Displaying publications 1 - 20 of 135 in total

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  1. Loh YC, Trail IA
    Med J Malaysia, 2002 Jun;57(2):205-8.
    PMID: 24326652
    Fourteen fit and healthy patients underwent arthroscopic subacromial decompression (ASD) of shoulder for rotator cuff impingement. Their blood chemistry was analysed pre-operatively, 24 hours post-operatively and 2-3 weeks post-operatively. Levels of haematocrit, sodium, potassium, creatinine and urea were measured. The blood chemistry returned almost to the pre-operative level at 2-3 weeks post-operatively. There was no statistically significant differences found. This study concludes that arthroscopic subacromial decompression is a safe technique when considering the blood parameters despite the haemodilution seen in all patients.
    Matched MeSH terms: Shoulder*; Shoulder Impingement Syndrome*
  2. Wang C, Bea K, Zulkiflee O
    Malays Orthop J, 2013 Nov;7(3):18-20.
    PMID: 25674302 MyJurnal DOI: 10.5704/MOJ.1311.002
    Clavicle fracture is commonly treated conservatively. However uncommon complication can arise causing impingement. We report a patient who sustained distal clavicle fracture and was treated conservatively. However he developed persistent shoulder pain that affected his daily life. Shoulder impingement was diagnosed and arthroscopic subacromioclavicular decompression was done. Following early physiotherapy the early recovery was good with full range of motion of the shoulder.
    Matched MeSH terms: Shoulder; Shoulder Impingement Syndrome; Shoulder Pain
  3. Leonar, J.H., Siti Salmiah, M.D., Das, S., Ayiesah, H.R.
    MyJurnal
    Arthroscopic sub acromial debridement surgery with acromioplasty is one of the shoulder surgeries performed to treat chronic shoulder pain. This surgical procedure is usually indicated in sub acromial impingement syndrome of shoulder, degenerative rotator cuff tears, severe functional limitation of shoulder joint and often surgery was performed in cases where all the conservative management had failed in the treatment of chronic shoulder pain. Even though the patient would be referred for early rehabilitation, post operative management of this surgical condition is highly challenging. Movement of the shoulder joint is often related with scapulo-thoracic joint, acromio-clavicular joint and sternoclavicular joint and the shoulder movements are governed by various different muscular forces from these joints. Failure to understand this biomechanical complexity of shoulder joint during post operative rehabilitation results in failure of the surgical outcome and might cause severe functional limitation with recurrent shoulder pain. Often in clinical practice, greater emphasis is given to achieve and regain movements in shoulder joint at the expense of the joint stability. However, inadequate scapular stability might further predispose the shoulder joint to excessive loading and results in repetitive injuries leading to chronic shoulder pain. This might affect the surgical and clinical outcome of the acromioplasty and result in surgical failure. Hence, surgeons and clinicians need to understand the biomechanical contributions in the post operative rehabilitation of the shoulder joint. The present case report emphasises the biomechanical model of post operative rehabilitation of a patient who had arthroscopic sub acromial debridement with acromioplasty.
    Matched MeSH terms: Shoulder; Shoulder Joint; Shoulder Pain
  4. Hazwan Ab. Wahid, Khairul Nizam bin Siron, Ahmad Zakiran
    MyJurnal
    Displaced and unstable proximal humerus fractures are difficult to treat
    and they have high morbidity. The main goal is to achieve painless shoulder with full
    recovery of the shoulder joint motion. Impingement syndrome is one of the commonest
    postoperative complication. This study aim is to appreciate the functional outcomes of
    Philos-plate fixation for proximal humerus fractures and to establish association with
    high plate positioning with impingement syndrome of the shoulder after Philos-plate
    fixation. (Copied from article).
    Matched MeSH terms: Shoulder; Shoulder Fractures; Shoulder Joint
  5. Tan GJS, Tan AGS, Peh WCG
    Med J Malaysia, 2008 Jun;63(2):164-5.
    PMID: 18942311
    A 74-year-old woman was incidentally found to have a left breast mass. The mass could not be adequately compressed to be visualized on mammography. Ultrasonography showed a heavily-calcified rounded mass in the left axillary tail of the left breast. Chest radiograph confirmed that the mass was a migrated humeral head. Remotely-displaced fracture-dislocations of the humeral head are very rare and to our knowledge, displacement into the breast, clinically mimicking a breast mass, has not been previously described.
    Matched MeSH terms: Shoulder Dislocation/complications*; Shoulder Fractures/complications*
  6. Choo C, Wong H, Nordin A
    Malays Orthop J, 2012 Nov;6(3):57-9.
    PMID: 25279061 MyJurnal DOI: 10.5704/MOJ.1207.008
    Shoulder girdle injuries after high energy traumatic impacts to the shoulder have been well documented. Based on the series of 1603 injuries of the shoulder girdle reported by Cave and colleagues, 85% of the dislocations were glenohumeral, 12% acromioclavicular and 3% sternoclavicular (1). Less frequently described are injuries involving both the sternoclavicular and acromioclavicular joints simultaneously in one extremity. The present report discusses a case of traumatic floating clavicle associated with ipsilateral forearm and wrist injury which was treated surgically.
    Matched MeSH terms: Shoulder; Shoulder Injuries
  7. Collin P, Hervé A, Walch G, Boileau P, Muniandy M, Chelli M
    J Shoulder Elbow Surg, 2019 Oct;28(10):2023-2030.
    PMID: 31405717 DOI: 10.1016/j.jse.2019.03.002
    BACKGROUND: Results of anatomic shoulder arthroplasty for glenohumeral osteoarthritis with severe glenoid retroversion are unpredictable with a high rate of glenoid loosening. Reverse shoulder arthroplasty (RSA) has been suggested as an alternative, with good early results. We sought to confirm this at longer follow-up (minimum 5 years). The study hypothesis was that early results would endure over time.

