Displaying publications 1 - 20 of 197 in total

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  1. Manuel JK, Yusof Bin Mohd M
    Am. J. Phys. Anthropol., 1974 Jul;41(1):133-7.
    PMID: 4843090
    Matched MeSH terms: Femur/anatomy & histology*; Femur Head/anatomy & histology; Femur Neck/anatomy & histology
  2. Malerba G, Basilico M, Bonfiglio N, Maccauro G
    Malays Orthop J, 2020 Nov;14(3):177-179.
    PMID: 33403082 DOI: 10.5704/MOJ.2011.029
    Isolated apophyseal avulsion of the greater trochanter is a rare condition in the paediatric population, frequently related to avascular necrosis of the femoral head. Since there are few cases in the literature, there is no consensus regarding the best treatment of this injury. Our study describes the case of a 9-year-old patient with an avulsion of the right greater trochanter. A minimally invasive osteosynthesis was performed, achieving complete clinical and radiographic healing of the patient and no long-term complications after four years.
    Matched MeSH terms: Femur; Femur Head; Femur Head Necrosis
  3. Mohamed Thajudeen MZ, Mahmood Merican A, Hashim MS, Nordin A
    Medicine (Baltimore), 2022 Nov 11;101(45):e31398.
    PMID: 36397421 DOI: 10.1097/MD.0000000000031398
    Femoral anteversion is an important parameter that can prevent complication following total hip arthroplasty (THA) caused by improper positioning of the implant. However, assessing femoral anteversion can be challenging in situation with significant defect of the femoral neck. In this study, linea aspera version was nominated as alternative parameter to femoral anteversion. So, the main objective of this study is to determine whether femoral anteversion correlates with linea aspera version. Cross-sectional study. Three-dimensional images of 100 femora were generated and their femoral anteversion and linea aspera version was measured. Correlation between the parameters was calculated. The mean linea aspera version was 7.27° ± 12.17° (mean ± standard deviation) while the mean femoral anteversion was 11.84° ± 10.06°. The linea aspera version was inversely correlated with the femoral anteversion with a correlation coefficient of -0.85. Linea aspera should be considered as an additional bony landmark to assess proper implant positioning in THA.
    Matched MeSH terms: Femur/surgery; Femur Neck/surgery
  4. Hwang PX, Wang CK
    Injury, 2023 Nov;54(11):111038.
    PMID: 37741171 DOI: 10.1016/j.injury.2023.111038
    We have read the paper "Important tips and numbers on using the cortical step and diameter difference sign in assessing femoral rotation - Should we abandon the technique?" [1] with great interest. Restoring femoral rotation during intramedullary nailing can pose challenges to many experienced surgeons. Femur rotational side-to-side asymmetry which is greater than 10 ° will cause functional deficit. We propose a surgical technique which allows surgeons to evaluate and reduce the malrotated femur intraoperatively. This technique also improves the ergonomics of the surgery and can be used simultaneously with other femoral rotation evaluation techniques. LEVEL OF EVIDENCE: V.
    Matched MeSH terms: Femur/surgery
  5. Pan K, Reuben P
    Malays Orthop J, 2012 Nov;6(3):66-8.
    PMID: 25279064 MyJurnal DOI: 10.5704/MOJ.1207.011
    We report a method for removing the distal segment of a broken locked intramedullary nail secondary to nonunion of the femur following radiotherapy for fibromatosis. A Kirschner wire with one tip fashioned into a hook was used to remove the distal segment without opening with the nonunion site. Details of the procedure are described.
    Matched MeSH terms: Femur
  6. Hwang PX, Anuwar NA, Khaw YC, Hadizie D
    Malays Orthop J, 2020 Mar;14(1):74-77.
    PMID: 32296485 DOI: 10.5704/MOJ.2003.011
