Uncontrolled bleeding due to pelvic fractures contributes to trauma-related morbidity and mortality. Three main strategies that have been outlined to combat this condition which include reduction of pelvic volume that lead to tamponade-like effect, arresting haemorrhage through angioembolization of the major vessels, and stabilization of the pelvic bone with external fixation need to be initiated early. A prehospital device that allow these strategies will aid significantly in the management of the patient. At present most devices used to treat pelvic fractures in the pre-hospital setting do have its’ own advantages but also have some limitations. A characteristic ‘wish-list’ of a good pelvic and lower limb immobilization device was created and the research team from UKM takes the challenge to design and produce a device that concurs to it. A two phase development project that incorporate anthropometric, biomechanical, cadaveric and radiological study was carried out over a period of seven years. Finally, BRIMTM immobilizer, a new pelvic and lower limb immobilization device that is user friendly, tough, cost effective, radiolucent, light and reusable that answers most of the requirement of a good device was invented.
Older adults are at risk of osteoporotic fractures. Osteoporotic vertebral fractures are associated with a reduced cross-sectional area and muscle strength of the back extensor muscles, increased intramuscular fat infiltration and thoracic and lumbar curvature alterations. This study proposed a protocol to examine in more detail the contributions of altered spinal morphological, physical performance and biochemical markers to the risk of developing osteoporotic vertebral fractures. In this cross-sectional study, we plan to recruit 100 adults aged 50 years and above from an orthopaedic clinic, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia. The fracture prediction tool (FRAX) will be used to categorise high and low risk groups. Back muscle strength will be quantified using a load cell system. Thoracolumbar curvatures will be examined using an electromagnetic tracking system and intramuscular fat infiltration in the lumbar muscles will be measured using Magnetic Resonance Imaging. The Short Physical Performance Battery and JAMA dynamometer will quantify physical performance and the European Quality of Life Questionnaire will be used to assess self-perceived quality of life. Biochemical markers of serum C terminal telopeptide and N terminal propeptide of type I procollagen will be assessed using an enzyme-linked immunosorbent assays kit. A spine-specific model using regression analysis will be developed to predict osteoporotic vertebral fractures using the measured parameters in the present study.