1.FUNCTIONAL OUTCOME OF SURGICAL STABILIZATION OF ACETABULAR FRACTURES
Nor Hamdan F ; Yahaya S ; Din MH
Malaysian Orthopaedic Journal 2019;13(Supplement A):40-
2.Functional Outcome of Surgical Stabilisation of Acetabular Fractures
Fakru NH ; Faisham WI ; Hadizie D ; Yahaya S
Malaysian Orthopaedic Journal 2021;15(No.2):129-135
Introduction: Approach to the management of displaced
acetabular fractures has evolved from conservative to
operative management after the work of Judet and Letournel.
Various surgical methods have been explored and described
by authors to address this type of fracture, leading to
improved clinical outcome. This study aimed to evaluate
functional outcome of surgically treated displaced acetabular
fractures in the Malaysian context.
Materials and methods: We analysed 43 patients with
isolated acetabular fractures who were treated operatively
with a minimum of three years follow-up. Anthropometric
data, Judet-Letournel fracture pattern, surgical approach and
complications were recorded. Post-operative Matta
radiological outcome were evaluated for joint congruency
and hip functional outcome was evaluated using Merle
d’Aubgine-Postel and Harris Hip Score (HHS). All statistical
analyses were analysed using SPSS version 24.0.
Results: The most frequent elementary fracture type was
posterior wall (30.2%) while associated type was both
columns (23.3%). Mean functional outcome of Merle
d'Aubigné-Postel was 15.77 and HHS was 86.6. Thirty-three
(76.7%) patients achieved satisfactory functional outcome,
19 (44.1%) patients achieved anatomic reduction (<2 mm
step-off) based on Matta classification while 24 (55.8%) did
not achieve the desired outcome. Fracture pattern exhibited
strong association with post-operative Matta radiological
outcome (p-value 0.001). However both fracture pattern and
Matta radiological outcome did not exhibit association with
the functional outcome group. The mean time for surgical
interventions was 10.8 days and there was no significant
association with final functional outcome score.
Conclusion: Fracture pattern is a strong contributing factor
towards post-operative Matta radiological outcome.
However, achieving the perfect anatomical reduction is not
of utmost important factor to predict the good functional
outcome.
4.Study of Deep Vein Thrombosis Screening by using Ultrasound Doppler in Patients with Pelvic and Acetabulum Fractures Requiring Operative Intervention
Hadizie D ; Deyoi YB ; Faisham WI ; Yahaya S ; Ghani SA ; Ahmad-Mohd-Zain MR
Malaysian Orthopaedic Journal 2022;16(No.1):51-57
Introduction: Pelvic and acetabulum fractures are
commonly caused by high impact injuries, increasing the
risk of patients developing thromboembolic diseases such as
deep vein thrombosis (DVT) and pulmonary embolism (PE).
Therefore, this study was performed to determine the
incidence of lower extremity DVT in patients with pelvic
and acetabulum fractures and the importance of preoperative screening with Doppler ultrasound prior to surgical
intervention.
Materials and methods: This retrospective study involved
78 patients with pelvic and acetabulum fractures requiring
surgical intervention from January 2015 until December
2019. Patients who underwent surgical interventions were
screened pre-operatively with Doppler ultrasound to detect
lower limb DVT and later compared with the incidence of
lower limb DVT post-operatively. Descriptive statistical
analysis was performed using IBM SPSS Statistics Version
24.
Results: The participants of this study consisted of 30.8%
females and 69.2% males. Pre-operative screening with
Doppler ultrasound showed that three patients (3.8%) were
diagnosed with lower limb DVT, whereas one of them
(1.3%) was symptomatic and diagnosed with PE. Postoperatively, one patient developed DVT, and one patient
developed PE. Both patients were negative for DVT preoperatively.
Conclusion: The incidence of DVT in patients with pelvic
and acetabulum fractures requiring operative intervention
was significant despite the initiation of mechanical and
pharmacological thromboprophylaxis upon admission.
Despite the low incidence of DVT in our study, it has a high
impact on patients’ morbidity and mortality; thus, preoperative screening is important for early detection and the
subsequent reduction of the risk of developing PE. The
compulsory use of Doppler ultrasound of bilateral lower
limbs as a part of pre-operative screening is highly
recommended because it is cost-effective, efficient and
readily available in most tertiary hospitals nationwide.
5.Grisel’s Syndrome: Challenges In Diagnosis And Role Of Conservative Management
Kunabal P ; MY Yahaya ; S Lloyd ; Satriya SHA
Malaysian Orthopaedic Journal 2018;12(Supplement A):22-
7.Angular Deformities of the Knee in Children Treated with Guided Growth
Jamil K ; Yahaya MY ; Abd-Rasid AF ; Ibrahim S ; Abdul-Rashid AH
Malaysian Orthopaedic Journal 2021;15(No.2):26-35
Introduction: The guided growth technique is an alternative
to corrective osteotomy for treating angular deformities of
the extremities. It has the advantage of being minimally
invasive and is effective in a growing child. This study
reports on the outcome of guided growth technique using a
plate in correcting knee angular deformities.
Materials and methods: We conducted a retrospective study
of children with angular deformity of the knee treated by the
guided growth technique from January 2010 to December
2015 in a tertiary centre. The guided growth technique was
done using either the flexible titanium plate (8-plate) or the 2-
hole reconstruction plate. Correction of deformity was
assessed on radiographs by evaluating the mechanical axis
deviation and tibiofemoral angle. The implants were removed
once deformity correction was achieved.