    METHODS: We retrospectively reviewed all RSAs performed in 7 centers from 1998 to 2010. The inclusion criteria were primary glenohumeral osteoarthritis with B1, B2, B3, or C glenoid. Forty-nine shoulders in 45 patients fulfilled the criteria. Bone grafting was performed in 16 cases. Clinical outcomes were evaluated with the Constant score (CS) and shoulder range of motion.

    RESULTS: The mean total CS increased from 30 preoperatively to 68 points (P < .001) with significant improvements in all the subsections of the CS and range of motion. Scapular notching was observed in 20 shoulders (43%), grade 1 in 5 (11%), grade 2 in 7 (15%), grade 3 in 5 (11%), and grade 4 in 3 (6%). The glenoid bone graft healed in all the shoulders. Partial inferior lysis of the bone graft was present in 8 cases (50%). Scapular notching and glenoid bone graft resorption had no influence on the CS (P = .147 and P = .798).

    CONCLUSION: RSA for the treatment of primary glenohumeral osteoarthritis in patients with posterior glenoid deficiency and humeral subluxation without rotator cuff insufficiency resulted in excellent clinical outcomes at a minimum of 5 years of follow-up.

    Matched MeSH terms: Shoulder Dislocation/complications; Shoulder Dislocation/surgery*; Shoulder Joint/physiopathology; Shoulder Joint/surgery*; Arthroplasty, Replacement, Shoulder/adverse effects; Arthroplasty, Replacement, Shoulder/methods*
  8. Lee DJK, Yeap JS, Fazir M, Muhd Borhan TA, Kareem BA
    Med J Malaysia, 2005 Mar;60(1):15-20.
    PMID: 16250275
    The radiographs of 115 anterior shoulder dislocations (100 patients; 74 males, 26 female were reviewed to assess the radiographic views used in the management of this dislocation. Eighty-eight patients (88%) had only the anteroposterior (AP) view, 10 patients had 2 radiographic views taken and only 2 patients had three radiographic views. Hill-Sachs lesions were found in 18%, and glenoid rim fractures in 3% of the patients. A greater tuberosity fracture was found in 18% of the patients. Therefore, the current practice in the management of an acute anterior shoulder dislocation appears to be to perform a single view (AP) pre-reduction radiograph to confirm the diagnosis and a single view (AP) post reduction radiograph to confirm reduction after a close manipulative reduction has been performed. This practice is likely to result in an underestimate of associated Hill Sachs lesion and glenoid rim fractures, but not greater tuberosity fractures.
    Matched MeSH terms: Shoulder Dislocation/epidemiology; Shoulder Dislocation/radiography*
  9. Dhillon KS
    Malays Orthop J, 2019 Nov;13(3):1-7.
    PMID: 31890103 DOI: 10.5704/MOJ.1911.001
    Subacromial impingement syndrome (SAIS) is a commonly diagnosed disorder of the shoulder. Though this disorder has been known for a long time, it remains a poorly understood entity. Over the years several hypotheses have been put forward to describe the pathogenesis of SAIS but no clear explanation has been found. Two mechanisms, the extrinsic and intrinsic mechanism, have been described for the impingement syndrome. The intrinsic mechanism theories which deny the existence of impingement are gaining popularity in recent years. The various shoulder tests used to diagnose SAIS have low specificity with an average of about 50%. Meta-analysis shows that neither the Neer sign nor the Hawkins sign has diagnostic utility for impingement syndrome. Several randomised controlled trials have shown that the outcome of treatment of SAIS by surgery is no better than conservative treatment. Physiotherapy alone can provide good outcome which is comparable to that achieved with surgery without the costs and complications associated with surgery. Since decompression with surgery does not provide any additional benefits as compared to conservative treatment for patients with SAIS, the impingement theory has become antiquated and surgical treatment should have no role in the treatment of such patients. There are calls by some practitioners to abandon the term impingement syndrome and rename it as anterolateral shoulder pain syndrome. It appears that SAIS is a medical myth. There are others who called SAIS as a clinical illusion.
