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Morphometrics of nuchal ligament in greyhound in different neck and body positions

Ismail SMY, Murray CM, Olusa TAO, Ismail MM, Hailat NQ, Yen HH, et al.

Anat Histol Embryol, 2022 Jan;51(1):143-152.
PMID: 34882828 DOI: 10.1111/ahe.12771

This study was conducted to describe the morphometrics of nuchal ligament and investigate the effects of different neck and body positions on the nuchal ligament in greyhounds. Nine adult greyhounds cadavers without any locomotion abnormalities were dissected through the neck musculature on the left side to expose the nuchal ligament. Three pins were placed to mark regions of interest on the nuchal ligament: at one cm cranial to the site of origin (the most dorsal point of the spinous process of the first thoracic vertebra), at the midpoint of the nuchal ligament and one cm caudal to the nuchal ligament site of insertion (close to the caudal aspect of the spinous process of the axis). Each cadaver was positioned on a masonite board and placed on a table on the floor in their lateral recumbency and seven different standardized body positions; P1-P7 were mimicked using goniometers and metal wires. Photographs were taken by positioning and fixing the camera above the nuchal ligament region. The length and widths (W1, W2 and W3) of nuchal ligament were measured using Image Pro software (Image-Pro Express version 5.0) on standardized photographs of each of seven different body and neck positions. The length of nuchal ligament in relation to the neutral position (P1) was less (- 7%, p > 0·05) in P6 (neck elevated) and increased in all other positions (+1%, p > 0·05 for P2, +19%, p 0·05 for P5, +40%, p

Matched MeSH terms: Ligaments, Articular
Fulltext Injury to ulnar collateral ligament of thumb

Madan SS, Pai DR, Kaur A, Dixit R

Orthop Surg, 2014 Feb;6(1):1-7.
PMID: 24590986 DOI: 10.1111/os.12084

Injury of the ulnar collateral ligament (UCL) of thumb can be incapacitating if untreated or not treated properly. This injury is notorious for frequently being missed by inexperienced health care personnel in emergency departments. It has frequently been described in skiers, but also occurs in other sports such as rugby, soccer, handball, basketball, volleyball and even after a handshake. The UCL of the thumb acts as a primary restraint to valgus stress and is injured if hyperabduction and hyperextension forces are applied to the first metacarpophalangeal joint. The diagnosis is best established clinically, though MRI is the imaging modality of choice. Many treatment options exist, surgical treatment being offered depending on various factors, including timing of presentation (acute or chronic), grade (severity of injury), displacement (Stener lesion), location of tear (mid-substance or peripheral), associated or concomitant surrounding tissue injury (bone, volar plate, etc.), and patient-related factors (occupational demands, etc.). This review aims to identify the optimal diagnostic techniques and management options for UCL injury available thus far.

Matched MeSH terms: Collateral Ligaments/injuries*
Fulltext The effect of relaxin on the musculoskeletal system

Dehghan F, Haerian BS, Muniandy S, Yusof A, Dragoo JL, Salleh N

Scand J Med Sci Sports, 2014 Aug;24(4):e220-9.
PMID: 24283470 DOI: 10.1111/sms.12149

Relaxin is a hormone structurally related to insulin and insulin-like growth factor, which exerts its regulatory effect on the musculoskeletal and other systems through binding to its receptor in various tissues, mediated by different signaling pathways. Relaxin alters the properties of cartilage and tendon by activating collagenase. This hormone is also involved in bone remodeling and healing of injured ligaments and skeletal muscle. In this review, we have summarized the literature on the effect of relaxin in musculoskeletal system to provide a broad perspective for future studies in this field.

Matched MeSH terms: Ligaments/physiology*
Biomechanical features of six design of the delta external fixator for treating Pilon fracture: a finite element study

Ramlee MH, Sulong MA, Garcia-Nieto E, Penaranda DA, Felip AR, Kadir MRA

Med Biol Eng Comput, 2018 Oct;56(10):1925-1938.
PMID: 29679256 DOI: 10.1007/s11517-018-1830-3

Pilon fractures can be caused by high-energy vertical forces which may result in long-term patient immobilization. Many experts in orthopedic surgery recommend the use of a Delta external fixator for type III Pilon fracture treatment. This device can promote immediate healing of fractured bone, minimizing the rate of complications as well as allowing early mobilization. The characteristics of different types of the Delta frame have not been demonstrated yet. By using the finite element method, this study was conducted to determine the biomechanical characteristics of six different configurations (Model 1 until Model 6). CT images from the lower limb of a healthy human were used to reconstruct three-dimensional models of foot and ankle bones. All bones were assigned with isotropic material properties and the cartilages were assigned to exhibit hyperelasticity. A linear link was used to simulate 37 ligaments at the ankle joint. Axial loads of 70 and 350 N were applied at the proximal tibia to simulate the stance and swing phase. The metatarsals and calcaneus were fixed distally in order to prevent rigid body motion. A synthetic ankle bone was used to validate the finite element model. The simulated results showed that Delta3 produced the highest relative micromovement (0.09 mm, 7 μm) during the stance and swing phase, respectively. The highest equivalent von Mises stress was found at the calcaneus pin of the Delta4 (423.2 MPa) as compared to others. In conclusion, Delta1 external fixator was the most favorable option for type III Pilon fracture treatment. Graphical abstract ᅟ.