    Coronal malalignment due to malrotated trochanteric nail placement in femoral fracture fixation has never been reported. We present a case of a femoral segmental fracture fixed with a trochanteric nail, with a malrotated placement resulting in a valgus malaligned nail and femur, associated with a rotational malalignment. Knowledge of the modern nail design with proper intra-operative precautions, would avoid this underestimated technical error.
    Matched MeSH terms: Femur
  7. Baharuddin MY, Salleh ShH, Zulkifly AH, Lee MH, Mohd Noor A
    Biomed Res Int, 2014;2014:692328.
    PMID: 25025068 DOI: 10.1155/2014/692328
    A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angle, bowing angle, anteversion, and medullary canal diameters from the osteotomy level to 150 mm below the osteotomy level to determine the position of the isthmus. Other indices and ratios for the endosteal canal, metaphyseal, and flares were computed and examined. The results showed that Asian femurs are smaller than Western femurs, except in the metaphyseal region. The canal flare index (CFI) was poorly correlated (r < 0.50) to the metaphyseal canal flare index (MCFI), but correlated well (r = 0.66) with the corticomedullary index (CMI). The diversity of the femoral size, particularly in the metaphyseal region, allows for proper femoral stem design for Asian patients, improves osseointegration, and prolongs the life of the implant.
    Matched MeSH terms: Femur/anatomy & histology*; Femur/pathology; Femur/radiography; Femur Head/anatomy & histology*; Femur Head/pathology; Femur Head/radiography
  8. Tariq U, Hussain R, Tufail K, Haider Z, Tariq R, Ali J
    Mater Sci Eng C Mater Biol Appl, 2019 Oct;103:109863.
    PMID: 31349467 DOI: 10.1016/j.msec.2019.109863
    Quick setting and poor injectability due to liquid-solid phase separation have limited the clinical use of brushite and monetite cements. The presence of certain ions in the cement during the setting reaction moderate the setting time and properties of the cement. This study reports the preparation of injectable bone cement by using biphasic calcium phosphate (BCP) extracted from femur lamb bone by calcination at 1450 °C. EDX analysis infers the presence of Mg and Na ions as trace elements in BCP. X-ray diffraction patterns of the prepared cement confirmed the formation of brushite (DCPD) along with monetite (DCPA) as a minor phase. DCPA phase diminished gradually with a decrease in powder to liquid ratio (PLR). Initial and final setting time of 5.3 ± 0.5 and 14.67 ± 0.5 min respectively are obtained and within the acceptable recommended range for orthopedic applications. Exceptional injectability of ≈90% is achieved for all prepared bone cement samples. A decrease in compressive strength was observed with increase in the liquid phase of the cement, which is attributed to the higher degree of porosity in the set cement. Immersion of bone cement in simulated body fluid (SBF) for up to 7 days resulted in the formation of apatite layer on the surface of cement with Ca/P ratio 1.71, which enhanced the compressive strength from 2.88 to 9.15 MPa. The results demonstrate that bone cement produced from BCP extracted from femur lamb bone can be considered as potential bone substitute for regeneration and repair of bone defects.
    Matched MeSH terms: Femur/chemistry*
  9. Lee M, Ho JPY, Chen JY, Ng CK, Yeo SJ, Merican AM
    J Knee Surg, 2022 Feb;35(3):280-287.
    PMID: 32629512 DOI: 10.1055/s-0040-1713733
    BACKGROUND:  Restoration of the anatomical joint line, while important for clinical outcomes, is difficult to achieve in revision total knee arthroplasty (rTKA) due to distal femoral bone loss. The objective of this study was to determine a reliable method of restoring the anatomical joint line and posterior condylar offset in the setting of rTKA based on three-dimensional (3D) reconstruction of computed tomography (CT) images of the distal femur.

