1.Traumatic Floating Clavicle: A Case Report
Malaysian Orthopaedic Journal 2012;6(2):57-59
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.
2.Conservative Management of Calcaneal Fractures. A Retrospective Review of Treatment Outcome
Malaysian Orthopaedic Journal 2008;2(1):28-32
Int roduction: Treatment of calcaneal fracture is still
controversial and indication for surgery is not well
established. We are reporting the mid term outcome of
calcanel fractures treated conservatively.
Material and Methods: Patients admitted with calcaneal
fractures from 1st November 2002 till 31st December 2004
and were treated conservatively were included in this study.
The fractures were grouped according to Essex-Lopresti
classification and their outcomes were assessed with the
Maryland foot score. We also looked at time to weight
bearing and returning to occupational activity.
Results: Forty-four patients were included for evaluation.
Patients with extraarticular calcaneal fractures had
significantly higher rating scores compared to those with
intraarticular fractures (98.2 and 88.8 respectively, with a p value = 0.0001). Generally, both group of patients had a good clinical outcome. 18 of the 44 patients (41%) started partial weight bearing before or at 6 weeks and 31 patients (72%) were able to start full weight bearing by 12 weeks. 31 patients (72%) were back to work 12 weeks after the injury.
Conclusion: Conservative management for calcaneal
fractures is an acceptable mode of treatment with satisfactory functional outcome.
3.Unlocked Nailing vs. Interlocking Nailing for Winquist Type I and II Femoral Isthmus Fractures. Is there a Difference?
CK Yu ; HY Wong ; AS Vivek ; BC Se To
Malaysian Orthopaedic Journal 2008;2(1):23-27
Interlocking intramedullary nailing is suitable for
comminuted femoral isthmus fractures, but for noncomminuted
fractures its benefit over unlocked nailing is
debatable. This study was undertaken to compare outcomes
of interlocking nailing versus unlocked intramedullary
nailing in such fractures. Ninety-three cases of noncomminuted femoral isthmus fractures (Winquist I and II)
treated with interlocking nailing and unlocked nailing from 1 June 2004 to 1 June 2005 were reviewed; radiological and clinical union rates, bony alignment, complication and knee function were investigated. There was no statistical significant difference with regard to union rate, implant failure, infection and fracture alignment in both study groups. Open fixation with unlocked femoral nailing is technically less demanding and requires less operating time; additionally, there is no exposure to radiation and cost of the
implant is cheaper. We therefore conclude that unlocked
nailing is still useful for the management of non-comminuted isthmus fractures of the femur.
4.Potential endophenotype for schizophrenia: neurological soft signs.
Christy Lm HUI ; Gloria Hy WONG ; Cindy Py CHIU ; May Ml LAM ; Eric Yh CHEN
Annals of the Academy of Medicine, Singapore 2009;38(5):408-406
INTRODUCTIONNeurological soft signs (NSS) are suggested as a candidate endophenotype for schizophrenia. This article aims to review relevant literature and discuss the role of NSS in understanding schizophrenia.
METHODSThis is an update on a review article published in 2003. Articles from 2003 onwards were specifically reviewed and discussed with relevance to the role of NSS as endophenotype for schizophrenia.
RESULTSConsistent data suggest an excess of NSS in schizophrenic patients. NSS appear to be related to schizophrenic symptoms, in particular negative symptoms and disorganisation. Information on NSS and demographic correlates is scarce, and the confounding effects between age, education and intelligence on NSS constitute an important gap in current knowledge. Longitudinal data suggest NSS as both a trait and state variable in the course of disease. NSS are not specific with regard to diagnosis, although there are claims that individual sub-components may be more specific. The weight of evidence raises question on the specificity of NSS for schizophrenia.
CONCLUSIONSThe usefulness and feasibility of NSS as a specific endophenotype target for schizophrenia is unclear. However, NSS remain an important feature and symptom correlate of schizophrenia. Future research should focus on delineating the effects of NSS from those of confounding demographic variables, and the stability of NSS over the course of illness to elucidate its role in schizophrenia.
Humans ; Mental Disorders ; Neurologic Examination ; Phenotype ; Risk Factors ; Schizophrenia ; diagnosis ; genetics ; Sensitivity and Specificity