1.Venous Anastomosis with Dorsal Veins Using Additional Incisions after Wound Closure in Metacarpophalangeal Joint Level Replantation.
Sang Hyun CHO ; Ahmed Suparno BAHAR-MONI ; Jong Ick WHANG ; Hyeung Gyo SEO ; Hyun Sik PARK ; Ji Sup KIM ; Hyun Chul PARK
Archives of Reconstructive Microsurgery 2016;25(1):12-14
In cases of replantation, accurate closure of all structures, including bone, tendons, arteries, nerves, and veins is essential. Among these, the vein is a weaker structure and is damaged severely in most amputation cases. After fixation of bone, repair of tendons, nerves, and arteries, surgeons often experience difficulty in performing venous anastomoses. We found that in such cases, venous anastomosis is easy to perform using an additional incision after closure of the original wound. In a 33-year-old male patient with amputation of all four fingers at the metacarpophalangeal joint level, venous anastomoses were performed with dorsal veins using additional incisions after completion of the fixation of bones and repair of all other structures and closure of the skin due to surgical site tension.
Adult
;
Amputation
;
Arteries
;
Fingers
;
Humans
;
Male
;
Metacarpophalangeal Joint*
;
Replantation*
;
Skin
;
Surgeons
;
Tendons
;
Veins*
;
Wounds and Injuries*
2.A Review of Surgically Treated Distal Radius Fractures in a University Hospital
Bahar-Moni AS ; Wong SK ; Mohd-Shariff N ; Sapuan J ; Abdullah S
Malaysian Orthopaedic Journal 2021;15(No.3):52-57
Introduction: Distal radius fracture (DRF) is the most
common orthopaedic injury with a reported incidence of
17.5%. It is commonly seen in young males and elderly
females. Over the last two decades, there is an increasing
tendency to treat DRF surgically by open reduction and
internal fixation (ORIF) with plate and screws owing to
improved device design, better fixation and operative
technique. The purpose of this study was to evaluate the
demographic characteristics, type and method of fixation,
and outcome in all surgically treated DRF cases from 2014
to 2018 in a university hospital.
Materials and methods: A retrospective review of all
surgically treated DRF cases with one year follow-up in a
tertiary hospital in Malaysia was done. Patients who left the
follow-up clinic before one-year post-surgery or before
fracture union were excluded. A total of 82 patients with 88
DRF were finally included into the study and outcome in
terms of union time and need of multiple surgeries were
analysed along with the predictors.
Results: In this study, mean age of the patient was 46.2
years. Motor vehicle accident was the commonest cause of
the fracture and AO Type C fracture was the commonest
fracture type. Seventeen (19.3%) out of 88 fractures were
compound fracture. Open reduction and internal fixation
with volar plate was the most common surgical technique
done in this series (93.2%). Three (3.5%) out of 88 fractures
required multiple surgeries and eighty-three (94.3%) DRF
cases were united before nine months of the surgery in this
study. There was statistically significant association between
clinical type of the fracture and the union time (p-value
<0.05).
Conclusion: There was a 1.7:1 male-female ratio with AOC fracture being the most common type of fracture. The most
common method of fixation was ORIF with volar locked
plate. Patients with closed fractures have a higher rate of
union compared to open fractures at nine months.
3.Demographics of Patients Undergoing Carpal Tunnel Release in an Urban Tertiary Hospital in Malaysia
Bahar-Moni AS ; Abdullah S ; Fauzi H ; Chee-Yuen SY ; Abdul-Razak FZ ; Sapuan J
Malaysian Orthopaedic Journal 2019;13(3):53-59
Introduction: Carpal tunnel syndrome (CTS) is the most commonly encountered neuropathy. The entrapment of the median nerve at the wrist can be corrected with a carpal tunnel release (CTR) procedure. The objective of this retrospective study was to determine the demographic, medical, and surgical characteristics of the patients with CTS who presented for CTR surgery in a tertiary hospital in Malaysia. Materials and Methods:Malaysians patients with CTS who had undergone a CTR during the period from 1st June 2017 to 31st December 2017 were enrolled into the study. Each patient had a minimum follow-up of three months. The demographic data of age, gender, race and occupation, and the comorbid illnesses and associated risk factors were recorded. The prevalence and occurrence of CTS in the dominant or non-dominant hand and the effectiveness of surgical intervention were also noted. Data was collected, analysed and stored in Microsoft Excel and SPSS 25. Results: There was a total of 76 cases of CTR surgeries done in 62 patients in the study. Eighty percent of the patients were female, and most of the patients belonged to the age group of 41-60 years. Malays constituted 74.2% of the patients, and 34% were housewives. Hypertension, dyslipidaemia and diabetes mellitus were the three major comorbidities. Cervical spondylosis was seen in one-fourth of the patients. Bilateral hand involvement was present in 54.8% of patients. 59.7% of CTR surgery was done on the dominant hand alone, 17.7 % CTR on the non-dominant hand alone and 22.6% CTR on both hands. Numbness and pain (50%) were the predominant presenting symptoms. The most positive signs were the Durkan test (77.6%), followed by the Tinel sign at the carpal tunnel and the Phalen’s test. At follow-up, three months or more, after the surgery, 75% of the patients showed a satisfactory improvement. Conclusion:Patients, who had undergone CTR, had a higher prevalence of pre-morbid conditions, and a quarter of them presented with associated cervical spondylosis. The most common presentation was a combination of numbness and pain. Many obtained satisfactory improvement post-surgery and thus open surgery could be considered a reliable treatment for CTS.