    METHODS:  CT scans of 50 lower limbs were analyzed. Key anatomical landmarks such as the medial epicondyle (ME), lateral epicondyle, and transepicondylar width (TEW) were determined on 3D models constructed from the CT images. Best-fit planes placed on the most distal and posterior loci of points on the femoral condyles were used to define the distal and posterior joint lines, respectively. Statistical analysis was performed to determine the relationships between the anatomical landmarks and the distal and posterior joint lines.

    RESULTS:  There was a strong correlation between the distance from the ME to the distal joint line of the medial condyle (MEDC) and the distance from the ME to the posterior joint line of the medial condyle (MEPC) (p 

    Matched MeSH terms: Femur/surgery
  10. Kumar A, Chong YT, Jamil K, Rusli E
    BMJ Case Rep, 2021 Nov 05;14(11).
    PMID: 34740908 DOI: 10.1136/bcr-2021-245415
    Osteoglophonic dwarfism, also known as osteoglophonic dysplasia (OD), is an uncommon skeletal dysplasia with an autosomal dominant mode of inheritance, which equally affects boys and girls. OD is saliently featured by craniosynostosis, dysmorphic facial features, impacted mandibular teeth, rhizomelic limb shortening and non-ossifying fibromas habitually at the metaphyseal regions, which usually disappear after skeletal maturity. The long bones in OD are portrayed by this distinguishable 'hollowed-out' appearance with metaphyseal cystic defects that have a natural history of spontaneous resolution. We report a case of a rare and unusual presentation of OD in a 23-year-old woman whom has been diagnosed with OD during her early childhood. She presented with a progressively enlarging right thigh swelling associated with pain for the past 1 year. Her right femur plain radiograph revealed diffuse lysis of the whole femur with cortical thinning. MRI revealed multiple bilateral femur benign cystic lesion synonymous with a severe spectrum of OD. She was started on a trial of oral bisphosphonates, which led to a significant improvement in pain.
    Matched MeSH terms: Femur/pathology
  11. Soliman MM, Islam MT, Chowdhury MEH, Alqahtani A, Musharavati F, Alam T, et al.
    J Mater Chem B, 2023 Nov 15;11(44):10507-10537.
    PMID: 37873807 DOI: 10.1039/d3tb01469j
    The UK's National Joint Registry (NJR) and the American Joint Replacement Registry (AJRR) of 2022 revealed that total hip replacement (THR) is the most common orthopaedic joint procedure. The NJR also noted that 10-20% of hip implants require revision within 1 to 10 years. Most of these revisions are a result of aseptic loosening, dislocation, implant wear, implant fracture, and joint incompatibility, which are all caused by implant geometry disparity. The primary purpose of this review article is to analyze and evaluate the mechanics and performance factors of advancement in hip implants with novel geometries. The existing hip implants can be categorized based on two parts: the hip stem and the joint of the implant. Insufficient stress distribution from implants to the femur can cause stress shielding, bone loss, excessive micromotion, and ultimately, implant aseptic loosening due to inflammation. Researchers are designing hip implants with a porous lattice and functionally graded material (FGM) stems, femur resurfacing, short-stem, and collared stems, all aimed at achieving uniform stress distribution and promoting adequate bone remodeling. Designing hip implants with a porous lattice FGM structure requires maintaining stiffness, strength, isotropy, and bone development potential. Mechanical stability is still an issue with hip implants, femur resurfacing, collared stems, and short stems. Hip implants are being developed with a variety of joint geometries to decrease wear, improve an angular range of motion, and strengthen mechanical stability at the joint interface. Dual mobility and reverse femoral head-liner hip implants reduce the hip joint's dislocation limits. In addition, researchers reveal that femoral headliner joints with unidirectional motion have a lower wear rate than traditional ball-and-socket joints. Based on research findings and gaps, a hypothesis is formulated by the authors proposing a hip implant with a collared stem and porous lattice FGM structure to address stress shielding and micromotion issues. A hypothesis is also formulated by the authors suggesting that the utilization of a spiral or gear-shaped thread with a matched contact point at the tapered joint of a hip implant could be a viable option for reducing wear and enhancing stability. The literature analysis underscores substantial research opportunities in developing a hip implant joint that addresses both dislocation and increased wear rates. Finally, this review explores potential solutions to existing obstacles in developing a better hip implant system.
    Matched MeSH terms: Femur/surgery
  12. Hassan Shukur M
    Med J Malaysia, 2006 Feb;61 Suppl A:1-2.
    PMID: 17042219
    In this issue of the Journal, there are two articles addressing relevant clinical problems that we may encounter in our practice. The main issue related to the occurrence of the inevitability of the avascular necrosis (AVN) following treatment of two different major types of capital femoral epiphyseal 'injury'.
    Matched MeSH terms: Femur Head/injuries*; Femur Head/radiography; Femur Head/surgery; Femur Head Necrosis/etiology; Femur Head Necrosis/prevention & control
  13. Aminudin CA, Suhail A, Shukur MH, Yeap JK
    Med J Malaysia, 2006 Feb;61 Suppl A:94-6.
    PMID: 17042240
    Acute traumatic transphyseal fracture of the capital femoral epiphysis is a rare but serious injury. The injury is typically inflicted by a severe trauma. Because of the vulnerability and predisposed anatomy of the femoral epiphysis in relation to its blood supply, the fracture has been designated to have poor prognosis with inevitable osteonecrosis and eventual deformity of the hip. We report a case of such fracture in a 13-year-old child in view to highlight some of the anticipated problems in the management of such injury.
    Matched MeSH terms: Femur Head/injuries*; Femur Head/radiography; Femur Head/surgery; Femur Head Necrosis/etiology; Femur Head Necrosis/prevention & control
  14. Ismail TB, Mahmoud MM, Ahmed OE, Bola AH, Bahaa ZH
    Med J Malaysia, 2023 Mar;78(2):163-170.
    PMID: 36988525
    INTRODUCTION: Benign bone tumours occur most commonly during the first through third decades of life and often weaken the bones, which may predispose them to pathological fractures. Great diversity and debate in the management of primary bone tumours are based on the tumour extent. There has been an increasing trend toward the intra-operative filling of these lesions. We hypothesised that in some benign bone tumours, filling the resulting cavity after curettage was unnecessary. This study was carried out to determine whether it is necessary to fill the resultant cavity after the curettage of benign bone tumours and to represent various fillers.

