Displaying publications 1 - 20 of 60 in total

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  1. Sinha NK, Bhardwaj A, Sadashiva Rao A, Trivedy PD
    J Orthop Surg (Hong Kong), 2019 2 26;27(1):2309499018816450.
    PMID: 30798736 DOI: 10.1177/2309499018816450
    Matched MeSH terms: Osteotomy*
  2. Lee OS, Ahn S, Ahn JH, Teo SH, Lee YS
    Arch Orthop Trauma Surg, 2018 Feb;138(2):227-236.
    PMID: 29143167 DOI: 10.1007/s00402-017-2826-4
    INTRODUCTION: The purpose of this systematic review and meta-analysis was to evaluate the efficacy of concurrent cartilage procedures during high tibial osteotomy (HTO) for medial compartment osteoarthritis (OA) by comparing the outcomes of studies that directly compared the use of HTO plus concurrent cartilage procedures versus HTO alone.

    MATERIALS AND METHODS: Results that are possible to be compared in more than two articles were presented as forest plots. A 95% confidence interval was calculated for each effect size, and we calculated the I 2 statistic, which presents the percentage of total variation attributable to the heterogeneity among studies. The random effects model was used to calculate the effect size.

    RESULTS: Seven articles were included to the final analysis. Case groups were composed of HTO without concurrent procedures and control groups were composed of HTO with concurrent procedures such as marrow stimulation procedure, mesenchymal stem cell transplantation, and injection. The case group showed a higher hospital for special surgery score and mean difference was 4.10 [I 2 80.8%, 95% confidence interval (CI) - 9.02 to 4.82]. Mean difference of the mechanical femorotibial angle in five studies was 0.08° (I 2 0%, 95% CI - 0.26 to 0.43). However, improved arthroscopic, histologic, and MRI results were reported in the control group.

    CONCLUSION: Our analysis support that concurrent procedures during HTO for medial compartment OA have little beneficial effect regarding clinical and radiological outcomes. However, they might have some beneficial effects in terms of arthroscopic, histologic, and MRI findings even though the quality of healed cartilage is not good as that of original cartilage. Therefore, until now, concurrent procedures for medial compartment OA have been considered optional. Nevertheless, no conclusions can be drawn for younger patients with focal cartilage defects and concomitant varus deformity. This question needs to be addressed separately.

