METHODS: A search was conducted using the PubMed and Cochrane Database of Systematic Review databases from January 1, 1997 until September 9, 2017. The search strategy was constructed using the Population Intervention Comparison Outcome framework with keywords related to nasal fracture and its treatment. Two sets of independent researchers performed the analysis. Qualitative analysis was performed using the Methodological Index for Non-Randomized Studies and National Institute for Clinical Excellence methodology for randomized controlled trial checklists.

RESULTS: The 4276 titles were obtained from PubMed database alone. Exclusion was made based on the title, abstract and full-text analysis. Finally, 23 papers were included and analyzed. Of the 23 papers, 13 (56.5%) were retrospective record review, 2 (8.7%) were randomized clinical trial or a randomized study and 8 case series (34.8%). 16 (69.6%) studies addressed closed reduction, 3 studies (13%) on open reduction and 4 studies (17.4%) addressed both open and closed reduction. The main focus in the outcome in all studies was accuracy of the anatomical reduction of the nasal bones. Three studies (13.0%) reported restoration of function such as breathing comfort or release in respiratory obstruction and another 3 (13.0%) addressed both cosmetic and breathing outcomes. Residual deformity was the most described complications in the studies (30.4%). In general, most of the studies were not of high quality as they lacked in some key elements in the Methodological Index for Non-Randomized Studies checklist.

Case Report: Case Report 1: Mrs P, a 27-year-old right-hand dominant female, was involved in a motor vehicle accident (MVA) and sustained an isolated Regan-Morrey type III ulnar coronoid process fracture. In view of the large coronoid process fragment causing elbow joint instability, she underwent an open reduction and internal fixation when the elbow swelling had subsided. An anterior approach was used to identify the fracture fragment and it was fixed with two half-threaded cancellous lag screws with washers to achieve an anatomical reduction. Postoperatively, she recovered with excellent outcome based on the Mayo elbow performance score (MEPS).Case Report 2: Mr M, a 23-year-old right-hand dominant gentleman, was involved in a MVA and sustained an isolated Regan-Morrey type III ulnar coronoid process fracture. During examination under general anesthesia, passive range of the movement of his right elbow was noted to be <90°due to the impaction of the fracture fragment. An open reduction through an anterior approach was performed and Kirschner wires were inserted to fix the coronoid process fracture. Kirschner wires were opted for the ease of post-operative removal as the patient was not keen to have a retained implant after recovery. He recovered with good outcome based on the MEPS.

Materials and Methods: This is a retrospective study. Parameters such as patient data, injury details, osteosynthesis implant system information, stability of fracture fragments, occlusion and complications were evaluated at different time intervals and logistic regression applied to determine the association of these factors with complications.

Results: Five hundred and ninety-three patients with mandibular fractures were included in this study (male 87.9% and female 12.1%), age range of 13-72 years (median = 22 years). Most fractures were caused by motor vehicle accidents (85.8%), assault (6.2%) and falls (4.7%). Parasymphyseal fractures were the most common (50.1%), followed by angle (35.2%) and body of mandible (25%). Median time interval between injury and intervention was 7 days (IQR 4-10). Median duration of follow-up from date of surgery was 72 days (IQR 30-230). 76.9% (456) were completely free of complications. Most complications (46%) occurred in the intermediate post-surgical period (1-6 weeks). Median interval period between surgery and complication was 15 days (IQR 7-67.5). Nerve injury and surgical site infection were the most common complications at 6.7% and 5.7%, respectively. There was a significant difference between the plating system in terms of complication outcome (p = 0.017).

METHODOLOGY: A retrospective review was conducted from January 2008 until December 2011. All patients diagnosed with zygomatic complex fractured that met the inclusion and exclusion criteria were included in the study. Zingg's Classification was used in the study.

RESULTS: The median age was 23.5. Type A was the most common fracture type made up 26.6%. About 90.8% of the injury was caused by road traffic accident. Forty-four patients were treated with open reduction and internal fixation and 4 patients were treated with close reduction only. Fifty patients were treated conservatively. Gillies approach in combination with fixation is the most common procedure accounted for 50%. Three-point fixation at infraorbital, maxillary buttress, frontozygomatic suture, and zygomatic arch was the most common site. However, there were no significant associations between the number of fixation and the occurrence of the complication (P = 0.307). About 29.2% in the treatment group and 66% in the conservative group had complications. About 35.7% of patients in treatment group had complications, while 66% had trismus in conservative group.

Methods: This is a cross-sectional study in which all the elderly patients who underwent early primary total knee replacement due to trauma around the knee at the Segamat Hospital between January 2015 and June 2019 were identified. Data were collected from clinical and operative notes. The clinical outcomes of these patients were evaluated by the range of motion of the knee and the Knee Society Score (KSS).

Results: Ten patients were identified to have undergone this procedure. Six patients sustained supracondylar femur fractures, two patients had tibial plateau fractures and two patients had concurrent supracondylar femur and tibial plateau fractures. The mean follow-up duration was 22.3 ± 13.9 months, the mean knee score was 87.7 ± 10.0 and the mean functional knee score was 56 ± 41.9.