Displaying publications 81 - 100 of 135 in total

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  1. Khoo, S.W., Khoo, S.M., Yeong, Y.K., Towil, B.
    Malays Orthop J, 2009;3(2):29-32.
    MyJurnal
    According to recently reported outcome studies, functional outcomes after arthroscopic rotator cuff repair are reasonable and comparable to open or mini-open techniques. We report the functional outcomes after arthroscopic rotator cuff repair of 10 consecutive patients. The average age was 53.9(range 46-59) years. There was a significant improvement of the function of the shoulder when the preoperative scores were compared with those at the time of at least six months follow-up (range of 6 months to 18 months). With the UCLA rating scale, the average total score increased from preoperative 9.8 (range, 6-15) to postoperative 32.6 (range,23-35). With the use of ASES shoulder index, the average total score improved from 14.6 range, 1.6-35) to 92.3 (range,66.6 to 100). We concluded that arthroscopic rotator cuff repair is a treatment method in selective patients with symptomatic rotator cuff pathology to alleviate shoulder pain and improve function.
    Matched MeSH terms: Shoulder; Shoulder Pain
  2. Widiastuti-Samekto M, Sianturi GP
    Med J Malaysia, 2004 Aug;59(3):312-6.
    PMID: 15727375
    Twenty-six patients with frozen shoulder syndrome (Stage 2 and 3) were included in this study conducted at Dr. Kariadi General Hospital, Semarang, Indonesia and randomly allocated into 2 groups: 40 mg triamcinolone intra-articular injection and triamcinolone oral tablets. The result showed that triamcinolone intra-articular injection group "cured" rate was 5.8 times higher at week one compared to the triamcinolone tablet group. Sixty-two percent of the cases with triamcinolone intra-articular injection achieved their "cured" condition after one week of therapy, compared with only 14% of the triamcinolone tablets group. We conclude that, intra-articular corticosteroid injection provide faster improvement compared to oral route.
    Matched MeSH terms: Shoulder Joint/pathology*; Shoulder Pain/drug therapy; Shoulder Pain/etiology
  3. Chiu CK, Tan RL, Gani SMA, Chong JSL, Chung WH, Chan CYW, et al.
    Asian Spine J, 2021 May 07.
    PMID: 33957021 DOI: 10.31616/asj.2020.0649
    Study Design: Retrospective study.

    Purpose: To report the perioperative and radiological outcomes of single-stage posterior passive correction and fusion (SSPPCF) in adolescent patients who present with congenital scoliosis.

    Overview of Literature: The surgical treatment for congenital scoliosis is complex. There is no definitive guide on surgical options for skeletally matured adolescent patients who have congenital scoliosis.

    Methods: Patients with congenital scoliosis who underwent SSPPCF using a pedicle screw system were reviewed. We identified the following three surgical indications: (1) hemivertebra or wedge vertebra over the thoracic or thoracolumbar region with structural lumbar curves, (2) hemivertebra or wedge vertebra at the lumbar region with significant pelvic obliquity or sacral slanting, and (3) mixed or complex congenital scoliosis. The demographic, perioperative, and radiographic data of these patients were collected.

    Results: Thirty-four patients were reviewed. The mean patient age was 14.6±3.4 years. There were 13 hemivertebrae, three wedged vertebrae, two butterfly vertebrae, three hemivertebrae with butterfly vertebra, eight unsegmented bars, and five multiple complex lesions. The average surgical duration was 219.4±68.8 minutes. The average blood loss was 1,208.4±763.5 mL. Seven patients required allogeneic blood transfusion. The mean hospital stay duration was 6.1±2.5 days. The complication rate was 11.8% (4/34): one patient had severe blood loss, one had rod breakage, and two had distal adding-on. The Cobb angle reduced from 65.9°±17.4° to 36.3°±15.3° (p<0.001) with a correction rate (CR) of 44.8%±17.4%. The regional kyphotic angle decreased from 39.9°±20.5° to 27.5°±13.9° (p=0.001) with a CR of 19.3%±49.6%. Radiographic parameters (radiographic shoulder height, clavicle angle, T1 tilt, cervical axis, pelvic obliquity, coronal balance, and apical vertebral translation) showed significant improvement postoperatively.

    Conclusions: SSPPCF was a feasible option for adolescent patients with congenital scoliosis who were skeletally matured.