    MATERIALS AND METHODS: A retrospective study of patients diagnosed as benign bone tumours according to the Enneking classification who underwent simple or extended curettage at Menoufia university-Orthopedic Oncology Division (with or without grafting or filling) during the surgical treatment (Jan 2015 to Feb 2020). A review of the medical records was done. Lesions' size (length, width and depth) was measured on plain radiographs using the image j program. When applicable, degrees of filling of the resultant cavity were classified into four categories, according to Modified Neer's classification. Functional evaluation using the musculoskeletal tumour society (MSTS) score was reviewed.

    RESULTS: Overall, 88 patients diagnosed with a primary bone tumour and who received the surgical intervention were included in the study. The mean age of the patients was 22.61+13.497 (3-58) years. There were 48 males and 40 females (54 right and 34 left). The mean follow-up period was 28.09+16.13 months. The most common location was the distal femur in 15 patients, the proximal femur in 10 patients and the proximal tibia in 12 patients. The most common diagnosis was giant cell tumour in 20 patients, followed by UBC in 19 patients, ABC in 15 patients and enchondroma in 13 patients. Twenty-three patients had simple curettage, while 65 patients had extended curettage. Mean MSTS was 28.78±1.68. Fifty-five lesions were classified according to modified Neer's classification.Thirtty-two patients were classified as type 1 with complete healing,22 patient was classified as type 2 with partial healing, and only one was classified as a recurrent lesion. Seven patients (7.9%) developed local recurrences.

    CONCLUSION: Filling the resulting cavity after the removal of the pathological tissues is usually necessary but not always required. This is determined by the type of lesion and the size of the resulting cavity following curettage. Individualised surgery is required; additional fixation should be considered.

    Matched MeSH terms: Femur/pathology; Femur/surgery
  15. Lloyd S, Rashid AH, Das S, Ibrahim S
    Anat Sci Int, 2014 Mar;89(2):122-5.
    PMID: 24158808 DOI: 10.1007/s12565-013-0211-0
    Tibial hemimelia is a rare anomaly of unknown etiology. This condition can occur sporadically or may have a familial inheritance. It is characterized by deficiency of the tibia with a relatively intact fibula. The anomaly may be unilateral or bilateral. We report a case of a 2-year-old girl who presented with right lower limb deformity since birth. She was diagnosed with proximal femur focal deficiency with absence of the ipsilateral tibia. She presented with a shorter right lower limb and a deformed foot. She was treated with a through-knee amputation. Anatomical dissection of the amputated limb was carried out to verify the anomalies. The dissection showed that the distal phalanx of the great toe was trifid. The anatomical and clinical significance of this interesting case is discussed.
    Matched MeSH terms: Femur/abnormalities*
  16. Kamath SU, Agarwal S, Austine J
    Malays Orthop J, 2020 Nov;14(3):143-150.
    PMID: 33403075 DOI: 10.5704/MOJ.2011.022
    Introduction: With a higher proportion of young individuals undergoing uncemented hip arthroplasty, a close match in the dimension of the proximal femur and the implanted prosthesis is paramount. This is a study to gain insight into geographical variation in proximal femur morphology to determine the reference values to design uncemented femoral stems for a south Indian population, and also the effect of ageing and gender on the proximal femur morphology.

