1.The Surgical Challenges of Intertrochanteric Hip Fracture in a Patient with Polio Dysplastic Hip and Previous Distal Femur Fracture: A Case Report
Lai MC ; Ng SHA ; Premchand AXR
Malaysian Orthopaedic Journal 2022;16(No.1):130-133
Poliomyelitis is on the verge of eradication since the
introduction of the vaccine in 1950. In developed countries,
those afflicted with the disease are primarily in their sixth
decade and beyond, usually with disabling complications.
Due to the diminished muscle power coupled with the
abnormal bony anatomy and joint contractures, patients with
polio present unique surgical challenges when they sustain
fragility fractures. We report an uncommon case of
intertrochanteric hip fracture in a limb affected with polio
and hip dysplasia, on a background of ipsilateral distal femur
fracture with previous surgical fixation. We aim to outline
the challenges encountered during the surgery and the preoperative planning to overcome these shortcomings.
2.Simultaneous Correction of a Tibia Deformity and Non-union in Achondroplasia: A Case Report
Achudan S ; Premchand AXR ; Low JS ; Decruz J ; Khan SA
Malaysian Orthopaedic Journal 2022;16(No.2):131-135
Tibial non-union with deformity in abnormal bone is rarely
reported in literature. We report a case of a 65 years old male
with a history of achondroplasia. The patient presented after
a mechanical fall with an undisplaced right midshaft tibia
fracture associated with pre-existing varus and procurvatum
tibial deformities, which was initially managed nonoperatively. However, after nine months he developed a
painful non-union. Because of the symptomatic non-union as
well as the pre-existing deformities, osteotomy of the tibia
and fibula was performed with the application of a TruelokHexapod (TL-Hex, Orthofix) frame. We were able to achieve
compression at the fracture site, and the software guided TLHex frame enabled gradual three-dimensional correction of
the deformity. At six months, bony union and simultaneous
correction of the tibia deformity were achieved. At two
years, the patient was able to ambulate well without pain and
perform his activities of daily living. We present a case of
tibial non-union with pre-existing deformity in an
achondroplasia patient successfully treated with a circular
frame application.