MyMedR

3D printing in surgery: revolutionizing trauma and fracture care in low and middle-income countries

Awuah WA, Tenkorang PO, Adebusoye FT, Ng JC, Wellington J, Abdul-Rahman T, et al.

Postgrad Med J, 2023 Dec 21;100(1179):1-3.

PMID: 37857514 DOI: 10.1093/postmj/qgad100

Matched MeSH terms: Fractures, Bone*

The need for organized fracture treatment

Cameron JAP

Journal of the Malaya Branch of the British Medical Association, 1939;3:12-21.

Matched MeSH terms: Fractures, Bone

Fulltext Rare combination of seven fractures in the same forearm and wrist

Pan KL, Masbah O, Razak M

Med J Malaysia, 2000 Jun;55(2):268-70.

PMID: 19839159

A rare combination of a segmental ulnar fracture with fracture dislocation of the head of the radius and intraarticular fracture of the distal radius concomitant with an ipsilateral scaphoid, lunate and coronoid process fractures is presented. The mechanism of injury could possibly be a tremendous impact on the outstretched hand with a dorsiflexed wrist, fracturing the carpal bones and the distal radius. Transmitted axial forces on the ulna in a pronating forearm resulted in the other fractures. To the best of our knowledge, no such case has been reported. Open reduction with screw fixation of the scaphoid, plating of the proximal ulna and Kirschner wiring of the distal radius and radial head dislocation were done.

Matched MeSH terms: Fractures, Bone/diagnosis; Fractures, Bone/physiopathology*; Fractures, Bone/radiography

Fulltext A Biomechanical Comparison between Taylor's Spatial Frame and Ilizarov External Fixator

Tan B, Shanmugam R, Gunalan R, Chua Y, Hossain G, Saw A

Malays Orthop J, 2014 Jul;8(2):35-9.

PMID: 25279090 DOI: 10.5704/MOJ.1407.012

Taylor's spatial frame (TSF) and Ilizarov external fixators (IEF) are two circular external fixator commonly used to address complex deformity and fractures. There is currently no data available comparing the biomechanical properties of these two external fixators. This study looks into the mechanical characteristics of each system. TSF rings with 6 oblique struts, 4 tube connectors, 4 threaded rods, and 6 threaded rods were compared to a standard IEF rings with 4 threaded rods. Compression and torsional loading was performed to the frame as well as construct with Polyvinylchloride tubes. TSF rings with 4 tube connectors had the highest stiffness (3288 N/mm) while TSF rings with 6 struts was the least stiff. The situation was reversed for torsion where TSF rings with 6 oblique struts had the highest torsional stiffness (82.01 Nm/Degree) and frame Ilizarov rings with 4 threaded rods the least. Standard TSF construct of two ring with 6 oblique struts have better torsional stiffness and lower axial stiffness compared to the standard IEF.

Matched MeSH terms: Fractures, Bone

Fulltext Fracture of the penis

Kamil N, Hisham AN, Abdullah M, Khairullah A

Med J Malaysia, 1993 Sep;48(3):373-6.

PMID: 8183157

Fracture of the penis is not an uncommon urological emergency. Six patients with this injury, treated at the Institute of Urology, General Hospital, Kuala Lumpur, since 1988, were reviewed. Their ages ranged from 21 to 30 years old (mean 25). Four cases were self-inflicted by abnormal bending and 2 cases occurred during sexual intercourse. A sudden "cracking sound", violent pain, rapid flaccidity and deformity of the penis were documented. Duration of injury at presentation ranged from 12 to 90 hours (mean 35 hours). Primary repair of the tunica albuginea with absorbable suture was performed in all cases. The results of surgery was excellent, with restoration of normal function in 4 patients (2 patients defaulted follow-up). We advocate immediate surgical repair for this injury.

Matched MeSH terms: Fractures, Bone/surgery*

Fulltext A systematic review of the outcomes of osteoporotic fracture patients after hospital discharge: morbidity, subsequent fractures, and mortality

Nazrun AS, Tzar MN, Mokhtar SA, Mohamed IN

Ther Clin Risk Manag, 2014;10:937-48.

PMID: 25429224 DOI: 10.2147/TCRM.S72456

PURPOSE:
Osteoporotic fracture is the main complication of osteoporosis. The current management is to discharge patients as early as possible so they can get back to their daily activities. Once discharged, there are three main issues relating to morbidity, mortality, and risk of a subsequent fracture that need to be addressed and discussed. Therefore, the aim of this systematic review was to summarize and evaluate the evidence from published literature, to determine the outcome of osteoporotic fracture patients after their hospital discharge.

METHODS:
The MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched, using the terms "osteoporosis", "fracture", "osteoporotic fracture", "hip fracture", and "vertebral fracture". We included only human studies published in English between 2004 and 2014. The reference lists of included studies were thoroughly reviewed in search for other relevant studies.

