Displaying all 16 publications

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  1. Sinha N, Rao BS, Bhardwaj A, Singh S
    J Orthop Surg (Hong Kong), 2015 Aug;23(2):272.
    PMID: 26321570
    Matched MeSH terms: Fractures, Comminuted/therapy*
  2. Yu, C.K., Wong, H.Y., Vivek, A.S., To, BC Se
    Malays Orthop J, 2008;2(1):23-27.
    MyJurnal
    Interlocking intramedullary nailing is suitable for comminuted femoral isthmus fractures, but for noncomminuted fractures its benefit over unlocked nailing is debatable. This study was undertaken to compare outcomes of interlocking nailing versus unlocked intramedullary nailing in such fractures. Ninety-three cases of noncomminuted femoral isthmus fractures (Winquist I and II) treated with interlocking nailing and unlocked nailing from 1 June 2004 to 1 June 2005 were reviewed; radiological and clinical union rates, bony alignment, complication and knee function were investigated. There was no statistical significant difference with regard to union rate, implant failure, infection and fracture alignment in both study groups. Open fixation with unlocked femoral nailing is technically less demanding and requires less operating time; additionally, there is no exposure to radiation and cost of the implant is cheaper. We therefore conclude that unlocked nailing is still useful for the management of non-comminute isthmus fractures of the femur.
    Matched MeSH terms: Fractures, Comminuted
  3. Ngeow WC, Lian CB
    Singapore Dent J, 1996 Jul;21(1):16-8.
    PMID: 10597177
    Fractures of the mandible and their management are discussed in detail in textbooks and articles dealing with facial trauma. This paper presents the management and treatment of a case of a unilateral comminuted and complicated fracture of the mandible due to dog attack on a geriatric patient. The attack also severed the patient's right arm. Due to the severity of the trauma, an emergency surgery was performed on the mandible and arm.
    Matched MeSH terms: Fractures, Comminuted/etiology; Fractures, Comminuted/pathology; Fractures, Comminuted/surgery*
  4. Khoo, C. C. H., Amber Haseeb, Vivek Ajit Singh
    Malays Orthop J, 2014;8(2):14-21.
    MyJurnal
    Cannulated screw fixation is a widely accepted surgical method for management of fractures of the neck of femur especially in patients with poor premorbid conditions, minimally displaced fractures and those from a younger age group. A five year retrospective study was carried out in 53 consecutive patients between 2006 to 2010 to determine the pattern of injuries, management, outcomes and the associated predictive factors.All the patients underwent cannulated screw fixation, with 37 (69.8%) having had surgery within 24 hours and the remaining 16 (30.2%) 24 hours after the initial injury. All patients were followed up to union of fractures and complications thereafter if any. Good outcome was observed in 43 (81.1%) patients leaving only 10 (18.9%) patients with a poor outcome, of whom nine developed avascular necrosis (90%) and one non-union (10%). We found no significant relationship between the incidence of avascular necrosis and age of patient, fracture displacement, numbers of cannulated screws used, fracture reduction acceptability and anatomical location of the fracture. The time interval from injury to surgery and the presence of posterior comminution did seem to influence the rate of avascular necrosis but due to the small number of patients, was not statistically significant.We conclude that cannulated screw fixation is a viable option of treatment for fractures of the neck of femur.
    Matched MeSH terms: Fractures, Comminuted
  5. Lee BH, Ho SW, Kau CY
    Malays Orthop J, 2018 Mar;12(1):54-56.
    PMID: 29725516 DOI: 10.5704/MOJ.1803.013
    Surgical fixation of hip fractures in patients with below knee amputation is challenging due to the difficulty in obtaining optimal traction for reduction of the fracture. Surgeons may face difficulty in positioning such patients on the traction table due to the absence of the foot and distal lower limb. There are several techniques described to overcome this technical difficulty. In this case report, we present a case of a 64-year old gentleman with bilateral below knee amputation presenting with a comminuted right intertrochanteric fracture. We highlight a simple and effective method of applying skin traction to obtain adequate reduction for hip fracture fixation.
    Matched MeSH terms: Fractures, Comminuted
  6. Nazimi AJ, Ezulia T, Rajaran JR, Mohd Yunus SS, Nabil S
    Case Rep Dent, 2017;2017:2732907.
    PMID: 29391956 DOI: 10.1155/2017/2732907
    We describe a case of extensively comminuted mandibular fracture that extends bilaterally to the angle of mandible successfully treated with the use of condylar positioning device (CPD). This simple, yet effective, technique that almost exclusively described in orthognathic surgery is useful when advance surgical techniques such as pre- or intraoperative landmark identification may not be readily available. CPD technique optimizes the manual manipulations of the comminuted distal segments during fracture reduction and internal fixation. At the same time, it allows greater control of the proximal segments to avoid further surgical complication.
    Matched MeSH terms: Fractures, Comminuted
  7. Mukundala VV, Lim HH
    Singapore Med J, 2001 Feb;42(2):82-4.
    PMID: 11358198
    Fracture-dislocation of the lumbo-sacral spine was an unusual injury and was divided into anterior, posterior and lateral types depending on the displacement of the cephalad portion of the spine over the caudal portion. According to the authors' knowledge, only 31 cases of traumatic fracture-dislocation of the lumbo-sacral spine were reported in the English literature. Only 3 previous reports referred to this injury with a posterior displacement, which was an even rarer injury. This was the fourth report of this type of injury.
    Matched MeSH terms: Fractures, Comminuted/etiology; Fractures, Comminuted/radiography*; Fractures, Comminuted/surgery*
  8. Chung WH, Eu WC, Chiu CK, Chan CYW, Kwan MK
    J Orthop Surg (Hong Kong), 2019 12 27;28(1):2309499019888977.
    PMID: 31876259 DOI: 10.1177/2309499019888977
    PURPOSE: To describe the reduction technique of thoracolumbar burst fracture using percutaneous monoaxial screws and its radiological outcomes compared to polyaxial screws.