    Matched MeSH terms: Osteotomy*
  3. Mustafa AA, Raad K, Mustafa NS
    Clin Case Rep, 2015 Nov;3(11):907-11.
    PMID: 26576270 DOI: 10.1002/ccr3.373
    Here, we aimed to assess whether postoperative oral rehabilitation for mandibulectomy patients is necessary to improve patients' general health in terms of health-related quality of life.
    Matched MeSH terms: Mandibular Osteotomy
  4. Khairul Bariah Chi Adam, Firdaus Hariri, Lim, Kwong Cheung, Syed Nabil, Aung, Lwin Oo, Zainal Ariff Abdul Rahman
    MyJurnal
    Distraction osteogenesis allows superior skeletal advancement compared to conventional surgical osteotomy. It can be considered as a reliable and predictable surgical procedure and is widely used to correct the craniomaxillofacial bone discrepancy. Nevertheless, the outcome is technically dependent and requires comprehensive peri-operative assessment, preparation, and precision in application. The objective of this study is to highlight some important technical issues in distraction osteogenesis when the technique is indicated in various craniomaxillofacial regions and at the same time to discuss the options of preventing and overcoming these technical complications based on our experience and relevant literature. Important technical issues on the application of distraction osteogenesis in 5 different craniomaxillofacial regions were selectively highlighted based on the completed cases in one centre. Potential complications and its prevention methods were documented and discussed. The 5 highlighted regions of craniomaxillofacial distraction osteogenesis were alveolar, mandibular, cleft maxilla, craniofacial and facial cleft. Technical issues and complications were mostly device related and associated with anatomical limitations and surgical technique. Nevertheless, these complications are preventable and can be appropriately managed. From the literature and our experience, the technical aspects vary according to its application in different craniomaxillofacial regions. Preventing the potential complications contribute to the success of its application. This article also discussed the concept of Ihsan application in the medical field, to achieve the best of treatment in terms of delivery and technical preparation for the patients.
    Matched MeSH terms: Osteotomy
  5. Manohar A, Beard AJ
    Hand Surg, 2011;16(2):207-10.
    PMID: 21548163
    Congenital duplication of the thumb is usually reconstructed by 18 months of age. This paper reports satisfactory outcome following reconstruction of two Wassel Type IV duplicate thumbs in adults aged over 40. Both achieved a good outcome based on Tada's criteria and a subjective Visual analogue score 8.
    Matched MeSH terms: Osteotomy/methods
  6. Goh YC, Tan CC, Lim D
    J Stomatol Oral Maxillofac Surg, 2020 Sep;121(4):397-403.
    PMID: 31904534 DOI: 10.1016/j.jormas.2019.12.019
    Coronoid hyperplasia is one of the rare causes of progressive limitation of mouth opening due to impingement of the enlarged coronoid process of the mandible on the zygomatic bone. A review was performed on all cases reports and case series on coronoid hyperplasia. Gender, age at treatment, age of onset, types of hyperplasia (unilateral/bilateral), associated history, treatment, surgical approach, preoperative mouth opening, intraoperative mouth opening, mouth opening at follow up and follow up period were recorded and analyzed. A total of 82 articles which reported 115 cases were included. Coronoid hyperplasia was commonly reported at mean age of 22.64 years old with male preponderance. Most of the cases were diagnosed and treated between the age of 11-20 years old. This condition commonly involved bilateral coronoid process of mandible. The mean width of preoperative mouth opening was 16.5mm and was improved to a mean mouth opening of 36.3mm intraoperatively. Mean mouth opening was 34.8mm at an average follow up of 19 months. While the etiopathogenesis of coronoid hyperplasia is still not conclusive, treatment with either coronoidectomy or coronoidotomy produced good improvement in mouth opening.
    Matched MeSH terms: Mandibular Osteotomy*
  7. Ozcelik IB, Jusoh MH, Cavit A
    Tech Hand Up Extrem Surg, 2024 Mar 01;28(1):16-18.
    PMID: 37702374 DOI: 10.1097/BTH.0000000000000453
    Ulnar impaction syndrome occurs when excessive load across the ulnocarpal joints results in pathologic changes, especially over the articular surface of the ulnar head and proximal ulnar corner of the lunate. The 2 main surgical options in ulnar impaction syndrome are ulnar shortening osteotomy and wafer procedure, whether open or arthroscopically, to decompress the ulnocarpal joint load. However, all of these techniques have their shortcomings and drawbacks. The current study demonstrates a novel technique to decompress the ulnocarpal joint load: the "reverse wafer procedure" for ulnar impaction syndrome. In this surgical technique, we resected the proximal ulnar side of the lunate instead of partial resection of the thin wafer of the distal ulnar head dome in the standard wafer procedure. This technique avoids iatrogenic central tear of triangular fibrocartilage and distal radioulnar joint portal arthroscopy, which is technically demanding while preserving the distal radioulnar joint.
    Matched MeSH terms: Osteotomy/methods
  8. Kandasamy R, Abdullah JM
    World Neurosurg, 2016 07;91:640-1.
    PMID: 27157281 DOI: 10.1016/j.wneu.2016.04.109
    Matched MeSH terms: Osteotomy
  9. Munajat I, Sulaiman AR, Mohd EF, Zawawi M
    Malays Orthop J, 2020 Mar;14(1):49-54.
    PMID: 32296482 DOI: 10.5704/MOJ.2003.008
    Introduction: Submuscular plating after lengthening shortened the period of external fixation in distraction osteogenesis of the femur. In the femur, where monolateral or ring fixators had been used for the distraction, plates, could be inserted laterally, anteriorly or medially. Specific technical modification of the plate insertion, however, would be necessary to accommodate the femoral varus angular correction created at the end of the distraction, in the pelvic support osteotomy lengthening.