    Materials and Methods: The study comprised of two groups. For the first group, 50 unpaired dry femur bones were obtained from adult human cadavers; and the second group was a clinical group of 50 adult patients. Standardised radiographic techniques were used to measure the extra-cortical and intra-cortical morphometric parameters. Based on these, dimensionless ratios were calculated to express the shape of the proximal femur. The data were expressed in terms of mean and standard deviation and a comparison made with other studies.

    Results: A significant difference was noted across various population subsets within the Indian subcontinent and also in comparison to the Western population, suggestive of regional variation. The measurements made in cadaveric bone differed significantly from those in live patients, especially the femoral head diameter and extra-cortical and intra-cortical width. Femoral offset, head height and diameter were significantly less in females.

    Conclusion: The south Indian population needs customised implants with an increase in neck shaft angle and a decrease in intra-cortical and extra-cortical width for press fit in hip arthroplasty. The variation between the two sexes must also be accounted for during prosthesis design.

    Matched MeSH terms: Femur; Femur Head
  17. Law GW, Koh J, Yew A, Howe TS
    Malays Orthop J, 2020 Mar;14(1):7-17.
    PMID: 32296476 DOI: 10.5704/MOJ.2003.002
    Introduction: Medial migration is the paradoxical migration of the femoral neck element (FNE) superomedially against gravity with respect to the intramedullary component of the cephalomedullary device, increasingly seen in the management of pertrochanteric hip fractures with the intramedullary nail. We postulate that the peculiar anti-gravity movement of the FNE in the medial migration phenomenon stems from a ratcheting mechanism at the intramedullary nail-FNE interface, which should inadvertently produce unique wear patterns on the FNE that can be seen with high-powered microscopy. By examining the wear patterns on retrieved implants from patients with medial migration, our study aims to draw clinical correlations to the ratcheting mechanism hypothesis.

    Material and Methods: Four FNEs were retrieved from revision surgeries of four patients with prior intramedullary nail fixation of their pertrochanteric hip fractures complicated by femoral head perforation. The FNEs were divided into two groups based on whether or not there was radiographic evidence of medial migration prior to the revisions. Wear patterns on the FNEs were then assessed using both scanning electron microscopy and light microscopy.

    Results: Repetitive, linearly-arranged, regularly-spaced, unique transverse scratch marks were found only in the group with medial migration, corresponding to the specific segment of the FNE that passed through the intramedullary component of the PFNA during medial migration. These scratch marks were absent in the group without medial migration.

    Conclusion: Our findings are in support of a ratcheting mechanism behind the medial migration phenomenon with repetitive toggling at the intramedullary nail-FNE interface and progressive propagation of the FNE against gravity.