RESULTS:
A total of 18 studies met the selection criteria. Most were observational and cohort studies. Out of all the studies, five studies looked into the morbidity, six studies looked into the risk of subsequent fractures, and seven studies looked into mortality. Vertebral fracture caused the greatest health burden, but hip fracture patients were the main users of informal care after hospital discharge. There was an increased risk of a subsequent fracture after a primary fracture compared with the control group, a cohort comparison, or the general population. Osteoporotic fractures, especially hip fractures, are associated with higher mortality rate despite the advances in the management of osteoporotic fracture cases.

CONCLUSION:
There is strong evidence to show that after hospital discharge, osteoporotic fracture patients are faced with higher morbidity, subsequent fractures, and mortality.

KEYWORDS:
hip fracture; osteoporosis; vertebral fracture

Matched MeSH terms: Fractures, Bone*

Epidemiology of fractures in the Chinese children of Singapore

Wong PC

Med J Malaya, 1966 Jun;20(4):288-99.

PMID: 4224337

Matched MeSH terms: Fractures, Bone/etiology; Fractures, Bone/epidemiology*

Enhancing knowledge, attitude, and perceptions towards fall prevention among older adults: a pharmacist-led intervention in a primary healthcare clinic, Gemas, Malaysia

Manirajan P, Sivanandy P, Ingle PV

BMC Geriatr, 2024 Apr 02;24(1):309.

PMID: 38566052 DOI: 10.1186/s12877-024-04930-5

BACKGROUND: Falls and fall-related injuries are very common among older adults, and the risk of falls increases with the aging process. The lack of awareness of falls and fall-related injuries among older adults can contribute to an increasing risk of falls. Hence, a study was carried out to improve the knowledge, attitude, and perception of falls and fractures among older adults in a primary care setting in Gemas, a rural area of the Selangor state of Malaysia.

METHOD: A structured educational intervention was provided to older adults who visited the primary care setting in Gemas and provided written informed consent to participate in the study. A total of 310 older adult patients was included in the study using a convenience sampling technique.

RESULTS: Before the intervention, 74.84% of the respondents (n = 232) agreed that falls and related fractures are the leading causes of hospital admission among older adults. In post-intervention, the number of respondents who agreed with this statement increased to 257 (82.91%). At baseline, 28 respondents (9.03%) had poor knowledge, 160 respondents (51.61%) had average knowledge levels, and 122 respondents (39.35%) had good knowledge. In post-intervention, respondents with poor and average knowledge reduced to 1.93% (n = 6) and 29.35% (n = 91) respectively. A majority of respondents' knowledge levels improved significantly after the intervention (n = 213; 68.71%). About eight respondents (2.58%) had a negative perception of falls. In post-intervention, the percentage reduced to 0.65% as only two respondents had a negative perception. A total of 32 types of fall-risk-increasing drugs (FRIDs) have been prescribed to the respondents. A strong correlation (r = 0.89) between pre- and post-intervention knowledge was shown among the respondents. Paired t-test analysis showed a statistically significant difference.

CONCLUSION: The pharmacist-led educational intervention significantly improved the knowledge, attitude, and perception of falls among older adults. More structured and periodical intervention programmes are warranted to reduce the risk of falls and fractures among older adults.

Matched MeSH terms: Fractures, Bone*

Fulltext Are Gap and Cast Indices Predictors of Efficacy of Reduction in Fractures of Both Bones of the Leg? A Cohort Study

Shalabh K, Ajai S, Vineet K, Sabir A

Malays Orthop J, 2018 Jul;12(2):15-19.

PMID: 30112123 DOI: 10.5704/MOJ.1807.003

Introduction: Non-operative management has successfully been practised for long in diaphyseal fractures of both bones of the leg. This study attempts to establish an acceptability criteria for plaster cast in order to predict future loss of reduction and its adequacy. Materials and Methods: A total of forty subjects were included as per inclusion-exclusion criteria. Gap and cast indices were calculated in the immediate post reduction phase and at third week follow-up visit. Results: The mean values of gap and cast indices in the immediate post-reduction phase were 0.35±0.220 and 0.99±0.08 respectively and at the third week follow-up the mean value for both the parameters in those without loss of reduction were 1.11±0.50 and 1.03±0.09 respectively and in those with loss of reduction were 0.84±0.44 and 1.01±0.06 respectively. Conclusion: Gap and cast indices are not informative in assessing adequacy of reduction in diaphyseal fractures of both bones of the leg.

Matched MeSH terms: Fractures, Bone

A numerical study on fracture-plugging behaviour of granular lost circulation materials

Wang G, Pu X

Sains Malaysiana, 2014;43:807-812.