    Material and Methods: We reviewed a series of eight cases with standard and modified techniques of plating after lengthening. The amount of lengthening, the period of distraction, the external fixator index and the associated complications were assessed.

    Results: The mean lengthening was 5cm, with a range of 3cm to 9cm. The external fixation index, the period of external fixators in days in relation to the length of distraction in cm, was between 18 days/cm to 58 days/cm. One patient with quadriceps contracture, underwent quadriceplasty to improve knee flexion. Three patients with transient knee stiffness had resolution with aggressive physiotherapy. One patient with transient hypoesthesia recovered spontaneously. None of the patients developed joint subluxation, deep infection, re-fracture or implant failures.

    Conclusion: Standard and modified techniques of plating after lengthening were safe and required only a short period of external fixation. The modified technique offered an easier way of plate insertion in a deformed bone.

    Matched MeSH terms: Osteotomy
  10. Raja Izaham RM, Abdul Kadir MR, Abdul Rashid AH, Hossain MG, Kamarul T
    Injury, 2012 Jun;43(6):898-902.
    PMID: 22204773 DOI: 10.1016/j.injury.2011.12.006
    The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. Three dimensional model of the tibia was reconstructed from computed tomography images obtained from the Medical Implant Technology Group datasets. Osteotomy and fixation models were simulated through computational processing. Simulated loading was applied at 60:40 ratios on the medial:lateral aspect during single limb stance. The model was fixed distally in all degrees of freedom. Simulated data generated from the micromotions, displacement and, implant stress were captured. At the prescribed loads, a higher displacement of 3.25 mm was observed for the Puddu plate model (p<0.001). Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p<0.001). There was significant negative correlation (p<0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures.
    Matched MeSH terms: Osteotomy/instrumentation; Osteotomy/methods*
  11. Lee YS, Lee SH, Lee ES, Fong TS
    BMC Musculoskelet Disord, 2019 Mar 20;20(1):118.
    PMID: 30894158 DOI: 10.1186/s12891-019-2505-4
    BACKGROUND: We report a case of hardware failure after distal femoral osteotomy (DFO) with a broken screw pulled out from the locking hole and positioned within the knee joint.

    CASE PRESENTATION: A 57-year-old man presented to our orthopedic outpatient department with 3-months history of an unusual painful swelling at the operated area following DFO. The leakage of joint fluid from the penetrated suprapatellar pouch was assumed to be the reason for this complication.

    CONCLUSIONS: The overall aim of this case report is to provide a lesson to budding surgeons who might experience a similar situation that cannot be easily explained, like the unexpected complication in the present case.

    Matched MeSH terms: Osteotomy/adverse effects*; Osteotomy/instrumentation
  12. Kim JE, Won S, Jaffar MSA, Lee JI, Kim TW, Lee YS
    Knee, 2020 Jun;27(3):940-948.
    PMID: 32331827 DOI: 10.1016/j.knee.2020.04.008
    BACKGROUND: Open-wedge high tibial osteotomy (OWHTO) produces three- dimensional (3D) geometric changes. Among them, increased posterior tibial slope (PTS), and altered coronal inclination that induces unintended tibial translation may affect anterior cruciate ligament (ACL) status. The purpose of current study was to evaluate the geometric changes following OWHTO, such as increasing PTS and decreasing tibial subluxation, which may affect the status of ACL.

    METHODS: From April 2014 to December 2015, a total of 72 knees in 64 patients that underwent OWHTO, second-look arthroscopy, and magnetic resonance imaging (MRI) assessment, were enrolled. Preoperative and postoperative coronal and sagittal translation, joint line orientation angle, the distance between medial femoral notch marginal line and medial tibial spine, and PTS were evaluated. ACL status was arthroscopically graded from grade 1 (best) to 4 (worst). The MRI signal of the graft in three portions (proximal, middle, and distal) was graded from grade 1 (best) to 4 (worst).