    Matched MeSH terms: Femur Head; Femur Neck
  18. Curnoe D, Datan I, Goh HM, Sauffi MS
    J Hum Evol, 2019 02;127:133-148.
    PMID: 30777354 DOI: 10.1016/j.jhevol.2018.12.008
    The skeletal remains of Pleistocene anatomically modern humans are rare in island Southeast Asia. Moreover, continuing doubts over the dating of most of these finds has left the arrival time for the region's earliest inhabitants an open question. The unique biogeography of island Southeast Asia also raises questions about the physical and cultural adaptations of early anatomically modern humans, especially within the setting of rainforest inhabitation. Within this context the Deep Skull from the West Mouth of the Niah Caves continues to figure prominently owing to its relative completeness and the greater certainty surrounding its geological age. Recovered along with this partial cranium in 1958 were several postcranial bones including a partial femur which until now has received little attention. Here we provide a description and undertake a comparison of the Deep Skull femur finding it to be very small in all of its cross-sectional dimensions. We note a number of size and shape similarities to the femora of Indigenous Southeast Asians, especially Aeta people from the Philippines. We estimate its stature to have been roughly 145-146 cm and body mass around 35 kg, confirming similarities to Aeta females. Its extreme gracility indicated by low values for a range of biomechanical parameters taken midshaft meets expectations for a very small (female) Paleolithic East Asian. Interestingly, the second moment of area about the mediolateral axis is enlarged relative to the second moment of area about the anteroposterior axis, which could potentially signal a difference in activity levels or lifestyle compared with other Paleolithic femora. However, it might also be the result of sexual dimorphism in these parameters as well as possibly reflecting changes associated with aging.
    Matched MeSH terms: Femur/anatomy & histology*
  19. Harna B, Dutt DD, Sabat D
    Malays Orthop J, 2020 Nov;14(3):174-176.
    PMID: 33403081 DOI: 10.5704/MOJ.2011.028
    Hoffa fractures are rare and difficult fractures to manage. Hoffa fracture involves a coronal plane fracture of posterior femoral condyle. Non-union in Hoffa fracture is further difficult to manage. The surgical management for such nonunion includes open reduction with recon/LCP plate or screw fixation with bone grafting. The problem with plates is the difficulty in contouring the plates according to the shape of posterior femoral condyles. We describe a new technique with 2 L shaped neutralisation plates placed in a circular fashion. This technique provides a more rigid construct and gives better holding strength of screws in Hoffa fragment. This enhances union and mobilisation can be started early.
    Matched MeSH terms: Femur
  20. Chee, Winnie Siew Swee, Ting, Geik Poh, Tan, Soon Yean, Chan, Siew Pheng, Zaitun Yassin, Suriah Abdul Rahman
    MyJurnal
    Kehilangan jisim tulang adalah lebih ketara selepas menopaus. Jangka masa menopaus dan umur yang meningkat dikaitkan dengan penurunan jisim tubuh tanpa lemak, peningkatan lemak badan dan peningkatan berat badan. Kajian ini melihat sumbangan relatif jisim tubuh tanpa lemak dan lemak badan ke atas ketumpatan mineral tulang (KMT) di kalangan 139 wanita Cina posmenopaus sihat di Kuala Lumpur. KMT di kawasan seluruh tubuh, tulang belakang ( L2-L4), leher femur dan keseluruhan tulang pinggul diukur dengan alat dual-energy X-ray absorptiometry (DxA). Hasil kajian mendapati 80% daripada wanita posmenopaus Cina mempunyai jisim tulang yang rendah (osteopenia) manakala 8% daripada mereka mengalami osteoporosis di bahagian tulang belakang atau tulang pinggul. Secara keseluruhan, lemak badan mempunyai korelasi yang positif dengan KMT di semua bahagian diukur (keseluruhan tubuh, r = 0.265, p < 0.001; tulang belakang r = 0.214, p < 0.05, leher femur, r = 0.254, p < 0.001; keseluruhan tulang pinggul r = 0.332, p < 0.001). Jisim tubuh tanpa lemak juga mempunyai korelasi yang positif dengan KMT kebanyakan kawasan diukur (keseluruhan tubuh, r = 0.239, p < 0.001; leher femur r = 0.365, p < 0.001; keseluruhan tulang pinggul r = 0.352, p < 0.001) kecuali tulang belakang. Analisis regresi menunjukkan lemak badan dapat meramal KMT pada keseluruhan badan (p < 0.0001) dan tulang belakang (p < 0.005) manakala jisim tubuh tanpa lemak dapat meramal KMT pada tulang femur dan tulang pinggul (p < 0.0001). Hasil kajian menunjukkan kedua-dua lemak tubuh dan jisim tubuh tanpa lemak memainkan peranan dalam mempengaruhi KMT, di mana lemak badan memainkan peranan yang lebih di kalangan wanita posmenopaus. Oleh itu, wanita posmenopaus perlu elakkan mempunyai berat badan yang terlalu rendah (kurang lemak badan) dan mengekalkan jisim tubuh tanpa lemak untuk mencegah osteoporosis.
    Matched MeSH terms: Femur
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