    Matched MeSH terms: Shoulder
  4. Ting SL, Saimon R, Rahman MM, Safii R, Ho SL, John N, et al.
    Med J Malaysia, 2020 11;75(6):649-654.
    PMID: 33219172
    BACKGROUND AND OBJECTIVE: Physical and behavioural problems from extended usage of electronic devices are issues among primary school children. This study is aimed to investigate the prevalence of physical and behavioural complaints arising from the electronic device usage and to identify the potential factors that predicted the complaints.

    METHODS: This was a primary school-based cross-sectional study using multistage cluster sampling, conducted at Bau district in Sarawak, Malaysia in 40 primary schools. A questionnaire was used to collect information of usage pattern in insufficient lighting, timing and position. The physical and behavioural complaints were traced. Data analysis was performed using SPSS version 22. A p-value < 0.05 with 95% CI was considered as statistically significant.

    RESULTS: About 52.8% of the 569 students used digital devices in a bright room, 69.8% in the day time and 54.4% in sitting position. The physical complaints were headache (32.9%), neck, shoulder and back pain (32.9%) followed by by eye strain (31.8%). Regarding behavioural problems, 25.7% of the students had loss of interest in study and outdoor activities (20.7%), skipped meals (19.0%) and arguments/disagreements with parents (17.9%). After logistic regression analysis, the lying position (OR=1.71, 95% CI: 1.096, 2.688) and darkroom lighting (OR=2.323 95% CI: 1.138, 4.744) appeared to be potential predictors of the complaint.

    CONCLUSION: One-quarter of the students studied experienced physical complaints, and one-fifth had behavioural problems associated with the use of electronic devices. Lying position and darkroom lighting are the potential predictors of complaints. Therefore, we suggest that the children should use electronic devices in the sitting position with adequate room lighting.

    Matched MeSH terms: Shoulder
  5. Hazwan Ab. Wahid, Khairul Nizam bin Siron, Ahmad Zakiran
    MyJurnal
    Displaced and unstable proximal humerus fractures are difficult to treat
    and they have high morbidity. The main goal is to achieve painless shoulder with full
    recovery of the shoulder joint motion. Impingement syndrome is one of the commonest
    postoperative complication. This study aim is to appreciate the functional outcomes of
    Philos-plate fixation for proximal humerus fractures and to establish association with
    high plate positioning with impingement syndrome of the shoulder after Philos-plate
    fixation. (Copied from article).
    Matched MeSH terms: Shoulder; Shoulder Fractures; Shoulder Joint
  6. Zulfikri N, Selvanayagam VS, Yusof A
    J Sport Rehabil, 2021 Jan 19;30(5):717-724.
    PMID: 33465761 DOI: 10.1123/jsr.2019-0483
    CONTEXT: Badminton continues to be a highly competitive sport where training is introduced at an early age and load has intensified. This exposes players to a greater risk of injuries, in particular when assessing related training outcomes such as strength, agonist-antagonist ratio, and bilateral deficit among adolescents where age- and sex-associated growth and development should be considered.

    OBJECTIVE: To evaluate strength profile of the upper and lower limbs among adolescent elite Malaysian badminton players.

    DESIGN: Cross-sectional study.

    SETTING: Laboratory.

    PARTICIPANTS: Forty-eight asymptomatic athletes (24 males and 24 females) were grouped into early and late adolescence (13-14 y old and 15-17 y old, respectively).

    MAIN OUTCOME MEASURE(S): Strength (absolute and normalized) of the external/internal rotators of the shoulder and flexor/extensor of the knee and strength derivatives, conventional strength ratio (CSR), dynamic control ratio (DCR), and bilateral deficits were measured.

    RESULTS: Males showed greater strength in all strength indices (P < .05). The older group had greater strength compared to younger for most of the upper and lower limb indices (P < .05); these effects diminished when using normalized data. For females, there was no age group effect in the shoulder and knee strength. All players displayed lower shoulder and knee normative values for CSR and DCR. Dominant and non-dominant knee strength were comparable between sex and age groups.

    CONCLUSIONS: For males, growth and maturation had a greater contribution to strength gained compared to training, whereas for females, growth, maturation, and training did not improve strength. The normalized data indicated that training did not improve all indices measured apart from external rotator strength in females. All players also displayed lower normative values of CSR and DCR. These results suggest that training in elite adolescent Malaysian badminton players lacks consideration of strength gain and injury risk factors.

