1.Graft and Button Modification of Technique of Coracoclavicular Joint Reconstruction in Treatment of Chronic Type V Acromioclavicular Joint Dislocation: A Case Report
Malaysian Orthopaedic Journal 2019;13(2):45-48
Treatment of chronic Rockwood’s type V Acromioclavicular (AC) joint dislocation remains controversial. We describe a surgical technique to reduce and maintain AC joint using a combination of gracilis autograft with GraftMax™ button (Conmed Inc, Utica, NY). Graft was prepared using running whip stitch technique with No. 5 Hi-Fi high strength suture (ConMed Linvatec, Largo, FL). Our technique reduces intraoperative clavicular and coracoid tunnel fracture and restores anatomical coracoclavicular ligament. At sixth week and third month postoperatively, the patient demonstrated good clinical and radiographic outcome.
3.A Case Report On Repair Of Patellar Osteochondral Defect Using Osteochondral Scaffold
Or SY ; Leong YC ; Kam ML ; Juhari MS
Malaysian Orthopaedic Journal 2019;13(Supplement A):238-
4.Nation-Wide Observational Study of Cardiac Arrests Occurring in Nursing Homes and Nursing Facilities in Singapore.
Andrew Fw HO ; Kai Yi LEE ; Xinyi LIN ; Ying HAO ; Nur SHAHIDAH ; Yih Yng NG ; Benjamin Sh LEONG ; Ching Hui SIA ; Benjamin Yq TAN ; Ai Meng TAY ; Marie Xr NG ; Han Nee GAN ; Desmond R MAO ; Michael Yc CHIA ; Si Oon CHEAH ; Marcus Eh ONG
Annals of the Academy of Medicine, Singapore 2020;49(5):285-293
INTRODUCTION:
Nursing home (NH) residents with out-of-hospital cardiac arrests (OHCA) have unique resuscitation priorities. This study aimed to describe OHCA characteristics in NH residents and identify independent predictors of survival.
MATERIALS AND METHODS:
OHCA cases between 2010-16 in the Pan-Asian Resuscitation Outcomes Study were retrospectively analysed. Patients aged <18 years old and non-emergency cases were excluded. Primary outcome was survival at discharge or 30 days. Good neurological outcome was defined as a cerebral performance score between 1-2.
RESULTS:
A total of 12,112 cases were included. Of these, 449 (3.7%) were NH residents who were older (median age 79 years, range 69-87 years) and more likely to have a history of stroke, heart and respiratory diseases. Fewer NH OHCA had presumed cardiac aetiology (62% vs 70%, <0.01) and initial shockable rhythm (8.9% vs 18%, <0.01), but had higher incidence of bystander cardiopulmonary resuscitation (74% vs 43%, <0.01) and defibrillator use (8.5% vs 2.8%, <0.01). Non-NH (2.8%) residents had better neurological outcomes than NH (0.9%) residents ( <0.05). Factors associated with survival for cardiac aetiology included age <65 years old, witnessed arrest, bystander defibrillator use and initial shockable rhythm; for non-cardiac aetiology, these included witnessed arrest (adjusted odds ratio [AOR] 3.8, <0.001) and initial shockable rhythm (AOR 5.7, <0.001).
CONCLUSION
Neurological outcomes were poorer in NH survivors of OHCA. These findings should inform health policies on termination of resuscitation, advance care directives and do-not-resuscitate orders in this population.
5.Acromion Morphology of Patients with Rotator Cuff Disease in Standard AP Shoulder Radiograph in Hospital Sultanah Bahiyah and Hospital Kuala Lumpur
Leong YC ; Yeoh CW ; Azman MI ; Juhari MS ; Siti HT
Malaysian Orthopaedic Journal 2022;16(No.3):50-54
Introduction: Rotator cuff pathology is commonly
attributed to acromion morphology that is demonstrable in
standard AP shoulder radiographs by measuring the critical
shoulder angle (CSA), the lateral acromial angle (LAA), and
the acromial index (AI). However, these parameters vary
among races and countries. Therefore, our study aimed to get
the local data on acromion morphology in patients with
rotator cuff disease.
Materials and methods: MRI shoulder reports between
January 2012 and June 2018 were reviewed. The study group
consisted of 47 patients with rotator cuff injury with a partial
or complete tear, and a control group of 37 patients with
tendinitis or osteoarthritis and intact rotator cuffs. The CSA,
LAA, and AI of both groups were measured on the
anteroposterior shoulder radiograph. The risk factors for
both groups and the acromion morphology were recorded.
Results: The CSA for the rotator cuff tear and the control
group was 39.08° and 38.28°, LAA was 72.57 ° and 73.51°,
and AI was 0.79 and 0.75. The acromion morphology
differed in terms of gender, and only LAA was different
among the different ethnic groups. There was a negative
correlation between age and CSA, age and AI, LAA and
CSA, LAA and AI, but a positive correlation between AI and
CSA.
Conclusion: The CSA for rotator cuff tear patients in our
population was 39.08°, LAA was 72.57°, and AI was 0.79.
The acromion morphology was significantly influenced by
age and gender.