk group for deep vein thrombosis. Ascending venography was used to confirm deep vein thrombosis on patients with equivocal or positive results from colour flow duplex scan. One patient showed positive evidence of post-operative deep vein thrombosis on colour flow duplex scan which was further confirmed by ascending venography; giving an incidence of 2.2%. The incidence of post-operative deep vein thrombosis in general surgical patients is lower than the Western studies.
    Matched MeSH terms: Orthopedics
  12. 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
  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 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
  15. 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
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
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