Results: A total of 17 patients (27 knees) were evaluated.
Twenty-two knees (81.5%) achieved complete correction of
the deformity. The median age was 4.0 (interquartile range
3.0-6.0) years and the median Body Mass Index (BMI) was
26.0 (25.0-28.0). There were 7 unilateral and 10 bilateral
deformities with different pathologies (14 tibia vara, 3 genu
valgus). The median rate of correction was 0.71° per month.
One patient (1 knee) had screw pull-out and two patients (4
knees) had broken screws in the proximal tibia. Three
patients (5 knees) failed to achieve complete correction and
were subsequently treated with corrective osteotomies. Out
of five patients (8 knees) who were followed-up for at least
12 months after removal of hardware, two had rebound
deformities. No permanent growth retardation occurred in
our patients.
Conclusion: Our outcome for guided growth to correct knee
angular deformity was similar to other studies. Guided
growth is safe to perform in children below 12 years old and
has good outcome in idiopathic genu valgus and Langeskiold
II for tibia vara. Patients should be observed for recurrence
until skeletal maturity following implant removal.
8.Functional Outcome after Treatment of Aggressive Tumours in the Distal Radius: Comparison between Reconstruction using Proximal Fibular Graft and Wrist Fusion
Choo CY ; Mat-Saad AM ; Wan-Azman WS ; Wan Z ; Nor-Azman MZ ; Yahaya S ; Faisham WI
Malaysian Orthopaedic Journal 2018;12(3):19-23
Introduction: Restoration of a functional hand is the ultimate goal following a distal radius tumour resection. The early outcomes of mobile wrist reconstruction are satisfactory; however, long-term results are unpredictable due to late wrist instability and degenerative arthritis. Our aim is to compare mobile wrist reconstruction with wrist fusion (pan-carpal fusion) in our cohort of patients. Materials and Methods: A retrospective cohort study was performed for functional outcomes of all patients who underwent resection for distal radius tumour and treated with either fusion or reconstruction of the wrist in a single institution from years 2000-2013 with a minimum of three years follow-up. Results: Eleven patients were included in the study, six of whom had wrist reconstruction with proximal fibula graft and the remaining five wrist fusion, with a mean follow-up of 6.3 years. The mean Musculoskeletal Tumour Society (MSTS) score was 82.78%, ranging from 70% to 93.3%. Average grip strength compared to the normal contralateral hand was 60.0% for total wrist fusion, which was better than wrist reconstruction with 58.07%. There was no difference in the functional outcome between fusion and mobile reconstruction in our study. Osteoarthritis changes and subluxation of the wrist joint were the most common findings in the long-term follow-up for this group. Conclusion: There was no difference in the functional outcome of the long-term follow-up between the two groups.
9.High incidence of Plasmodium knowlesi malaria compared to other human malaria species in several hospitals in Malaysia
Lai, M.Y. ; Rafieqin, N. ; Lee, P.Y.@Lee, Z. ; Amir Rawa, M.S. ; Dzul, S. ; Yahaya, N. ; Abdullah, F.H. ; Othman, N. ; Jelip, J. ; Ooi, C.H. ; Ibrahim, J. ; Aung, M. ; Abdullah, A.H. ; Laili, Z. ; Lau, Y.L.
Tropical Biomedicine 2021;38(No.3):248-253
Through the regional control programme, Malaysia has been successfully reducing the incidence of Plasmodium falciparum and Plasmodium vivax infections. However, the incidence of zoonotic malaria Plasmodium knowlesi infection is increasing and now has been the major cause of malaria in Malaysia especially Malaysian Borneo. The emergence of knowlesi infection has threatened the malaria elimination programme which the government aims to reduce the overall malaria infections by 2020. Unlike other benign human Plasmodium spp., P. knowlesi can cause fatal infections. The aim of this study was to determine the incidence and distribution of five human malaria parasites including P. knowlesi in Peninsular Malaysia and Malaysian Borneo. A total of 112 blood samples were collected from seven states and district hospitals in Peninsular Malaysia and Malaysian Borneo from year 2015 to 2016. The samples were examined by microscopy and further confirmed by nested PCR assay targeting 18S rRNA gene of Plasmodium spp. Following the nested PCR assays, a total of 54 (48.2%) samples were positive for P. knowlesi infections, 12 (10.7%) cases were positive for P. vivax infections, followed by 7 (6.3%) cases of P. falciparum and 4 (3.5%) cases of P. malariae. There were 3 cases (2.7%) of mixed infections (P. knowlesi/P. vivax). However, no cases were identified as P. ovale. A total of 32 (28.6%) cases were found as negative infections. LoopMediated Isothermal Amplification Assay (LAMP) was performed to confirm inconclusive results produced by microscopy and nested PCR. P. knowlesi showed the highest prevalence in Sarawak (n= 30), Sabah (n=13), Pulau Pinang (n=5) and Pahang (n=6). PCR and LAMP was not able to detect a large number of microscopy positive samples due to DNA degradation during storage and shipping. Among all the states involved in this study, the highest prevalence of P. knowlesi infection was found in Sabah and Sarawak.