    METHODS: All surgeries were performed by minimally invasive technique with either percutaneous monoaxial or percutaneous polyaxial screws inserted at adjacent fracture levels perpendicular to both superior end plates. Fracture reduction is achieved with adequate rod contouring and distraction maneuver. Radiological parameters were measured during preoperation, postoperation, and follow-up.

    RESULTS: A total of 21 patients were included. Eleven patients were performed with monoaxial pedicle screws and 10 patients performed with polyaxial pedicle screws. Based on AO thoracolumbar classification system, 10 patients in the monoaxial group had A3 fracture type and 1 had A4. In the polyaxial group, six patients had A3 and four patients had A4. Total correction of anterior vertebral height (AVH) ratio was 0.30 ± 0.10 and 0.08 ± 0.07 in monoaxial and polyaxial groups, respectively (p < 0.001). Total correction of posterior vertebral height (PVH) ratio was 0.11 ± 0.05 and 0.02 ± 0.02 in monoaxial and polyaxial groups, respectively (p < 0.001). Monoaxial group achieved more correction of 13° (62.6%) in local kyphotic angle compared to 8.2° (48.0%) in polyaxial group. Similarly, in regional kyphotic angle, 16.5° (103.1%) in the monoaxial group and 8.1° (76.4%) in the polyaxial group were achieved.

    CONCLUSIONS: Monoaxial percutaneous pedicle screws inserted at adjacent fracture levels provided significantly better fracture reduction compared to polyaxial screws in thoracolumbar fractures.

    Matched MeSH terms: Fractures, Comminuted/diagnosis; Fractures, Comminuted/surgery*
  9. Bajuri MY, Maidin S, Rauf A, Baharuddin M, Harjeet S
    Clinics (Sao Paulo), 2011;66(4):635-9.
    PMID: 21655759
    OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function.

    METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique.

    RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion).

    CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes.

    Matched MeSH terms: Fractures, Comminuted/physiopathology; Fractures, Comminuted/therapy*
  10. Khoo C, Haseeb A, Ajit Singh V
    Malays Orthop J, 2014 Jul;8(2):14-21.
    PMID: 25279087 DOI: 10.5704/MOJ.1407.010
    Cannulated screw fixation is a widely accepted surgical method for management of fractures of the neck of femur especially in patients with poor premorbid conditions, minimally displaced fractures and those from a younger age group. A five year retrospective study was carried out in 53 consecutive patients between 2006 to 2010 to determine the pattern of injuries, management, outcomes and the associated predictive factors.All the patients underwent cannulated screw fixation, with 37 (69.8%) having had surgery within 24 hours and the remaining 16 (30.2%) 24 hours after the initial injury. All patients were followed up to union of fractures and complications thereafter if any. Good outcome was observed in 43 (81.1%) patients leaving only 10 (18.9%) patients with a poor outcome, of whom nine developed avascular necrosis (90%) and one non-union (10%). We found no significant relationship between the incidence of avascular necrosis and age of patient, fracture displacement, numbers of cannulated screws used, fracture reduction acceptability and anatomical location of the fracture. The time interval from injury to surgery and the presence of posterior comminution did seem to influence the rate of avascular necrosis but due to the small number of patients, was not statistically significant.We conclude that cannulated screw fixation is a viable option of treatment for fractures of the neck of femur.
    Matched MeSH terms: Fractures, Comminuted
  11. Zamzuri Z, Yusof M, Hyzan MY
    Med J Malaysia, 2004 Mar;59(1):15-9.
    PMID: 15535330
    This is a prospective study of a series of 26 patients with closed unstable comminuted intra-articular fracture distal end of the radius treated with two different methods of treatment to compare their anatomical and functional results. The external fixation group consisted of 12 patients and internal fixation group consisted of 14 patients. The anatomical and functional assessments were performed at six months and one year. The anatomical results at six months and one year showed that the internal fixation group was effective in maintaining the reduction compared to the external fixation group. The radial height, volar tilt and radial inclination were well maintained. However, the functional results at six months and one year showedno differences between these two types of fixation. The complication rate was higher in external fixation group.
    Matched MeSH terms: Fractures, Comminuted/therapy*
  12. Saw KY, Gill R, Low TC
    Malays Orthop J, 2020 Nov;14(3):166-169.
    PMID: 33403079 DOI: 10.5704/MOJ.2011.026
    This is a case report of a Gustilo-Anderson Type IIIB comminuted open right tibial fracture with massive bone loss, complicated by methicillin-resistant Staphylococus aureus (MRSA) infection. Non-viable and contaminated bony fragments were removed and infected bone resected. Soft tissue coverage and antibiotics were effective against the MRSA infection. A unifocal bone transport with the Ilizarov method regenerated 13cm of the missing tibia. Autologous peripheral blood stem cells (PBSC) injections into the osteogenesis site boosted bone regeneration and consolidation with a shortened Bone Healing index (BHI) of 23 days/cm.
    Matched MeSH terms: Fractures, Comminuted
  13. Touloupakis G, Biancardi E, Theodorakis E, Ghirardelli S, Ferrara F, Gherlinzoni F, et al.
    Malays Orthop J, 2020 Nov;14(3):124-128.
    PMID: 33403072 DOI: 10.5704/MOJ.2011.019
    Introduction: The aim of our retrospective study was to investigate the role of the medial side involvement in the treatment choice of radial head fractures.