A distinct element approach has been introduced for simulating the plugging performance of granular lost circulation materials (LCM) in a fracture. This approach solves the fully coupled fracture walls, fluid and particles system in an interactive environment. The effects of the particle shape, size distribution and concentration on the fracture-plugging performance of the granular LCM have been investigated using the three-dimensional particle flow code (PFC3D). The simulated results showed that the irregular granular LCM could plug a fracture width larger than the sieving granulation by single-particle bridging type. The particle size distribution (PSD) of LCM dominates the plugging depth and efficiency in a fracture and there exists an optimum concentration for maximum effect of LCM additives.

Matched MeSH terms: Fractures, Bone

Lower limb fractures and their treatment

Robert EL

Malayan Medical Journal, 1932;7:33-8.

Matched MeSH terms: Fractures, Bone

Experimental identification on thresholds for early warning of rainfall-induced failure on fractured slopes after giant earthquake

Zong-ji Yang, Taro Uchimura, Jian-ping Qiao, Jian-ping Qiao

Sains Malaysiana, 2017;46:2029-2034.

Prevention and mitigation of rainfall induced geological hazards after the Ms=8 Wenchuan earthquake on May 12th, 2008 were significant for rebuild of earthquake hit regions. After the Wenchuan earthquake, there were tens of thousands of fractured slopes which were broken and loosened by the ground shaking, they were very susceptible to heavy rainfall and change forms into potential debris flows. In order to carry out this disaster reduction and prediction effectively in Longmenshan region, careful real-time monitoring and pre-warning of mountain hazards in both regional and site-specific scales is reasonable as alternatives in Wenchuan earthquake regions. For pre-warning the failure of fractured slopes induced by rainfall, the threshold value or the critical value of the precipitation of hazards should be proposed. However, the identification of critical criterion and parameters to pre-warning is the most difficult issue in mountainous hazards monitoring and pre-warning system especially in the elusive and massive fractured slopes widespread in Wenchuan earthquake regions. In this study, a natural coseismic fractured landslide in the Taziping village, Hongkou County, Dujianyan City, was selected to conduct the field experimental test, in order to identify the threshold parameters and critical criterion of the fractured slopes of Taziping. After the field experimental test, the correlation of rainfall intensity, rainfall duration and accumulative rainfall was investigated. The field experimental test was capable of identifying the threshold factors for failure of rainfall-induced fractured slopes after the giant earthquake.

Matched MeSH terms: Fractures, Bone

A survey of fractures in the dog and cat in Malaysia

Wong WT

Vet Rec, 1984 Sep 15;115(11):273-4.

PMID: 6495579

A survey of 61 canine and 26 feline fractures diagnosed between January 1980 and June 1983 at a veterinary teaching hospital was conducted. More than 80 per cent of the fractures occurred in animals less than two years old. Male animals were more frequently involved. In the dog, the femur, tibia, pelvis, radius and ulna were most often affected while in the cat, the femur, mandible, pelvis and spine were more often involved. All the findings were consistent with other reports in the literature.

Matched MeSH terms: Fractures, Bone/etiology; Fractures, Bone/epidemiology; Fractures, Bone/veterinary*

Fulltext Bilateral fracture of prostheses post-hip replacement

Surinder S, George P

Med J Malaysia, 2017 02;72(1):71-72.

PMID: 28255148 MyJurnal

Fracture of hip prostheses is a rare occurrence. A case of bilateral hip prostheses fracture is described here. The need to follow-up and remain vigilant post hip replacement is highlighted.

Matched MeSH terms: Fractures, Bone

Fulltext Immediate Revascularization of A Traumatic Limb Vascular Injury associated with Major Pelvic Injuries

Hanifah J, Paiman M, Nawfar AS, Tengku-Muzaffar T, Wan-Azman WS, Faisham WI, et al.

Malays Orthop J, 2015 Nov;9(3):61-64.

PMID: 28611914 MyJurnal DOI: 10.5704/MOJ.1511.014

High velocity pelvic injury with limb vascular injury poses difficulties as immediate surgery for limb reperfusion is indicated. However immediate vascular intervention deviates from conventional principles of damage control following major injuries. We present two cases of this rare combination of injuries. In both cases, early limb revascularization is possible despite presented with multiple injuries and pelvic fracture.

Matched MeSH terms: Fractures, Bone

Fulltext A biomechanical comparison between Taylor’s spatial frame and ilizarov external fixator

Tan, B. B., Shanmugam, R., Chua, Y. P., Hossain, G., Saw, A.

Malays Orthop J, 2014;8(2):35-39.

