Displaying all 9 publications

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  1. Bahar Moni AS, Hoque M, Mollah RA, Ivy RS, Mujib I
    J Hand Surg Asian Pac Vol, 2019 Sep;24(3):317-322.
    PMID: 31438802 DOI: 10.1142/S2424835519500401
    Background: Hand infection in diabetics is an often ignored but challenging condition. If not addressed effectively, it may result in long term disability, contracture, amputation and even death. Methods: From August 2014 to December 2015, a study was done in our centre, where 49 diabetic hand infection cases were analyzed in two groups, superficial and deep hand infection. Results: Mean age of the patients was 51.63 years. There were 21 superficial infections and 28 deep infections. Cause of infection was unknown or spontaneous in 16 cases, traumatic laceration or crush in 14 patients, following minor prick in 10 cases. Most of the cases were the results of neglected minor wound. Forty-one patients were insulin dependent. Five cases were diagnosed as diabetic at the time of treatment. Four patients were treated conservatively and 45 (92%) cases required operation in the form of incision, drainage and debridement. In 16 (35%) cases, wound was left open and was healed by secondary intention following regular dressing. In five patients, wound was closed secondarily. Partial thickness skin graft was applied in 15 cases. Seven patients were treated with flap coverage. Partial digital or ray amputation were done in 16 cases. All fingers except thumb were amputated in one case and amputation from wrist was done in another patient. Wound swabs were taken, and antibiotics were changed or continued accordingly. But reports of 26 cases were available. No growth was found in four cases, monomicrobial infection was found in 15 patients and polymicrobial in seven cases. Infection resolved with healing in 47 cases. Two patients died during treatment from sepsis, both were insulin dependent, had associated renal failure and from deep infection group. One patient developed severe mental disorder. Conclusions: For diabetic hand infection, early diagnosis and prompt treatment with appropriate antibiotics and emergency surgery with extensile incision is crucial. Primary amputation of the part could be life and limb saving.
  2. Liew SK, Fong TS, Teh KK
    J Hand Surg Asian Pac Vol, 2021 Mar;26(1):103-106.
    PMID: 33559570 DOI: 10.1142/S2424835521720048
    Chronic embedded-ring injury is a rare and uncommon presentation. This is also known as "chronic ring erosion" or "embedded ring syndrome" in the literature. Injury of this type has been associated with psychological impairment causing neglect of such injury. We herein describe a case of double embedded rings on the right ring finger in a 30-year-old healthy construction worker. A primary amputation at the metacarpophalangeal joint was performed in view of the chronicity of his condition and associated neurovascular damage. Early removal of ring is of paramount importance in any ring-associated injuries. However, fear of losing a digit has been the reason of delay in seeking medical treatment, which in turn ended up in dire consequences.
  3. Lye JX, Kow RY, Ismail R, Khalid KA
    J Hand Surg Asian Pac Vol, 2021 Jun;26(2):166-179.
    PMID: 33928864 DOI: 10.1142/S2424835521500156
    Background: The Michigan Hand Outcomes Questionnaire (MHQ), a self-reported questionnaire for patients with hand disorders, has been widely used globally. It has been cross-culturally adapted into different languages across all continents. Aims of this study were to translate the MHQ into Malay language and to evaluate its reliability and validity compared with Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire in a Malay-speaking population. Methods: The MHQ was cross-culturally adapted into a Malay version based on the guidelines. A pre-testing involving thirty patients with hand disorders was performed to assess whether it was comprehensible to the target population. One hundred patients with hand disorders were recruited in this study to answer the MHQ and DASH questionnaires. The MHQ was tested twice with an interval of two weeks in between. Statistical analysis was performed to assess the reproducibility and internal consistency via the test-retest method and Cronbach's alpha calculation, respectively. The association between MHQ and DASH questionnaire was assessed with Spearman's correlation calculation. Results: In the pre-testing, twenty-six patients (86.7%) understood all the questions in the Malay version of MHQ. The test-retest analysis showed a good reliability across the duration of two weeks with the intraclass correlation coefficient of all subscales ranging from 0.925 to 0.984. Cronbach's alpha values of the Malay version MHQ ranged from 0.82 to 0.97, indicating a good internal consistency. Spearman's correlation factor of the MHQ in comparison with DASH showed a fair to moderately strong correlation with the values ranging from 0.513 to 0.757. Conclusions: The Malay version of MHQ was successfully translated and culturally-adapted with excellent reliability (reproducibility and internal consistency) and good construct validity.
  4. A RS, Abdullah S
    J Hand Surg Asian Pac Vol, 2016 10;21(3):439-43.
    PMID: 27595972 DOI: 10.1142/S2424835516970018
    A report on the 10(th) Asia-Pacific Federation of Societies for the Surgery of the Hand and 6(th) Asia-Pacific Federation of Societies for Hand Therapists is submitted detailing the numbers of attendees participating, papers presented and support received as well the some of the challenges faced and how best to overcome them from the local conference chair and scientific chair point of view.
  5. Tan LS, Daud MH, Nasirudin N
    J Hand Surg Asian Pac Vol, 2018 Dec;23(4):577-580.
    PMID: 30428790 DOI: 10.1142/S2424835518720335
    Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign vascular lesion of the skin or mucous membrane with rapid growth or repetitive trauma. Rarely seen in adult, its management varies and surgical intervention is usually common. We report a case of pyogenic granuloma of the right index finger in a 46-year-old gentleman who presented with painless swelling of the right index finger after a trivial injury. Wedge biopsy confirmed the diagnosis and excision of the granuloma measuring 3 cm × 3 cm × 2 cm was done with curettage and electrocautery over the base of granuloma. The wound subsequently healed well with good functional and aesthetic outcome.
  6. Looi CSK, S A R, Gill RS
    J Hand Surg Asian Pac Vol, 2017 Sep;22(3):396-402.
    PMID: 28774257 DOI: 10.1142/S0218810417720327
    Forearm fractures in children complicated with non-union are uncommon. Various methods have previously been reported to manage this condition. Well documented techniques would include iliac crest grafting, cancellous insert grafting, ulnar segment grafting, cortical tibial grafting, vascularized fibular grafting and bone transport by ring fixation. The authors present a case of a child with an atrophic non-union of the ulna who was successfully treated with a cortico-cancellous tibial strut bone graft.
  7. Yong MW, Yusof N, Rampal L, Arumugam M
    J Hand Surg Asian Pac Vol, 2017 Dec;22(4):484-489.
    PMID: 29117832 DOI: 10.1142/S021881041750054X
    BACKGROUND: Palmaris Longus is being widely used in reconstructive, plastic and cosmetic surgeries due to its long tendon. It is the most readily available source for tendon grafting. The objective of this study was to determine the prevalence of absence of Palmaris Longus and its association with gender, hand dominance and absence of FDS (flexor digitorum superficialis) tendon to little finger among Malay population.

