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  1. Hadizie D, Kor YS, Ghani SA, Mohamed-Saat MA
    Malays Orthop J, 2022 Nov;16(3):24-29.
    PMID: 36589367 DOI: 10.5704/MOJ.2211.005
    INTRODUCTION: The primary aim of open fracture management is to prevent fracture-related infection by early antibiotic administration, debridement and wound coverage. However, the timing of the initial debridement is still controversial, and 6 to 24 hours is commonly advocated. Studies have yet to provide substantial evidence regarding the best time for surgical debridement. Thus, this study was conducted to compare the incidence of fracture-related infection at different time intervals of initial debridement of the open tibia fracture.

    MATERIALS AND METHODS: A total of 91 patients with grade I, II and IIIa open tibia fractures were recruited from 2016 to 2018, and their data were obtained from the consensus book and medical records. Participants were divided into four groups based on the time of initial debridement: (1) less than 6 hours, (2) 6 to less than 12 hours, (3) 12 to less than 24 hours, and (4) 24 hours and more. Fracture-related infection was determined by using Metsemakers confirmative criteria. Association between time and infection were determine by Binary Logistic Regression analysis by remerged the group into three; (1) less than 12 hours, (2) 12 to less than 24 hours and (3) 24 hours and more. The collected information was analysed using SPSS version 24 and Microsoft Excel 2010.

    RESULTS: The mean age of the participants was 31.9 years old, with male predominant (n=80, 87.0%). Most participants had delayed initial debridement of more than 24 hours and predominantly Gustilo-Anderson type IIIa (n=47). A total of 8 fractures complicated with infection (8.7%), majority in grade IIIa and debridement performed within 12 to less than 24 hours. Binary logistic regression showed increased odds of infection with a delayed wound debridement both in clinical presentation and positive culture, but the association was not statistically significant. The commonest organism isolated was Pseudomonas aeruginosa.

    CONCLUSION: Comparing to different time interval, initial wound debridement of more than 24 hours did not have strong association with increasing infection rate. However, even though statistically not significant, the odds of infection was increase with increasing time of initial wound debridement of an open tibia fracture, thus it should be performed early.

  2. Din MH, Aziz AM, Sahran Y, Mohamed-Saat MA, Abdul-Ghani NS, Faisham WI, et al.
    Malays Orthop J, 2024 Nov;18(3):51-58.
    PMID: 39691574 DOI: 10.5704/MOJ.2411.007
    INTRODUCTION: Sacroiliac joint disruption, resulting from high energy trauma can cause significant morbidity if no proper treatment given. Many techniques can be used to stabilise pelvic ring injuries. We studied the functional and radiological outcome following open reduction and anterior fixation of the sacroiliac joint and agreement between both outcomes.

    MATERIAL AND METHODS: This retrospective study involved 15 patients with unstable pelvic injuries requiring surgical intervention from January 2015 to December 2020 who undergone anterior stabilisation of the sacroiliac joint. Radiological outcome assessments were done postoperatively by using Lindahl criteria. The complete functional outcome was assessed at least six months postoperatively when patients were able to weight bear by using Majeed system. Descriptive statistical analysis was performed using IBM SPSS Statistics Version 27.

    RESULTS: The participants consist of 73.3% male and 26.7% female patients. A total of 66.7% of patients had a Tile type B pelvic ring injury, and the remaining 33.3% had a Tile type C pelvic ring injury. Based on the Majeed system, 73.3% of patients had excellent functional outcomes, and based on Lindahl criteria; there were 60% of patients who had excellent radiological outcome. However, there was no significant agreement between functional and radiological outcomes.

    CONCLUSION: Definitive fixation of the sacroiliac joint by anterior plate stabilisation provided an excellent functional and radiological outcome mainly due to good anatomical reduction and mechanical stability. However, further study may be needed to evaluate the correlation between functional and radiological outcomes and compare the various method of fixation with a larger sample size.

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