MyJurnal

Taylor’s spatial frame (TSF) and Ilizarov external fixators (IEF) are two circular external fixator commonly used to address complex deformity and fractures. There is currently no data available comparing the biomechanical properties of these two external fixators. This study looks into the mechanical characteristics of each system. TSF rings with 6 oblique struts, 4 tube connectors, 4 threaded rods, and 6 threaded rods were compared to a standard IEF rings with 4 threaded rods. Compression and torsional loading was performed to the frame as well as construct with Polyvinylchloride tubes. TSF rings with 4 tube connectors had the highest stiffness (3288 N/mm) while TSF rings with 6 struts was the least stiff. The situation was reversed for torsion where TSF rings with 6 oblique struts had the highest torsional stiffness (82.01 Nm/Degree) and frame Ilizarov rings with 4 threaded rods the least. Standard TSF construct of two ring with 6 oblique struts have better torsional stiffness and lower axial stiffness compared to the standard IEF.

Matched MeSH terms: Fractures, Bone

Fulltext Bone Overgrowth after Fracture of the Femoral Shaft inChildren

Yong, S.M., Saw, A., Sengupta, S., Bulgib A.M.

Malays Orthop J, 2007;1(1):8-11.

MyJurnal

Forty children treated non-operatively for fractures of the femoral shaft were reviewed with regard to differences in limb length after treatment. Follow up duration ranged from two to seven years. The average femoral overgrowth was 0.85cm (range 0 - 2.5cm) and was influenced by age at the time of fracture. We were not able to find any association between the quantity of overgrowth and race, gender, level or configuration of the fracture.

Matched MeSH terms: Fractures, Bone

Fulltext Development of the pelvic and Lower Limb Immobilization Device: a Universiti Kebangsaan Malaysia (UKM) innovation project

Johar, M.J., Bala Krishnian M, Mohd Radhi, A., Saadah, N.A., Gan, K.B., Ismail, M.S.

Medicine & Health, 2012;7(1):1-11.

MyJurnal

Uncontrolled bleeding due to pelvic fractures contributes to trauma-related morbidity and mortality. Three main strategies that have been outlined to combat this condition which include reduction of pelvic volume that lead to tamponade-like effect, arresting haemorrhage through angioembolization of the major vessels, and stabilization of the pelvic bone with external fixation need to be initiated early. A prehospital device that allow these strategies will aid significantly in the management of the patient. At present most devices used to treat pelvic fractures in the pre-hospital setting do have its’ own advantages but also have some limitations. A characteristic ‘wish-list’ of a good pelvic and lower limb immobilization device was created and the research team from UKM takes the challenge to design and produce a device that concurs to it. A two phase development project that incorporate anthropometric, biomechanical, cadaveric and radiological study was carried out over a period of seven years. Finally, BRIMTM immobilizer, a new pelvic and lower limb immobilization device that is user friendly, tough, cost effective, radiolucent, light and reusable that answers most of the requirement of a good device was invented.

Matched MeSH terms: Fractures, Bone

Fulltext A review on the relationship between aspirin and bone health

Chin KY

J Osteoporos, 2017;2017:3710959.

PMID: 28163951 DOI: 10.1155/2017/3710959

Aspirin is a cyclooxygenase inhibitor commonly used in primary prevention of cardiovascular diseases and cancers. Its users are elderly population susceptible to osteoporosis. It also inhibits the synthesis of prostaglandin E2 essential in bone remodeling. This prompts the question whether it can influence bone health among users. This review aimed to summarize the current literature on the use of aspirin on bone health. A literature search on experimental and clinical evidence on the effects of aspirin on bone health was performed using major scientific databases. In vitro studies showed that aspirin could enhance the survival of bone marrow mesenchymal stem cells, the progenitors of osteoblasts, and stimulate the differentiation of preosteoblasts. Aspirin also inhibited the nuclear factor kappa-B (NFκB) pathway and decreased the expression of receptor activator of NFκB ligand, thus suppressing the formation of osteoclast. Aspirin could prevent bone loss in animal models of osteoporosis. Despite a positive effect on bone mineral density, the limited human epidemiological studies revealed that aspirin could not reduce fracture risk. A study even suggested that the use of aspirin increased fracture risk. As a conclusion, aspirin may increase bone mineral density but its effect on fracture prevention is inconclusive. More data are needed to determine the effects of aspirin and bone health in human.

Matched MeSH terms: Fractures, Bone

Fulltext A technique of distal clavicle fracture fixation using the tightrope procedure

Soh C, Sivapathasundaram N, Parthiban R, Ramanand A

Malays Orthop J, 2011 Nov;5(3):20-3.

PMID: 25279031 MyJurnal DOI: 10.5704/MOJ.1111.002

We present here a technique of fracture stabilization using the Tightrope procedure in a patient with a widely displaced Neer type IIB distal clavicle fracture. The Tightrope system, typically used for stabilization of acromioclavicular joint dislocation, has not been widely described for distal clavicle fractures. The patient achieved satisfactory results after surgery; we feel that this technique is appealing as it is simple, reproducible and avoids the complications associated with extensive metalwork. This technique may also appeal to the arthroscopic surgeon.

Matched MeSH terms: Fractures, Bone

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