    Matched MeSH terms: Shoulder; Shoulder Impingement Syndrome; Shoulder Pain
  10. Nagarajan M, Vijayakumar P
    J Back Musculoskelet Rehabil, 2013;26(3):227-42.
    PMID: 23893137 DOI: 10.3233/BMR-130373
    Recent evidences suggest functional thoracic hyperkyphosis (FTH) could be a different approach in the management of subacromial impingement syndrome (SIS). This case study aims firstly with the development of evidence informed FTH model for SIS. Secondly this study aimed to develop well defined multimodal physical therapy intervention for FTH and its related mechanical consequences in elderly patient with chronic SIS. As a result, Level IV positive evidence was found in both the short and long-term pain and disability of chronic SIS, using FTH model with 26 months of follow-up.
    Matched MeSH terms: Shoulder Joint/pathology; Shoulder Impingement Syndrome/complications; Shoulder Impingement Syndrome/pathology; Shoulder Impingement Syndrome/therapy*
  11. Wahab AHA, Saad APM, Harun MN, Syahrom A, Ramlee MH, Sulong MA, et al.
    J Mech Behav Biomed Mater, 2019 03;91:406-415.
    PMID: 30684888 DOI: 10.1016/j.jmbbm.2018.12.033
    Intact glenoid labrum is one of passive stabilizer for glenohumeral joint, which have various stiffness at different region. The aim of this study is to develop new artificial glenoid labrum from Polyvinyl Alcohol (PVA) hydrogel, which known as good biomaterial due to its biocompatibility and ability to tailor its modulus. PVA hydrogel was formed using freeze-thaw (FT) method and the stiffness of PVA was controlled by manipulating the concentration of PVA and number of FT cycles. Then, the gradual stiffness was formed using simple diffusion method by introducing the pre-freeze-and-thaw steps. The results showed 20% PVA with three FT cycles suit to highest stiffness of glenoid labrum while 10% PVA with three FT cycles suit to lowest stiffness of glenoid labrum. The functionally graded PVA hydrogel was then developed using the same method by diffusing two mixture (20% PVA and 10% PVA). Mechanical compression test showed, the highest modulus (0.41 MPa) found at the 20% PVA region and lowest modulus (0.1 MPa) found at 10% PVA region. While, at intermediate region, the compressive modulus was in between 20% and 10%, 0.2 MPa. The existence of gradual stiffness was further prove by checking crystallinity of material at each region using Differential Scanning Calorimetry (DSC) and Wide Angle X-ray Diffraction (WAXD). Microstructure of material was obtained from Scanning Electron Microscopy (SEM). This functionally graded PVA hydrogel also able to reduce about 51% of stress at glenoid implant and up to 17% for micromotion at the interfaces. Existence of artificial glenoid labrum could minimize the occurrence of glenoid component loosening.
    Matched MeSH terms: Shoulder Joint*
  12. Mat Ali AAB, Nasir A, Ramli N, Ibrahim NR, Van Rostenberghe H
    J Paediatr Child Health, 2020 05;56(5):704-709.
    PMID: 31821664 DOI: 10.1111/jpc.14705
    AIM: The optimal placement of the endotracheal tube (ETT) in ventilated infants is essential, but birthweight may be not the best parameter to predict it. The aim of this study was a direct comparison of shoulder-umbilical length (experimental group) versus birthweight (control group) as predictor of optimal ETT placement in Malaysian ventilated infants.

