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Fulltext Early functional and radiological outcomes between plaster cast and fiberglass cast in stable thoracolumbar burst fracture

Zamzuri Z., Ariff M.S., Mohd Fairuz Ad., Mohd Shukrimi A., Nazri My.

International Medical Journal Malaysia, 2018;17(1):121-126.
MyJurnal

Introduction: Burst fracture results from compression failure of both the anterior and middle columns under
substantial axial loads. Conservative treatment was a method of treatment for fractures without
neurological deficit. This cross sectional study was designed to evaluate the functional and radiological
outcome of patient with thoracolumbar burst fracture treated conservatively. Methods: 40 cases were
recruited from January 2013 till December 2015. They were followed-up with minimum period of 1 year and
evaluated for the functional (Oswetry Disbility Index) and radiological outcomes (kyphotic angle deformity
and anterior body compression). Results: 20 patients were treated with body cast made form plaster of
Paris and remaining 20 patients with fiberglass cast. In plaster of Paris group, mean kyphotic angle
deformity at last follow up was 16.60 ± 2.95 with a mean improvement 4.45 degree and anterior body
compression at last follow up was 30.35% ± 10.2 with mean improvement of 9.30%. In fiberglass group, mean
kyphotic angle deformity at last follow up was 15.55 ± 3.38 with a mean improvement 7.25 degree and
anterior body compression at last follow up was 25.90% ± 7.81 with mean improvement of 3.45%. The
functional outcome showed Oswetry Disability Index (ODI) score in plaster of Paris group was 23.70 (SD =
7.82) and in fiberglass group was 18.50 (SD = 5.94). Conclusions: Application of body cast using a fiberglass
material give better radiological outcome hence less pain, more functional and higher patient’s satisfaction
as compared to plaster of Paris.
Fulltext Primary fixation of AO type-C fracture of the distal radius with volar locking plates. A cross-sectional study of patient rated outcomes at Hospital Tengku Ampuan Afzan

Mohd Sallehuddin H, Zamzuri Z, Ariff MS, Mohd Shukrimi A, Mohamed Azril MA, Nazri MY

International Medical Journal Malaysia, 2014;13(2):3-6.
MyJurnal

Introduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate.

Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire.

Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score.

Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes.
Fulltext Outcome of infection following internal fixation of closed fractures

Nazri MY, Halim YA

Med J Malaysia, 2004 Dec;59(5):665-9.
PMID: 15889570

A retrospective study was done in 30 patients with infected closed fractures treated initially by open reduction and internal fixation. Nineteen fractures involved the femur, 8 the tibia, 2 the radius and 1 the ulna. Twenty-five were diaphyseal and 5 metaphyseal. Twenty-two fractures had initially been treated with plating and 8 with intramedullary nailing. Thirteen patients presented in the acute phase and 17 in the subacute phase of infection. Twenty-two patients presented with low grade infection and 8 with florid infection. The commonest organism isolated was Staphylococcus aureus (80%), of which fifty four percent was resistant to Methicillin (MRSA). This study showed that 77% of infected fractures with a stable implant united even in the presence of infection.
Construct and criterion validity of the Malaysia version of Lower Extremity Functional Scale (LEFS)

Mohd Yunus MA, Musa R, Nazri MY

Asia Pac J Sports Med Arthrosc Rehabil Technol, 2017 Oct;10:8-11.
PMID: 29392110 DOI: 10.1016/j.asmart.2017.09.002

Objective: The objective of this study is to translate the Lower Extremity Functional Scale (LEFS) into the Malay language and to validate the resulting version.
Methods: A two-stage observational study was conducted. The LEFS was initially cross-culturally adapted to Malay language through double forward and backward translation. The finalized version of Malay LEFS (M-LEFS) was subsequently validated for both construct validity and criterion validity. Participants (n = 208) with normal lower limb condition and various lower limb conditions completed the M-LEFS.
Results: Reliability of M-LEFS revealed excellent Cronbach's alpha value of 0.98. Construct validity, evaluated using exploratory factor analysis, exhibited good factor loadings (>0.6) of all 20 items. Interestingly, we extracted 2 components which was not reported elsewhere. With a cut-off point of 60, the sensitivity of the scale was 99% and the specificity was 81%.
Conclusions: The M-LEFS had very good psychometric properties among the studied population. Further studies are needed to enhance these preliminary outcomes in Malaysia.
Fulltext Cycle spokes and chain related injuries in children--emerging injuries in Malaysia

Nazri MY, Hafiz A, Yusof A, Khalid KA, Aminudin CA

Med J Malaysia, 2005 Jul;60 Suppl C:11-3.
PMID: 16381275

A descriptive prospective study of 16 children with injuries inflicted by bicycle spokes and chain was undertaken to identify the demographic profiles of such injuries. Aspects of preventive measures are proposed.
Fulltext Quality of life of diabetes amputees following major and minor lower limb amputations

Nazri MY, Aminudin CA, Ahmad FS, Mohd Jazlan MA, Jamalludin Ab R, Ramli M

Med J Malaysia, 2019 02;74(1):25-29.
PMID: 30846658

INTRODUCTION: Minor amputation was performed as a salvage procedure because most of the patients were not able to ambulate and become dependent following major amputation. Minor amputation is defined as amputation at the level of ankle joint and below while major amputation is defines by amputation above the ankle joint. The aim of this study was to compare the quality of life among diabetes patients following major and minor amputations.

METHODS: A total of 94 diabetes patients were reviewed six months following amputation. Their walking ability, dependency status and quality of life were evaluated, using the Malay translated version of the Short Form Health Survey 36 (SF-36) questionnaire.

RESULTS: During the follow up only three patients (8.3%) following major amputation were dependant compared to 30 patients (51.7%) following minor amputation. Forty-nine (84.5%) of minor amputation and only 15 (41.7%) of major amputation patients were ambulating independently. Patients with minor amputation have significantly better Physical functioning, Role - physical, General health, Role - emotional, and Mental health score (p<0.001). However, they have worse BP and SF score than those following major amputation (p<0.001). The VT score of both groups were not significantly different.

CONCLUSION: Patients with minor amputation are more independent, ambulatory and had better quality of life than those with major amputation. Despite the risk of persistent infection and amputation stump complication, minor amputation should be attempted in diabetes patients.