1.Schwannoma of the Common Peroneal Nerve – A Rare Incidence
Tan JA ; Levin KB ; Rhani SA ; Hisam A
Journal of Surgical Academia 2017;7(2):24-27
Schwannomas are benign tumours arising from neurilemmal cells which forms the myelin sheath of peripheral nerves. It usually occurs in the head, but may be found in the brachial plexus and sciatic nerve. Common peroneal nerve schwannoma are rare. We report a case of a middle age gentleman who presented with pain and swelling over the right popliteal fossa with associated right radicular pain of the anterolateral leg and weakness of ankle dorsiflexion. Examination revealed a 3x2 cm lump behind the posterolateral aspect of the right knee with positiveTinel’s sign upon tapping of the lump, sensory deficit over the anterolateral aspect of the leg and the ankle dorsiflexors had a muscle power of grade 3. Magnetic resonance imaging (MRI) of the right leg revealed a well circumscribed, oval lesion located along the pathway of the common peroneal nerve homogenously hypointense on T1-weighted images and heterogeneously hyperintense on T2 weighted images compared to the muscles. The lesion was not surpressed on fat suppression sequences. Intra-operatively, we noted that the schwannoma was in continuity with the common peroneal nerve. The patient underwent excision of the schwannoma. Post operatively, the pain reduced remarkably but patient suffers from numbness and right foot drop as a complication of the tumour. This case highlights the rarity of common peroneal nerve schwannoma which presents with neuropathic symptoms complicated with right foot drop.
2.Trapezius Rotational Flap for Cervico-thoracic Wound Breakdown in Post-radiotherapy Necrosis: A Case Report
MH Ariffin ; Selvyn Lloyd ; SA Rhani ; Kamalnizat A Baharudin
Malaysian Orthopaedic Journal 2014;8(2):40-42
The management of post-radiation wound breakdown
over the posterior cervico thoracic region can be a
challenging task for a surgeon. The aim of the treatment
is to produce a well vascularized and a low tensile flap
which will close a large defect. We describe the use of the
lower trapezius flap to reconstruct the wound breakdown
and to obtain stable tissue coverage in a patient with postradiation
necrosis. This flap minimizes the disruption
of the scapula-thoracic function while preserving the
range of movement over the shoulder. From the literature
review, it was noted that the dorsal scapular artery (DSA)
and transverse cervical artery (TCA) aid in the blood
supply to the trapezius muscle and prevent local necrosis
during rotation of the flap. The trapezius flap is widely
accepted because of the minor donor site morbidity, large
arc of rotation and adequate blood supply.
Superficial Back Muscles
3.Osteoradionecrosis in Subaxial Cervical Spine - a Rare and Devastating Complication: A Case Report
Rashid MZ ; Ariffin MH ; Rhani SA ; Baharudin A ; Ibrahim K
Malaysian Orthopaedic Journal 2017;11(3):53-55
Osteoradionecrosis, a rare complication of radiation therapy,
is a slow progression disease which affects the surrounding
structures of spinal components. It essentially weakens the
soft tissue and bony configuration and can cause nerve
impingement or cord compression. We describe a patient
who underwent radiotherapy for thyroid cancer and
presented with cervical kyphosis with anterolisthesis of
C3/C4 and C4/C5 some 32 years later. We explore the role of
anterior and posterior fusion, as well as hyperbaric oxygen
therapy in promoting healing.
Osteoradionecrosis
4.Early Decompression In Traumatic Cervical Dislocation Improve Patient Neurology Outcome
Leong JF ; Rhani SA ; Baharudin A ; Ariffin HM
Malaysian Orthopaedic Journal 2018;12(Supplement A):154-