    METHODS: All infants requiring ventilation in the neonatal intensive care unit of a tertiary hospital in Malaysia during the 4-month study period were eligible to enter this randomised controlled trial. All participants were randomised into two groups: experimental and control group. The main outcome measure was malposition of the ETT (requiring adjustment), as seen on the chest X-ray performed within 1 h after intubation. Tube placement was assessed by two neonatologists, blinded to the allocation.

    RESULTS: One hundred and ten infants were randomised, 55 in each group. The ETT was malpositioned in 13 of 55 infants (23%) for the experimental group and 22 of 55 infants (40%) in the control group (P = 0.06).

    CONCLUSION: In the experimental group, fewer infants showed a need for tube adjustment than in the control group. While a larger study may be necessary to show statistical significance, the difference shown in this study may be large enough to be of clinical significance.

    Matched MeSH terms: Shoulder*
  13. Khoo, S.W., Khoo, S.M., Yeong, Y.K., Towil, B.
    Malays Orthop J, 2009;3(2):29-32.
    MyJurnal
    According to recently reported outcome studies, functional outcomes after arthroscopic rotator cuff repair are reasonable and comparable to open or mini-open techniques. We report the functional outcomes after arthroscopic rotator cuff repair of 10 consecutive patients. The average age was 53.9(range 46-59) years. There was a significant improvement of the function of the shoulder when the preoperative scores were compared with those at the time of at least six months follow-up (range of 6 months to 18 months). With the UCLA rating scale, the average total score increased from preoperative 9.8 (range, 6-15) to postoperative 32.6 (range,23-35). With the use of ASES shoulder index, the average total score improved from 14.6 range, 1.6-35) to 92.3 (range,66.6 to 100). We concluded that arthroscopic rotator cuff repair is a treatment method in selective patients with symptomatic rotator cuff pathology to alleviate shoulder pain and improve function.
    Matched MeSH terms: Shoulder; Shoulder Pain
  14. Narayanan VL, Balasubramanian N
    Malays Orthop J, 2018 Jul;12(2):20-24.
    PMID: 30112124 DOI: 10.5704/MOJ.1807.004
    Introduction: Proximal humerus fracture fixation using plate osteosynthesis depends on the quality of the bone, design of the fixation devices and intra-operative soft tissue dissection. This study evaluates the functional outcome of minimally invasive percutaneous plate osteosynthesis using locking compression plate in proximal humerus fracture treatment. Materials and Methods: The study was conducted on 30 patients with complex proximal humerus fractures treated by minimally invasive percutaneous plate osteosynthesis using locking compression plate (PHILOS). There were 21 males and 9 females. The average age of our study group was 58.8 years. All the patients were evaluated at six weeks, three months, four months, six months and 12 months following surgery. Results: All patients had fracture union at an average of 13.2 weeks. The mean DASH score at the follow-up was 8.69 (2.5 to 17.16), the average range of flexion was 143.83 degrees (100 to 170 degrees) and abduction was 121.49 degrees (90 to 160 degrees). We had superficial infection in three patients which resolved with a short course of antibiotics. There was excellent outcome in 26 patients, good and fair in two patients each. Conclusion: Proximal humerus fractures treated with minimally invasive percutaneous plate osteosynthesis using locking compression plate with minimal soft tissue dissection, provides good functional outcome and early return of shoulder function.
    Matched MeSH terms: Shoulder; Shoulder Fractures
  15. Ogawa T, Sasaki T, Masayuki-Kawashima MK, Okawa A, Mahito-Kawashima MK
    Malays Orthop J, 2017 Nov;11(3):47-49.
    PMID: 29326767 DOI: 10.5704/MOJ.1711.003
    Bipolar segmental clavicle fractures are simultaneous clavicle fractures of both proximal and distal ends. Few case reports describing these fractures have been published, and the management of these injuries have remained controversial. Non-operative treatment is likely to result in poor shoulder function due to the instability of the fracture in patients with high physical demands. In contrast, surgical treatment with fixation of both proximal and distal ends of the clavicle possibly may cause life-threatening complications. We present a 74-year old female farmer who had injured her left shoulder and was diagnosed with a bipolar segmental clavicle fracture. Taking the fracture mechanism into consideration, we surgically treated only the distal end of the clavicle fracture with a locking plate. The proximal end of the clavicle fracture was treated without surgical intervention. Both fracture sites achieved bony union after four months and she returned to her activities as a farmer. Quick DASH score was 5.0 with excellent results at three years after operation.