    Materials and Methods: We searched the databases of our institutions for the surgical procedures diagnosed as "fracture of the radial head" and for the procedures related to "prosthesis of the radial head" and "osteosynthesis of the radial head" in the period from May 2014 to October 2017. The fractures were first classified according to the Mason classification . We then allocated the patients into three study groups according to the site of the fracture, either the medial or lateral side of the radial head : Group A, with an isolated lateral fracture of the radius head; Group B1, with a medial fracture of the radius head with two medial fragments; and Group B2, with a medial fracture of the radius head with multiple medial fragments. We performed a multivariate analysis to identify statistically significant correlation between the pre-operative classifications of Mason and our study, the type of surgical procedure, and the clinical outcome.

    Results: Mayo Elbow Performance (MEP) scores determined at the final follow-up of the study (mean 16.6 months, range 12-26 months) was excellent in 17 patients (4 in Group A, 6 in Group B1 and 7 in Group B2), and good in 12 patients (3 in Group A, 7 in Group B1, and 2 in Group B2). One patient showed a poor result in MEP score probably because of an infection and implant removal.

    Conclusion: Regarding medial fractures of the radial head, our study showed satisfactory results with a radial head prosthesis for comminuted or multifragmentary radial head fractures. For surgeons with advanced elbow fracture expertise, osteosynthesis could be attempted in a fracture pattern that involved only two medial fragments.

    Matched MeSH terms: Fractures, Comminuted
  14. Akma Kamaludin NA, Ferdaus Kamudin NA, Abdullah S, Sapuan J
    Chin J Traumatol, 2019 Feb;22(1):59-62.
    PMID: 30745113 DOI: 10.1016/j.cjtee.2018.04.007
    Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an anatomical locking plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome.
    Matched MeSH terms: Fractures, Comminuted
  15. Vinuthinee N, Azreen-Redzal A, Juanarita J, Zunaina E
    Int Med Case Rep J, 2015;8:47-50.
    PMID: 25709507 DOI: 10.2147/IMCRJ.S75198
    We report a rare case of sling shot injury that presented with a gunshot-like wound with preseptal cellulitis, in a toddler. An 11-month-old Malay child presented with a gunshot-like wound over the forehead following sling shot injury. On examination, he had a deep circular laceration wound over the forehead, measuring 2.0 cm in diameter, with minimal bleeding. There was no obvious foreign body seen inside the wound and no palpable foreign body surrounding the wound. The gunshot-like wound was associated with left preseptal cellulitis. A skull X-ray showed a white opaque foreign body in the left frontal bone. Computed tomography (CT) scan of orbit and brain revealed a left comminuted fracture of the left orbital roof, and left frontal brain contusion with prelesional edema. Wound exploration was performed and revealed a 0.5 cm unshattered marble embedded in the left frontal bone. The marble and bone fragments were removed. The left preseptal cellulitis responded well to intravenous antibiotic and topical antibiotic.
    Matched MeSH terms: Fractures, Comminuted
  16. Faisham W, Azman W, Muzaffar T, Muslim D, Azhar A, Yahya M
    Malays Orthop J, 2012 Nov;6(3):37-9.
    PMID: 25279054 MyJurnal DOI: 10.5704/MOJ.1207.002
    Traumatic hemipelvectomy is an uncommon and life threatening injury. We report a case of a 16-year-old boy involved in a traffic accident who presented with an almost circumferential pelvic wound with wide diastasis of the right sacroiliac joint and symphysis pubis. The injury was associated with complete avulsion of external and internal iliac vessels as well as the femoral and sciatic nerves. He also had ipsilateral open comminuted fractures of the femur and tibia. Emergency debridement and completion of amputation with preservation of the posterior gluteal flap and primary anastomosis of the inferior gluteal vessels to the internal iliac artery stump were performed. A free fillet flap was used to close the massive exposed area.
    Matched MeSH terms: Fractures, Comminuted
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