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Long-term results of tibialis posterior tendon transfer for drop-foot

Yeap JS, Birch R, Singh D

Int Orthop, 2001;25(2):114-8.
PMID: 11409449

Twelve patients with drop-foot secondary to sciatic or common peroneal nerve palsy treated with transfer of the tibialis posterior tendon were followed-up for a mean of 90 (24-300) months. In 10 patients the results were 'excellent' or 'good'. In 11 patients grade 4 or 5 power of dorsiflexion was achieved, although the torque, as measured with a Cybex II dynamometer, and generated by the transferred tendon, was only about 30% of the normal side. Seven patients were able to dorsiflex their foot to the neutral position and beyond. The results appeared to be better in men under 30 years of age with common peroneal palsies. A painful flatfoot acquired in adulthood does not appear to be a significant long-term complication despite the loss of a functioning tibialis posterior tendon.
Fulltext Synovial biopsy. A comparative study from Saudi Arabia and Malaysia

Sankaran-Kutty M, Das PK, Kannan Kutty M

Int Orthop, 1998;22(3):189-92.
PMID: 9728315 DOI: 10.1007/s002640050239

A comparative study of synovitis in Saudi Arabia and Malaysia was made with a view to determining any geographic variation in the incidence and pattern of the arthritides. The diagnostic spectrum in both series included pyogenic arthritis, rheumatoid arthritis, brucellar and tubercular arthritis, gout, pigmented villonodular synovitis, synovial chondromatosis and acute rheumatic fever. Date-palm thorn synovitis was observed only in the Saudi Arabian series. While brucellar and tuberculous arthritis were predominantly seen in Saudi Arabia, the incidence of rheumatoid arthritis, pigmented villonodular synovitis and acute suppurative arthritis was almost equal in both countries.
Spontaneous, extra-dural haematoma causing spinal cord compression

Mustafa M, Subramanian N

Int Orthop, 1996;20(6):383-4.
PMID: 9049770

We describe a patient with acute compression of the spinal cord by a spontaneous extra-dural haematoma. This rare condition is often misdiagnosed. We believe that an urgent MRI scan is indicated in patients presenting with progressive neurological deficit following spinal trauma. This allows the diagnosis of extra-dural haematoma to be made rapidly and for prompt decompression of the cord.
A review of patients with skeletal tuberculosis treated at the University Hospital, Kuala Lumpur

Silva JF

Int Orthop, 1980;4(2):79-81.
PMID: 7429684 DOI: 10.1007/bf00271088

Two hundred and nineteen patients with skeletal tuberculosis have been reviewed analysing the site of the lesion and the treatment given. Operative management is advocated since the results of this approach are encouraging.
Necrotizing fasciitis, causative agents and management: a five-year retrospective study in two tertiary care hospitals in Central Malaysia

Rampal S, Maniam S, Lim PY, Ramachandran R, Tan EK, Halim MAHA, et al.

Int Orthop, 2021 06;45(6):1399-1405.
PMID: 33484294 DOI: 10.1007/s00264-020-04905-2

PURPOSE: Necrotizing fasciitis (NF) is a rapidly progressive inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues. The severity of the disease depends on the virulence of the organism and host immunity. There is a paucity of reports on the prevalence of NF causing pathogens and management.
METHODS: Retrospective data of patients treated for NF were collected from two tertiary care hospitals in Central Malaysia between January 2014 and December 2018.
RESULTS: A total of 469 NF patients were identified. More than half of the NF patients were males (n = 278; 59.28%). The highest number of cases was found among age groups between 30 and 79, with mean age of 56.17. The majority of the NF cases (n = 402; 85.72%) were monomicrobial. Streptococcus spp. (n = 89; 18.98%), Pseudomonas aeruginosa (n = 63; 13.44%) and Staphylococcus spp. (n = 61; 13.01%) were identified as the top three microorganisms isolated. Among the 469 NF cases, 173 (36.8%) were amputated or dead while 296 (63.1%) recovered. Proteus spp. (n = 19; 12.93%), Klebsiella pneumoniae (n = 18; 12.24%) and Escherichia coli (n = 14; 9.52%) were associated with all types of amputations. The most common antibiotic prescribed was unasyn (n = 284; 60.56%), followed by clindamycin (n = 56; 11.94%) and ceftazidime (n = 41; 8.74%). A total of 239 (61.8%) recovered while 148 (38.2%) were either amputated or dead when managed with the unasyn, clindamycin or ceftazidime.
CONCLUSION: This study represents the largest NF cases series in Malaysia highlighting the causative agents and management.
Fulltext Rising within the leadership of an orthopaedic society: learning from the presidents

Thevendran G, Glazebrook M, Eastwood D, Weber K, Kit DCS, Johari A, et al.

