1.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.
2.Trivial Indirect Trauma Causing Recurrent Bilateral Quadriceps Tendon Rupture in End Stage Renal Failure Patient: A Case Report
Fakru NH ; Ruslan D ; Tengku M
Malaysian Orthopaedic Journal 2021;15(No.3):130-133
Recurrent bilateral quadriceps tendon rupture in a young
patient is a very rare incident. The underlying medical
condition is always present and may have contributed to this
injury. We report a recurrent bilateral quadricep tendon
rupture in a 28-year-old man with underlying end-stage renal
failure that occurred 10 months after the first repair. Injuries
were indirect and trivial during the first and second events.
Surgical repair was performed with similar technique for
both incidents and he was advised to exercise extreme
cautions after the second repair. He could return to his daily
activities with no further recurrence at 30 months follow-up.