    RESULTS: High grade (3: partial, and 4: complete rupture) was noted in 28 cases (38.9%) at the second-look arthroscopy compared with 10 cases (13.9%) at index arthroscopy. The MRI signal grade significantly increased at follow up MRI compared with preoperative MRI (P<0.01). An increased signal was commonly noted in the middle and distal portions of the graft.

    CONCLUSIONS: Geometric changes after OWHTO were related to ACL deterioration. The ACL was commonly affected at the middle and distal portions and rarely at the proximal portion. There is a possibility of impingement because of the geometric changes.

    LEVEL OF EVIDENCE: Level IV.

    Matched MeSH terms: Osteotomy/adverse effects*; Osteotomy/methods
  13. Teh KH, Ruben JK, Chan CK, Abbas AA
    Malays Orthop J, 2020 Jul;14(2):134-137.
    PMID: 32983389 DOI: 10.5704/MOJ.2007.022
    Avascular necrosis and non-union are two most dreaded complications of femoral neck fracture fixations. Hip replacement seems to be a simple solution for this complex problem. However, the long-term efficacy of prosthetic replacement in the young population with higher functional demand is still questionable. Femoral head preserving valgus subtrochanteric osteotomies in properly selected cases have strong support from literature. The conventional technique of valgus subtrochanteric osteotomy involves lateral based wedge resection. Alternatively, a simpler sliding oblique subtrochanteric osteotomy without any wedge removal can also be performed. We hereby describe a successful case of sliding subtrochanteric osteotomy with 135° dynamic hip screw (DHS) plate fixation in treating non-union neck of femur fracture in a young gentleman.
    Matched MeSH terms: Osteotomy
  14. Dhar SA, Mir NA, Dar TA
    Malays Orthop J, 2020 Nov;14(3):161-165.
    PMID: 33403078 DOI: 10.5704/MOJ.2011.025
    Introduction: The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg's infraction.

    Material and Methods: Twenty patients with Freiburg's infraction were admitted at our hospital over a period of six years. Patients with a normal plantar contour of the metatarsal head were included. All patients underwent a dorsal closing wedge osteotomy of the metatarsal.

    Results: The mean Leeds Movement Performance Index (LMPI) score was 84 (range 70-86). The mean metatarsal shortening was 2mm. the passive flexion restriction was 16° and extension restriction was 10°. Also, a strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r's = -0.85, P < .001).

    Conclusion: The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg's infraction.

    Matched MeSH terms: Osteotomy
  15. Sahdi H, Rasit AH, Khoo CS, Bojeng A, Nur-Alyana BA
    Malays Orthop J, 2019 Jul;13(2):52-55.
    PMID: 31467654 DOI: 10.5704/MOJ.1907.011
    Congenital humeroradial synostosis can occur as an isolated clinical entity or as part of a syndrome. Bilateral elbow fixed flexion deformity is very incapacitating and challenging to treat. Here we present the case of a boy with fixed flexion deformity of both elbows due bilateral humeroradial synostosis. Other characteristic features of multiple synostoses syndrome were also present in this child, his elder brother and mother. We elected to improve the position of the right elbow by adapting the modified French osteotomy described by Bellemore et al.
    Matched MeSH terms: Osteotomy
  16. Faruk NA, Mohd-Amin MZ, Awang-Ojep DN, Teo YY, Wong CC
    Malays Orthop J, 2018 Nov;12(3):50-52.
    PMID: 30555648 MyJurnal DOI: 10.5704/MOJ.1811.013
    Giant cell tumour (GCT) is a benign tumour but can be locally aggressive and with the potential to metastasise especially to the lungs. Successful treatments have been reported for long bone lesions; however, optimal surgical and medical treatment for spinal and sacral lesions are not well established. In treating spinal GCTs, the aim is to achieve complete tumour excision, restore spinal stability and decompress the neural tissues. The ideal surgical procedure is an en bloc spondylectomy or vertebrectomy, where all tumour cells are removed as recurrence is closely related to the extent of initial surgical excision. However, such a surgery has a high complication rate, such as dura tear and massive blood loss. We report a patient with a missed pathological fracture of T12 treated initially with a posterior subtraction osteotomy, who had recurrence three years after the index surgery and subsequently underwent a three level vertebrectomy and posterior spinal fusion.
    Matched MeSH terms: Osteotomy
  17. Gupta RK, Khiyani R, Majumdar KP, Potalia R
    Malays Orthop J, 2020 Jul;14(2):120-125.
    PMID: 32983386 DOI: 10.5704/MOJ.2007.021
    Introduction: To assess the results of Milch osteotomy in terms of deformity correction and functional outcome in the absence of ulnar nerve transposition.