    Matched MeSH terms: Shoulder; Shoulder Fractures
  16. Lim PJ, Peh WC
    Med J Malaysia, 2014 Oct;69(5):231-3.
    PMID: 25638239
    The scapula is a flat, triangular bone overlying the posterior chest wall and forming the posterior aspect of the shoulder girdle. To the best of our knowledge, there is no previous description of a notch of the medial aspect of the superior border of the scapula in the literature. The imaging findings of a supero-medial scapula border notch mimicking a bone tumour are presented in this case report.
    Matched MeSH terms: Shoulder
  17. Ho JP, Ahmad Faizal A, Sivapathasundaram N
    Malays Orthop J, 2013 Nov;7(3):30-2.
    PMID: 25674306 MyJurnal DOI: 10.5704/MOJ.1311.012
    We present a case of chronic acromioclavicular joint dislocation (Rockwood type 5) in which the choice of acromioclavicular reconstruction using autogenous semitendinosus tendon graft was made due to its superiority in anatomical reconstruction of the coracoclavicular ligaments, and the impact of postoperative rehabilitation on the recovery of this patient. We also discuss the rationale behind this.
    Matched MeSH terms: Shoulder Dislocation
  18. 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: Shoulder Dislocation
  19. Hazmy CHW, Parwathi A
    Med J Malaysia, 2005 Jul;60 Suppl C:22-5.
    PMID: 16381278
    This retrospective study was conducted in a state hospital set-up and aimed at identifying the incidence of sports-related shoulder dislocations and their characteristics and the sports events involved. All patients with shoulder dislocation related to sporting activities admitted to the hospital from January 1999 to December 2002 were included in the study. There were 18 sports-related shoulder dislocations out of 106 all shoulder dislocations admitted during this 4-year period. The average age of the patients was 25.4 years. All but two were male. All were anterior dislocations. Recurrent dislocation constitutes 78% of the cases with an average of 3 times re-dislocation. Rugby and badminton were the major contributors to the injuries followed by volleyball, soccer and swimming. Conservative treatment was successfully instituted for 88% of the patients and 12% opted for surgical intervention.
    Matched MeSH terms: Shoulder Dislocation/etiology; Shoulder Dislocation/epidemiology*; Shoulder Dislocation/therapy
  20. Hazmy CHW, Parwathi A
    Med J Malaysia, 2005 Jul;60 Suppl C:17-21.
    PMID: 16381277
    This retrospective study was conducted in a state hospital set-up and aimed at identifying the magnitude of shoulder dislocations and their demographic data, characteristics of the injury, mechanism and predisposing factors, and the instituted treatment. Patients with radiographic evidence of shoulder dislocation admitted to the hospital from January 1999 to December 2002 were included. Data were recorded from the case notes. There were 105 shoulder dislocations with male predomination in 77% cases and age ranged between 11 and 90 years (average 30.9 years). The right shoulder was affected in 68% of the cases. The contributing events were fall in 37% of cases, road traffic accident 23%, sports 17% and pathological conditions 13%. Anterior dislocation occurred in 96.2% of the cases. Posterior and inferior dislocations encountered in two patients for each type. Twelve dislocations were associated fracture of the greater tuberosity, two each with humeral neck fracture and cerebral injuries. First time dislocation occurred in 73.6% of the cases. The recurrences ranged between 2 to 6 times (average 3.4 times). Closed manipulative reduction and strapping was the definitive treatment in 92.4% of the cases and the remaining needed surgical reconstruction. Four patients had open reduction and internal fixation of the associated fractures while another four had arthroscopic Bankart's repair. In conclusion, shoulder dislocation represents the most common shoulder problems. It afflicted young adults of reproductive age (21-40 years) and participation in sports was a risk factor in men. Women over 40 years and fall were at risk to develop shoulder dislocation.
    Matched MeSH terms: Shoulder Dislocation/etiology; Shoulder Dislocation/epidemiology*; Shoulder Dislocation/therapy
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