    Matched MeSH terms: Shoulder Joint/physiology*
  7. Teo Chuun, B., Dian Darina Indah, D., Darliana, M.
    MyJurnal
    This study is aimed at seat design optimization for high-speed train based on the Malaysians sitting anthropometry
    data focusing on seat fit parameters. An analysis of anthropometry data composed of 15 dimensions that are
    required in seat design was done with 50 male subjects. These data were collected through direct measuring
    methods with standard equipment. According to the Malaysian automotive seat fit parameters, the backrest width,
    backrest height, cushion width, and cushion length were established based on these anthropometric dimensions:
    interscye breadth (5th percentile female and 95th percentile male), hip breadth (95th percentile female), sitting
    shoulder height (5th percentile female), and buttock-popliteal length (5th percentile female), respectively. This
    study uses the CATIA software to design and analyse the proposed seat design. The fit parameters proposed for the
    new design are seat height, 380mm; cushion width, 450mm; backrest width, 450mm and backrest height, 850mm.
    The CATIA human activity analysis (based on Rapid Upper Limb Analysis, RULA) was also executed. From the study,
    the new conceptual seat design gives the most optimized fit when compared to the current seat.
    Matched MeSH terms: Shoulder
  8. Mohamad Shariff A. Hamid, Stella Jane Joseph Rajah
    Sains Malaysiana, 2015;44:1473-1479.
    This study assessed the effects of progressive resistance exercise programmes on self-reported health related quality of life, body composition and muscle strength among patients with HIV. Twenty-nine men with HIV were randomly assigned to progressive resistance exercise programme using elastic band (PRE group) (n=14) or resistance exercise programme without elastic band (comparative group) (n=15). Both groups underwent exercise programmes for 12 weeks. Selfreported health related quality of life, body compositions and isometric shoulder lift strength were assessed at baseline and at week 12. Ten and nine men in the intervention and comparative groups, respectively, completed the 12-week programme. Participants in the comparative group showed significant improvements in the domain of mental health (p<0.05). No significant changes in all body composition parameters were found in both groups with time. Both groups showed significant improvements in peak and average shoulder lift strength (intervention, p=0.001; p=0.001; control, p=0.008; p=0.016). Progressive resistance exercise programmes significantly improves shoulder lift strength, showed positive effects on self-reported health related quality of life scores among patients with HIV.
    Matched MeSH terms: Shoulder
  9. Shaharudin S, Rahim MFA, Muhamad AS
    Int J Prev Med, 2018;9:90.
    PMID: 30450173 DOI: 10.4103/ijpvm.IJPVM_42_17
    Background: The study investigated the effects of isokinetic versus isotonic training among adolescent state-level weightlifters in terms of total leukocytes, total lymphocytes, and its subsets following 24 sessions of training program and a month following training program cessation.

    Methods: Nineteen adolescent state-level weightlifters were assigned into isokinetic or isotonic groups. All participants were recruited from a pool of weightlifters with standardized training program provided by their coach. Series of immunological tests were carried out before the commencement, immediately upon the completion, and a month after the cessation of the additional training program to evaluate total leukocytes and lymphocytes count.

    Results: The results revealed a significant time and group interaction and main effects of time on mean total leukocytes (P < 0.05). Mean total leukocytes count at posttest decreased in both groups. In isotonic group, it was further decreased following 1 month of training cessation (P < 0.05) but not in the isokinetic group. However, the decrement was not high and the values were in the normal range. No significant time and group interaction was observed in total lymphocytes and its subsets count.

    Conclusions: Eight weeks of isokinetic and isotonic additional training with emphasis on shoulder joint only affect mean total leukocytes count in state-level adolescent weightlifters.

    Matched MeSH terms: Shoulder Joint
  10. Sam CX, Anwar AZ, Ahmad AR, Solayar GN
    Malays Orthop J, 2021 Mar;15(1):119-123.
    PMID: 33880158 DOI: 10.5704/MOJ.2103.018
    Introduction: Reverse total shoulder arthroplasty provides a surgical alternative to standard total shoulder arthroplasty for the treatment of cuff tear arthropathy, arthritis and fracture sequelae. This study aimed to assess the short-term outcomes following reverse total shoulder arthroplasty for patients in a large public hospital in Malaysia.