    METHODS: An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers.

    RESULTS: The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male.

    CONCLUSIONS: In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.

  8. Abdullah S, Mohtar F, Abdul Shukor N, Sapuan J
    J Hand Surg Asian Pac Vol, 2017 Dec;22(4):429-434.
    PMID: 29117830 DOI: 10.1142/S0218810417500459
    BACKGROUND: Synthetic scaffold has been used for tissue approximation and reconstructing damaged and torn ligaments. This study explores the ability of tendon ingrowth into a synthetic scaffold in vitro, evaluate growth characteristics, morphology and deposition of collagen matrix into a synthetic scaffold.

    METHODS: Upper limb tendons were harvested with consent from patients with crush injuries and non-replantable amputations. These tendons (both extensor and flexor) measuring 1 cm are sutured to either side of a 0.5 cm synthetic tendon strip and cultured in growth medium. At 2, 4, 6 and 8 weeks, samples were fixed into paraffin blocks, cut and stained with haematoxylin-eosin (H&E) and Masson's trichrome.

    RESULTS: Minimal tendon ingrowth were seen in the first 2 weeks of incubation. However at 4 weeks, the cell ingrowth were seen migrating towards the junction between the tendon and the synthetic scaffold. This ingrowth continued to expand at 6 weeks and up to 8 weeks. At this point, the demarcation between human tendon and synthetic scaffold was indistinct.

    CONCLUSIONS: We conclude that tendon ingrowth composed of collagen matrix were able to proliferate into a synthetic scaffold in vitro.

  9. Diong TW, Haflah NHM, Kassim AYM, Habshi SMIA, Shukur MH
    J Hand Surg Asian Pac Vol, 2018 Mar;23(1):26-32.
    PMID: 29409409 DOI: 10.1142/S2424835518500030
    BACKGROUND: The use of volar locking plate in distal radius fracture can lead to extensor tendon rupture due to dorsal screw penetration. The aim of our study was to investigate the occurrence of dorsal and intra-articular screw penetration using CT scan after volar distal radius osteosynthesis for distal radius fractures.

    METHODS: Thirty patients who underwent distal volar locking plate for distal radius fracture were included in a retrospective study. In all 30 patients no dorsal and intra-articular screw penetration were detected on standard AP and lateral views of a plain radiograph. CT scan of the operated wrist was performed to determine the number of intra-articular and dorsal screw penetrations. Clinical examination was performed to determine the wrist functions in comparison to the normal wrist.

    RESULTS: Nineteen wrists were noted to have screw penetration either dorsally or intraarticularly. The highest incidence is in the 2nd extensor compartment where 13 screws had penetrated with a mean of 2.46 mm. Six screws penetrated into the distal radial ulnar joint and five screws into the wrist joint with a mean of 2.83 mm and 2.6 mm, respectively. However, there was no incidence of tendon irritation or rupture.

    CONCLUSIONS: This study demonstrated a high incidence of dorsal and intra-articular screw penetration detected by CT scan which was not apparent in plain radiograph. We recommend that surgeons adhere to the principle of only near cortex fixation and downsizing the locking screw length by 2 mm.

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