1.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.
2.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.
5.Cervical cancer patient reported gastrointestinal outcomes: intensity/volumetric modulated vs. 3D conformal radiation therapy
Ryan URBAN ; Justin WONG ; Peter LIM ; Susan ZHANG ; Ingrid SPADINGER ; Robert OLSON ; Francois BACHAND ; Clement HO ; Anna V. TINKER ; Lovedeep GONDARA ; Sarah Nicole HAMILTON
Journal of Gynecologic Oncology 2022;33(5):e70-
Objective:
To evaluate gastrointestinal (GI) patient reported outcomes (PROs) in cervical cancer patients treated with definitive radiotherapy (RT), comparing 3D conformal RT (3DCRT) vs. intensity modulated/volumetric modulated arc therapy (IMRT/VMAT).
Methods:
An analysis of patients treated with definitive RT between 2015–2018 was performed. GI PROs were prospectively collected at baseline, during RT (acute), ≤12 weeks after RT (subacute), and >12 weeks after RT (late). GI PROs evaluated three symptom domains: bowel problems (BPs), bowel bother (BB), and abdominal problems (APs). Multiple linear regression analysis was performed to investigate associations between mean changes of symptom scores with clinical and dosimetric variables.
Results:
The cohort included 167 patients. A total of 100 (60%) patients were treated with IMRT/VMAT and 67 (40%) with 3DCRT. In the subacute phase, the mean change of symptom scores from baseline in 3DCRT vs. IMRT/VMAT were +0.9 vs. −1.15 (p=0.004) for BP, +2.18 vs. −0.10 (p=0.019) for BB, and +1.41 vs. −0.38 (p=0.021) for AP. Likewise, in the late phase, mean changes were +0.72 vs. −0.82 (p=0.014) for BP, +1.98 vs. −0.03 (p=0.008) for BB, and +1.29 vs. −0.31 (p<0.001) for AP. On multiple linear regression, use of 3DCRT vs. IMRT/VMAT was associated with greater mean changes in subacute BP (p=0.023) and late phase AP (p=0.019). A higher small bowel V50Gy was associated increased symptom scores in late AP (p=0.012).
Conclusion
3DCRT was associated with significantly greater worsening of GI PRO symptom scores in the subacute and late phase. These data support the ongoing use of IMRT/VMAT in routine practice.
7.A PROSPECTIVE COHORT STUDY COMPARING PATIENTS’ PAIN, FUNCTIONAL OUTCOMES AND QUALITY OF LIFE PRE AND POST TOTAL KNEE ARTHROPLASTY: EXPERIENCE FROM A DISTRICT HOSPITAL, SOUTHERN KEDAH
Vijaya Kumar SL ; Wong BC ; Tew MM ; Vijay Kumar NK ; Ashutosh S Rao
Malaysian Orthopaedic Journal 2019;13(Supplement A):55-
9.Randomized, Open-Labelled Controlled Trial Comparing Efficacy And Cost Of Single-And Weekly Multiple-Dose Regimens Of Intra-Articular Viscosupplementation In Knee Osteoarthritis – 1 Year Follow Up
Suppan VK ; Tew MM ; Vijay Kumar NK ; Wong BC ; Chew YW ; Tan CS ; Rao AS
Malaysian Orthopaedic Journal 2018;12(Supplement A):20-