    Material and Methods: Nine patients with cubitus valgus deformity greater than 20° with tardy ulnar nerve palsy (TUNP) operated between 2012 and 2017 were evaluated. Correction by Milch osteotomy and fixation was done in each case, without osteosynthesis of the non-union lateral condyle humerus or transposition of the ulnar nerve. At one year post-operatively, carrying angle, elbow function (Mayo Elbow Performance Score) and ulnar nerve symptoms were assessed.

    Results: The mean carrying angle pre-operatively was 30.8° on the affected side which improved to a mean of 8.3° postoperatively with an average correction of 22.5°. The mean elbow flexion pre-operatively was 129.4° which improved to 133.3° post-operatively. The mean preoperative MEP score was 76.7 which improved to a mean of 92.2 post-operatively (p < 0.01). TUNP recovered completely in all the patients.

    Conclusion: Milch osteotomy is an effective procedure for cubitus valgus deformity correction and its associated tardy ulnar nerve palsy without a decrease in elbow ROM. Correction of even severe valgus deformities without concurrent anterior transposition of the ulnar nerve is likely to improve ulnar nerve symptoms.

    Matched MeSH terms: Osteotomy
  18. Sengupta, S.
    Malays Orthop J, 2008;2(1):55-57.
    MyJurnal
    A rare case of spontaneous bilateral stress fractures of femoral neck leading to coxa vara in a young female with history of chronic renal disease and secondary osteomalacia is described. Once the underlying disease was controlled, the fracture was treated by valgus osteotomy with good result.
    Matched MeSH terms: Osteotomy
  19. Faisham W.I., Zulmi, W.
    Malays Orthop J, 2009;3(1):81-84.
    MyJurnal
    Forearm deformity secondary to giant solitary ulna exostosis is rare. We describe a rare presentation of symptomatic solitary giant exostosis involving the entire distal ulna resulting in ulnar bowing of the forearm in a five-year-old boy. The tumour was completely resected and the defect was reconstructed with an allograft wrapped with a free autogenous periosteal tubular sleeve to deliver fresh pluripotential cells for better incorporation and integration. The distal ulna physes was preserved. An osteotomy was performed on the radius to correct the deformity. One year after surgery, the deformity remains corrected with normal bone length and excellent hand function. There is no evidence of local recurrence and the allograft has fully incorporated.

    Matched MeSH terms: Osteotomy
  20. Gooi SG, Wang CS, Saw A, Zulkiflee O
    Malays Orthop J, 2017 Mar;11(1):79-81.
    PMID: 28435583 MyJurnal DOI: 10.5704/MOJ.1703.015
    Missed Monteggia fracture leading to chronic radial head dislocation is a known complication. The surgical treatment options remain challenging. The aim of treatment is to reduce the radial head and to maintain the stability of the elbow in all ranges of motion. A few surgical techniques have been described with complications. We report the case of a 13 years old boy with chronic radial head dislocation as a result of an unrecognised Monteggia fracture-dislocation for eight years. We successfully reduced the radial head and corrected the cubital valgus from 45 degrees to 10 degrees with a proximal ulna osteotomy and gradual distraction with 2-pin Monotube external fixator. The correction was uneventful with good functional outcome.
    Matched MeSH terms: Osteotomy
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