    Materials and Methods: We identified and performed five primary reverse total shoulder arthroplasties between 1 May 2019 and 1 June 2020. All patients were contactable and available for analysis. Assessment of functional outcomes was performed using the Constant-Murley score, the patient satisfaction score (PSS), and imaging studies. The mean follow-up from operation to the time of reporting was 9.6 months (range, 3 to 14 months).

    Results: The median age for our patients was 58 years (±11.91). The most common indication for surgery was post-traumatic arthritis, followed by rotator cuff arthropathy and osteoarthritis. The mean Constant score improved from 9.0 pre-operatively to 52.3 post-operatively at a mean of 9.6 months. The majority of the patients were satisfied with the surgery as the post-operative range of motion, especially anterior elevation and abduction, improved in four of our patients and there were no short-term complications, for example, of infection or revisions, reported at the last follow-up.

    Conclusion: This study has shown that reverse total shoulder arthroplasty can yield good short-term outcomes for the treatment of complex shoulder problems in addition to cuff tear arthropathy. It should be considered a treatment for rotator cuff tears, severe arthritis and ≥ 3 parts proximal humeral fractures.

    Matched MeSH terms: Shoulder; Shoulder Fractures; Arthroplasty, Replacement, Shoulder
  11. Amir D, Yaszay B, Bartley CE, Bastrom TP, Newton PO
    Spine (Phila Pa 1976), 2016 Jul 15;41(14):1122-1127.
    PMID: 26863257 DOI: 10.1097/BRS.0000000000001497
    STUDY DESIGN: Retrospective review of prospective data.

    OBJECTIVE: To determine if surgically leveling the upper thoracic spine in patients with adolescent idiopathic scoliosis results in level shoulders postoperatively.

    SUMMARY OF BACKGROUND DATA: Research has shown that preoperatively tilted proximal ribs and T1 tilt are more correlated with trapezial prominence than with clavicle angle.

    METHODS: Prospectively collected Lenke 1 and 2 cases from a single center were reviewed. Clinical shoulder imbalance was measured from 2-year postoperative clinical photos. Lateral shoulder imbalance was assessed utilizing clavicle angle. Medial imbalance was assessed with trapezial angle (TA), and trapezial area ratio (TAR). First rib angle, T1 tilt, and upper thoracic curve were measured from 2-year radiographs. Angular measurements were considered level if ≤ 3° of zero. TAR was considered level if ≤ 1 standard deviation of the natural log of the ratio. Upper thoracic Cobb at 2-years was categorized as at or below the mean value (≤ 14°) versus above the mean.

    RESULTS: Eighty-four patients were identified. There was no significant difference in the percentage of patients with a level clavicle angle or TAR based on first rib being level, T1 tilt being level, or upper thoracic Cobb being at/below versus above the mean (P shoulders or clavicles. Trapezial prominence was impacted by leveling T1 and the first rib and by minimizing the upper thoracic curve. How to achieve laterally balanced shoulders postoperatively remains unclear.

    LEVEL OF EVIDENCE: 3.