Int Orthop, 2022 Mar;46(3):443-447.
PMID: 34982195 DOI: 10.1007/s00264-021-05295-9

Orthopaedic societies, with their diverse membership from across the world, serve a mission to endorse the progress and innovation in the field of orthopaedics and traumatology with a focus on improving patient care, as well as to encourage and develop education, teaching and research. Such organizations, whether small or large, have been successful in meeting the professional, educational and training needs of its members. The past and future presidents of these societies share insights addressing their professional experiences, lessons learnt and their vision for future leaders of the field. The objective of this article is to summarize the thoughts of presidents of orthopaedic societies from around the globe and to inspire younger and aspiring members of the global orthopaedic fraternity.
State-of-the-art review: The advantage and use of Wide Awake Local Anaesthesia No Tourniquet (WALANT) for nerve decompression surgery

Ahmad AA, Lalonde DH

Int Orthop, 2025 Feb 14.
PMID: 39951053 DOI: 10.1007/s00264-025-06432-4

PURPOSE: Wide Awake Local Anesthesia No Tourniquet (WALANT) has gained significant attention since its introduction in 2005. Over 343 publications since 2013 highlight its increasing use in nerve decompression surgeries. WALANT is known for its safety benefits, cost-effectivenes and improved patient experience compared to traditional sedation and tourniquet-based methods. This review examines the advantages of WALANT in nerve decompression surgery, emphasizing its growing adoption and benefits.
METHODS: A comprehensive review of the WALANT technique is provided, focusing on injection strategies, including buffered lidocaine with epinephrine, proper needle placement and generous volume of tumescent anesthesia. Specific injection protocols and surgical approaches are discussed for various nerve decompression procedures such as carpal tunnel, lacertus, cubital tunnel, radial tunnel and lateral intermuscular septum releases.
RESULTS: WALANT eliminates sedation-related risks such as nausea, aspiration pneumonia and thromboembolism, making it suitable for high-risk patients (ASA 4). It reduces healthcare costs by decreasing the need for post-anesthesia care units and operating in minor procedure rooms. The technique fosters greater surgeon-patient interaction, reduces hospital stays and avoids preoperative fasting and testing. WALANT has demonstrated positive outcomes across multiple nerve decompression procedures.
CONCLUSION: WALANT provides a transformative approach in nerve decompression surgery, offering enhanced safety, cost-effectiveness and improved patient-centered care. It significantly contributes to positive surgical outcomes, making it a valuable technique for both patients and healthcare providers.
Spin is Prevalent in the Abstracts of Systematic Reviews and Meta-Analyses Comparing Biceps Tenodesis and Tenotomy Outcomes

Khaled K, Alderhali R, Helbing J, Alzobi O, Zikria B

Int Orthop, 2025 Jan 24.
PMID: 39853426 DOI: 10.1007/s00264-025-06414-6

PURPOSE: This study aimed to assess the presence of spin in abstracts of systematic reviews and meta-analyses comparing biceps tenodesis and tenotomy outcomes and to explore associations between spin and specific study characteristics.
METHODS: Using Web of Science and PubMed databases, systematic reviews and meta-analyses comparing outcomes of biceps tenodesis and tenotomy were identified. Abstracts were evaluated for the nine most severe types of spin as described by Yavchitz et al. and appraised using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews). Study characteristics were extracted, including adherence to PRISMA guidelines,funding status, and impact metrics such as journal impact factor, total number of citations, and average annual citations.
RESULTS: A total of 16 studies were included, with spin detected in 81.3% of the abstracts. Type three spin was the most frequent (56.3%), followed by types six (43.8%), five (37.5%), nine (25.0%), two (12.5%), and four (6.3%). Spin types one, seven, and eight were not observed. AMSTAR 2 appraised 75% of the studies as 'low' quality, and 25% as 'critically low' quality. All studies had at least one critical flaw, with item 15 (investigation of publication bias) being the most frequent (93.8%). A strong positive correlation was found between AMSTAR 2 scores and citation counts (r = 0.821, p