1.Obturator Internus Pyomyositis in A Child: A Case Report
Malaysian Orthopaedic Journal 2014;8(1):69-71
Obturator internus pyomyositis is a rare disease that is more
commonly found in tropical countries. Due to its infrequent
occurrence, it is a differential of hip pain that has not been
sufficiently considered, which often results in delayed
diagnosis. We present a case report of a 4 year old boy with
pyomyositis of obturator internus as well as externus. He
was treated successfully with intravenous antibiotics. A
comparison is made with other case reviews to identify
symptoms and signs that could help in diagnosing the
condition early and accurately so as to initiate intravenous
antibiotics, the mainstay treatment in a timely fashion,
eventually avoiding surgical drainage of the sequelae when it
becomes an abscess.
Pyomyositis
2.Can Paediatric Femoral Fracture Hip Spica Application be Done in the Outpatient Setting?
Yap ST ; Lee NKL ; Ang ML ; Chui RW ; Lim KBL ; Arjandas M ; Wong KPL
Malaysian Orthopaedic Journal 2021;15(No.1):105-112
children with femur fractures. This study compares the
outcomes of spica cast application, in terms of quality of
fracture reduction and hospital charges when performed in
operating theatre versus outpatient clinics at a local
institution.
Materials and Methods: A total of 93 paediatric patients,
aged between 2 months to 8 years, who underwent spica
casting for an isolated femur fracture between January 2008
and March 2019, were identified retrospectively. They were
separated into inpatient or outpatient cohort based on the
location of spica cast application. Five patients with
metaphyseal fractures and four with un-displaced fractures
were excluded. There were 13 and 71 patients in the
outpatient and inpatient cohort respectively who underwent
spica casting for their diaphyseal and displaced femur
fractures. Variables between cohorts were compared.
Results: There were no significant differences in gender,
fracture pattern, and mechanism of injury between cohorts.
Spica casting as inpatients delayed the time from assessment
to casting (23.55 ± 29.67h vs. 6.75 ± 4.27h, p<0.05),
increased average hospital stay (41.2 ± 31.1h vs. 19.2 ±
15.0h, p<0.05) and average hospital charges (US$1857.14 vs
US$775.49, p<0.05). Excluding the un-displaced fractures,
there were no significant differences in the period of cast
immobilisation and median follow-up length. Both cohorts
had a similar proportion of unacceptable reduction and
revision casting rate.
Conclusion: Both cohorts presented similar spica casting
outcomes of fracture reduction and follow-up period. With
spica cast application in operating theatre reporting higher
hospital charges and prolonged hospital stay, the outpatient
clinic should always be considered for hip spica application.