    Matched MeSH terms: Shoulder/surgery*
  12. Wahab AHA, Saad APM, Harun MN, Syahrom A, Ramlee MH, Sulong MA, et al.
    J Mech Behav Biomed Mater, 2019 03;91:406-415.
    PMID: 30684888 DOI: 10.1016/j.jmbbm.2018.12.033
    Intact glenoid labrum is one of passive stabilizer for glenohumeral joint, which have various stiffness at different region. The aim of this study is to develop new artificial glenoid labrum from Polyvinyl Alcohol (PVA) hydrogel, which known as good biomaterial due to its biocompatibility and ability to tailor its modulus. PVA hydrogel was formed using freeze-thaw (FT) method and the stiffness of PVA was controlled by manipulating the concentration of PVA and number of FT cycles. Then, the gradual stiffness was formed using simple diffusion method by introducing the pre-freeze-and-thaw steps. The results showed 20% PVA with three FT cycles suit to highest stiffness of glenoid labrum while 10% PVA with three FT cycles suit to lowest stiffness of glenoid labrum. The functionally graded PVA hydrogel was then developed using the same method by diffusing two mixture (20% PVA and 10% PVA). Mechanical compression test showed, the highest modulus (0.41 MPa) found at the 20% PVA region and lowest modulus (0.1 MPa) found at 10% PVA region. While, at intermediate region, the compressive modulus was in between 20% and 10%, 0.2 MPa. The existence of gradual stiffness was further prove by checking crystallinity of material at each region using Differential Scanning Calorimetry (DSC) and Wide Angle X-ray Diffraction (WAXD). Microstructure of material was obtained from Scanning Electron Microscopy (SEM). This functionally graded PVA hydrogel also able to reduce about 51% of stress at glenoid implant and up to 17% for micromotion at the interfaces. Existence of artificial glenoid labrum could minimize the occurrence of glenoid component loosening.
    Matched MeSH terms: Shoulder Joint*
  13. Nurrulhidayah, A.F., Arieff, S.R., Rohman, A., Amin, I., Shuhaimi, M., Khatib, A.
    MyJurnal
    Differential scanning calorimetry (DSC) is developed and used for detection of butter adulteration with lard. Butter has the similar characteristics to lard makes lard a desirable adulterant in butter. DSC provides unique thermal profiling for lard and butter. In the heating thermogram of the mixture, there was one major endothermic peak (peak A) with a smaller shoulder peak embedded in the major peak that gradually smoothed out to the major peak as the lard percent increased. In the cooling thermogram, there were one minor peak (peak B) and two major exothermic peaks, peak C which increased as lard percent increased and peak D which decreased in size as the lard percent increased. From Stepwise Multiple Linear Regression (SMLR) analysis, two independent variables were found to be able to predict lard percent adulteration in butter with R2 (adjusted) of 95.82. The SMLR equation of lard percent adulteration in butter is 293.1 - 11.36 (Te A) - 2.17 (Tr D); where Te A is the endset of peak A and Tr D is the range of thermal transition for peak D. These parameters can serve as a good measurement parameter in detecting lard adulteration in butter. DSC is a very useful means for halal screening technique to enhance the authenticity of Halal process.
    Matched MeSH terms: Shoulder
  14. Rusli R, Haque MM, Saifuzzaman M, King M
    Traffic Inj Prev, 2018;19(7):741-748.
    PMID: 29932734 DOI: 10.1080/15389588.2018.1482537
    OBJECTIVE: Traffic crashes along mountainous highways may lead to injuries and fatalities more often than along highways on plain topography; however, research focusing on the injury outcome of such crashes is relatively scant. The objective of this study was to investigate the factors affecting the likelihood that traffic crashes along rural mountainous highways result in injuries.

    METHOD: This study proposes a combination of decision tree and logistic regression techniques to model crash severity (injury vs. noninjury), because the combined approach allows the specification of nonlinearities and interactions in addition to main effects. Both a scobit model and a random parameters logit model, respectively accounting for an imbalance response variable and unobserved heterogeneities, are tested and compared. The study data set contains a total of 5 years of crash data (2008-2012) on selected mountainous highways in Malaysia. To enrich the data quality, an extensive field survey was conducted to collect detailed information on horizontal alignment, longitudinal grades, cross-section elements, and roadside features. In addition, weather condition data from the meteorology department were merged using the time stamp and proximity measures in AutoCAD-Geolocation.

    RESULTS: The random parameters logit model is found to outperform both the standard logit and scobit models, suggesting the importance of accounting for unobserved heterogeneity in crash severity models. Results suggest that proportion of segment lengths with simple curves, presence of horizontal curves along steep gradients, highway segments with unsealed shoulders, and highway segments with cliffs along both sides are positively associated with injury-producing crashes along rural mountainous highways. Interestingly, crashes during rainy conditions are associated with crashes that are less likely to involve injury. It is also found that the likelihood of injury-producing crashes decreases for rear-end collisions but increases for head-on collisions and crashes involving heavy vehicles. A higher order interaction suggests that single-vehicle crashes involving light and medium-sized vehicles are less severe along straight sections compared to road sections with horizontal curves. One the other hand, crash severity is higher when heavy vehicles are involved in crashes as single vehicles traveling along straight segments of rural mountainous highways.

    CONCLUSION: In addition to unobserved heterogeneity, it is important to account for higher order interactions to have a better understanding of factors that influence crash severity. A proper understanding of these factors will help develop targeted countermeasures to improve road safety along rural mountainous highways.

