1.Acute Marjolin’s Ulcer in Chronic Foot Wounds with Previous Negative Biopsy: Report of Two Cases
Xu S ; Kang YBJ ; Soeharno H ; Yeo NEM
Malaysian Orthopaedic Journal 2020;14(No.3):194-197
Marjolin’s ulcer is a rare and often overlooked diagnosis
which can be encountered by a variety of specialities.
Majority of the literatures describe long latency period of 11
to 75 years. The authors present two unusual cases of rapid
progression to Marjolin’s ulcer in patients with previously
negative biopsy 8- and 10-month prior. This highlights the
importance for clinicians to have a high degree of suspicion
when encountered with any non-healing wound, especially
one who’s symptomatology and morphological features have
undergone an acute change. Even with previous negative
biopsy, patients should still be followed-up closely and
clinicians should not hesitate to perform re-biopsy if the
suspicion arises.
2.Concomitant Ulnar Styloid Fractures in Distal Radius Osteosynthesis Does Not Impact Radiographic Outcomes, Ulnar Sided Symptoms and Patient Outcomes
Wong KC ; Wu MWF ; Zai QJJ ; Wong MK ; Howe TS ; Koh SBJ ; Soeharno H
Malaysian Orthopaedic Journal 2023;17(No.1):142-148
Introduction: Current literature reports varied significance
of ulnar styloid fractures (USF) associated with distal radius
fractures. Our study assesses the role of ulnar styloid
fractures and fragment size in surgically managed distal
radius fractures.
Materials and methods: We reviewed patients who
underwent surgical fixation of distal radius fractures between
January 2004 to June 2006. Patients were divided into those
with (Group 1) and without (Group 0) USFs. Post-operative
radiographic parameters, clinical outcomes and overall wrist
function were analysed. Outcomes included ulnar-sided
wrist pain, extensor carpi ulnaris (ECU) tendinitis, triangular
fibrocartilage complex (TFCC) grind test, distal radioulnar
joint (DRUJ) instability and pain. Overall wrist function was
assessed with range of motion and Disabilities of the Arm,
Shoulder and Hand (DASH) score.
Results: Our study cohort included 31 males and 23 females,
and 38.9% of these patients had concomitant USFs. There
was no difference in terms of demographic data and fracture
configuration between groups. Radiographic parameters
were similar, except for palmar tilt, which was significantly
higher in Group 1 (4.6º vs 9.4º, p=0.047). At 24 months,
there were no differences in clinical outcomes and overall
wrist function. A sub-group analysis showed that mean USF
fragment size was larger in patients with a positive TFCC
grind test (3.9mm vs 7.3mm, p=0.033).
Conclusion: The presence of USFs in surgically managed
distal radius fractures does not compromise clinical and
functional outcome. Similarly, the size of USFs does not
impact clinical and functional outcome but is associated with
the presence of a positive TFCC grind test.