    Matched MeSH terms: Shoulder
  15. Miswan MF, Saman MS, Hui TS, Al-Fayyadh MZ, Ali MR, Min NW
    J Orthop Surg (Hong Kong), 2017 01;25(1):2309499017690317.
    PMID: 28215115 DOI: 10.1177/2309499017690317
    INTRODUCTION: We conducted a study to elucidate the correlation between the anatomy of the shoulder joint with the development of rotator cuff tear (RCT) and glenohumeral osteoarthritis (GHOA) by using acromioglenoid angle (AGA).

    MATERIALS AND METHODS: The AGA is a new measured angle formed between the line from midglenoid to lateral end of the acromion with the line parallel to the glenoid surface. The AGA was measured in a group of 85 shoulders with RCT, 49 with GHOA and 103 non-RCT/GHOA control shoulders. The AGA was compared with other radiological parameters, such as, the critical shoulder angle (CSA), the acromion index (AI) and the acromiohumeral interval (AHI). Correlational and regression analysis were performed using SPSS 20.

    RESULTS: The mean AGA was 50.9° (45.2-56.5°) in the control group, 53.3° (47.6-59.1°) in RCT group and 45.5° (37.7-53.2°) in OA group. Among patients with AGA > 51.5°, 61% were in the RCT group and among patients with AGA < 44.5°, 56% were in OA group. Pearson correlation analysis had shown significant correlation between AGA and CSA ( r = 0.925, p < 0.001). It was also significant of AHI in RCT group with mean 6.6 mm (4.7-8.5 mm) and significant AI in OA group with mean 0.68 (0.57-0.78) with p value < 0.001 respectively.

    CONCLUSION: The AGA method of measurement is an excellent predictive parameter for diagnosing RCT and GHOA.

    Matched MeSH terms: Shoulder Joint*
  16. Imma II, Nizlan NM, Ezamin AR, Yusoff S, Shukur MH
    Malays Orthop J, 2017 Jul;11(2):30-35.
    PMID: 29021876 MyJurnal DOI: 10.5704/MOJ.1707.012
    Introduction: The aims of this study are to define the coracoid process anatomy in a Malaysian population, carried out on patients in Hospital Serdang with specific emphasis on the dimension of the base of coracoid process which is important in coraco-acromial (CC) ligament reconstruction, to define the average amount of bone available for use in coracoid transfer, and to compare the size of coracoid process based on gender and race, and with findings in previous studies. Materials and Methods: Fifteen pairs of computed tomography (CT) based 3-dimensional models of shoulders of patients aged between 20 to 60 years old were examined. The mean dimensions of coracoid were measured and compared with regards to gender and race. The data were also compared to previously published studies. Results: The mean length of the coracoid process was 37.94 ± 4.30 mm. Male subjects were found to have larger-sized coracoids in all dimensions as compared to female subjects. The mean tip of coracoid dimension overall was 19.99 + 1.93mm length × 10.03 + 1.48mm height × 11.63 + 2.12mm width. The mean base of coracoid dimension was 18.96 + 3.71mm length × 13.84 + 1.76mm width. No significant differences were observed with regards to racial denomination. The overall coracoid size measurements were found to be smaller compared to previous studies done on the Western population. Conclusion: This study may suggest that Malaysians have smaller coracoid dimension compared to Caucasians. The findings further suggest that the incidence of coracoid fracture and implants pull out in Malaysian subjects may be higher.
    Matched MeSH terms: Shoulder
  17. Chiu CK, Chan CYW, Tan PH, Goh SH, Ng SJ, Chian XH, et al.
    Spine (Phila Pa 1976), 2020 Mar 15;45(6):E319-E328.
    PMID: 31593064 DOI: 10.1097/BRS.0000000000003275
    STUDY DESIGN: Retrospective study.

    OBJECTIVE: The primary objective of this study was to assess the conformity of the radiological neck and shoulder balance parameters throughout a follow-up period of more than 2 years.

    SUMMARY OF BACKGROUND DATA: Postoperative shoulder and neck imbalance are undesirable features among Adolescent Idiopathic Scoliosis patients who underwent Posterior Spinal Fusion. There are many clinical and radiological parameters used to assess this clinical outcome. However, we do not know whether these radiological parameters conform throughout the entire follow-up period.

    METHODS: This was a retrospective study done in a single academic institution. Inclusion criteria were patients with scoliosis who underwent posterior instrumented spinal fusion with pedicle screw fixation and attended all scheduled follow-ups for at least 24 months postoperatively. Radiological shoulder parameters were measured from both preoperative antero-posterior and postoperative antero-posterior radiographs. Lateral shoulder parameters were: Radiographic Shoulder Height, Clavicle Angle (Cla-A), Clavicle-Rib Intersection Difference, and Coracoid Height Difference. Medial shoulder and neck parameters were: T1 Tilt and Cervical Axis (CA).

    RESULTS: The radiographs of 50 patients who had surgery done from November 2013 to November 2015 were analyzed. Mean age of this cohort was 16.3 ± 7.0 years. There were 38 (76%) female patients and 12 (24%) male patients. Mean final follow-up was 38.6 ± 5.8 months. When conformity assessment of the radiological parameter using the interclass coefficient correlation was done, we found that all parameters had significant correlation (P Shoulder Height (0.22) and Cla-A (0.13) had poor reliability.

    CONCLUSION: All the radiological shoulder and neck balance parameters studied were conformed and suitable to be used to assess the patient postoperatively. Amongst these radiological parameters, T1 tilt followed by CA recorded to be the most reliable parameters over time.

    LEVEL OF EVIDENCE: 4.

    Matched MeSH terms: Shoulder/physiology
  18. Akhavan Hejazi SM, Mazlan M
    Acta Med Iran, 2012;50(4):292-4.
    PMID: 22592581
    Post-stroke shoulder pain is associated with either a peripheral or central pathology. However, most of the time, it is challenging to establish a cause-and-effect relationship between the suggested pathology and shoulder pain reported. We report a 66 year-old man who developed a right hemiplegic shoulder pain two months post stroke with initial investigations suggestive of peripheral pathologies. Pharmacological and non-pharmacological treatment did not improve his shoulder pain. Later he developed complex regional pain syndrome (CRPS) of the right hand and the initial shoulder pain subsequently relieved following resolution of the CRPS.
    Matched MeSH terms: Shoulder Pain/diagnosis; Shoulder Pain/etiology*; Shoulder Pain/therapy
  19. Narayanan VL, Balasubramanian N
    Malays Orthop J, 2018 Jul;12(2):20-24.
    PMID: 30112124 DOI: 10.5704/MOJ.1807.004
    Introduction: Proximal humerus fracture fixation using plate osteosynthesis depends on the quality of the bone, design of the fixation devices and intra-operative soft tissue dissection. This study evaluates the functional outcome of minimally invasive percutaneous plate osteosynthesis using locking compression plate in proximal humerus fracture treatment. Materials and Methods: The study was conducted on 30 patients with complex proximal humerus fractures treated by minimally invasive percutaneous plate osteosynthesis using locking compression plate (PHILOS). There were 21 males and 9 females. The average age of our study group was 58.8 years. All the patients were evaluated at six weeks, three months, four months, six months and 12 months following surgery. Results: All patients had fracture union at an average of 13.2 weeks. The mean DASH score at the follow-up was 8.69 (2.5 to 17.16), the average range of flexion was 143.83 degrees (100 to 170 degrees) and abduction was 121.49 degrees (90 to 160 degrees). We had superficial infection in three patients which resolved with a short course of antibiotics. There was excellent outcome in 26 patients, good and fair in two patients each. Conclusion: Proximal humerus fractures treated with minimally invasive percutaneous plate osteosynthesis using locking compression plate with minimal soft tissue dissection, provides good functional outcome and early return of shoulder function.
    Matched MeSH terms: Shoulder; Shoulder Fractures
  20. Choong C, Shalimar A, Jamari S
    Malays Orthop J, 2015 Nov;9(3):52-54.
    PMID: 28611911 MyJurnal DOI: 10.5704/MOJ.1511.017
    Brachial plexus injuries with intact yet flail limb presents with problems of persistent neuropathic pain and recurrent shoulder dislocations, that render the flail limb a damn nuisance. As treating surgeons, we are faced with the dilemma of offering treatment options, bearing in mind the patient's functional status and expectations. We present a case of a 55-year old housewife with complete brachial plexus injury begging for surgical amputation of her flail limb, 6 years post-injury. Here we discuss the outcome of transhumeral amputation and the possibility of offering early rather than delayed amputations in this group of patients.
    Matched MeSH terms: Shoulder Dislocation
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