Matched MeSH terms: Ligaments/physiopathology
Finite element analysis of the wrist in stroke patients: the effects of hand grip

Ramlee MH, Beng GK, Bajuri N, Abdul Kadir MR

Med Biol Eng Comput, 2018 Jul;56(7):1161-1171.
PMID: 29209961 DOI: 10.1007/s11517-017-1762-3

The provision of the most suitable rehabilitation treatment for stroke patient remains an ongoing challenge for clinicians. Fully understanding the pathomechanics of the upper limb will allow doctors to assist patients with physiotherapy treatment that will aid in full arm recovery. A biomechanical study was therefore conducted using the finite element (FE) method. A three-dimensional (3D) model of the human wrist was reconstructed using computed tomography (CT)-scanned images. A stroke model was constructed based on pathological problems, i.e. bone density reductions, cartilage wane, and spasticity. The cartilages were reconstructed as per the articulation shapes in the joint, while the ligaments were modelled using linear links. The hand grip condition was mimicked, and the resulting biomechanical characteristics of the stroke and healthy models were compared. Due to the lower thickness of the cartilages, the stroke model reported a higher contact pressure (305 MPa), specifically at the MC1-trapezium. Contrarily, a healthy model reported a contact pressure of 228 MPa. In the context of wrist extension and displacement, the stroke model (0.68° and 5.54 mm, respectively) reported a lower magnitude than the healthy model (0.98° and 9.43 mm, respectively), which agrees with previously reported works. It was therefore concluded that clinicians should take extra care in rehabilitation treatment of wrist movement in order to prevent the occurrence of other complications. Graphical abstract ᅟ.

Matched MeSH terms: Ligaments/physiopathology
Fulltext Emergency laparoscopic splenectomy for torsion of wandering spleen in a geriatric patient: A case report

Nastiti NA, Niam MS, Khoo PJ

Int J Surg Case Rep, 2019;61:91-95.
PMID: 31352320 DOI: 10.1016/j.ijscr.2019.07.021

INTRODUCTION: Wandering spleen (WS) is an uncommon congenital or acquired condition where the spleen is displaced from its normal position at the left hypochondrium to anywhere within the abdominal or pelvic cavity. The incidence is extremely rare in the geriatric population.
PRESENTATION OF CASE: We present a rare case of WS torsion in a 69-year-old elderly patient who presented with an acute abdomen. Physical examination revealed a tender right lower quadrant abdominal mass. Imaging studies confirmed the diagnosis of WS torsion with features of infarction. Subsequently, an emergency laparoscopic splenectomy was performed.
DISCUSSION: A WS occurs due to the hypermobility of the spleen secondary to the absence or laxity of splenic suspensory ligaments. It is more commonly seen in children and adults in the third decade of life. Symptoms are usually attributed to the consequences of splenic vascular pedicle torsion. Exhibited symptoms might be unspecific; thus, radiological modalities are essential to determine the diagnosis and aid in planning its management. The treatment of choice is either open or laparoscopic splenopexy or splenectomy.
CONCLUSION: Due to potentially life-threatening consequences and the rarity of such cases, a thorough history, detailed physical examination, and objective investigation are the pillars to attain a prompt diagnosis for appropriate management to be conducted as soon as possible to minimise complications.

Matched MeSH terms: Ligaments
Fulltext Unusual Posterior Epidural Migration of Intervertebral Herniated Disc: A Report of Two Cases

Tamburrelli FC, Perna A, Oliva MS, Giannelli I, Genitiempo M

Malays Orthop J, 2018 Nov;12(3):47-49.
PMID: 30555647 DOI: 10.5704/MOJ.1811.012

Disc herniation is one of most common causes of spine surgery. Because of the presence of posterior longitudinal ligaments, disc fragments often migrate into the ventral epidural space. A posterior epidural herniation of a disc fragment is a rare occurrence. We report two cases of posterior migrated disc fragments, with, radiological and clinical findings. Because of the rarity of a posterior migration of the intervertebral disc fragments, a differential diagnosis can be challenging. This painful syndrome associated with neurological lower limb deficits can be confused initially, with other posterior epidural space-occupying lesions such as tumours, abscess or hematomas. A gadolinium-enhanced MRI scan is the gold standard for a correct diagnosis. Early surgical decompression of the spine with a posterior approach remains the optimal technique in ensuring the best possible outcome for the patient.

Matched MeSH terms: Longitudinal Ligaments
Fulltext Carpal tunnel syndrome in pregnancy : is there really oedema in the carpal tunnel?

Mohamed Faizal Sikkandar, Shalimar Abdullah, Rajesh Singh, Parminder Singh Gill, Nur Azuatul Akmal Kamaludin, Tan Jin Aun, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):191-195.
MyJurnal

Introduction: Compression of the median nerve in pregnancy is thought to be due to fluid retention within the carpal tunnel space. We aim to discover the cause of carpal tunnel syndrome (CTS) in pregnancy using high resonance ul- trasonography. Methods: This is a cross-sectional study where obstetric patients were screened for CTS and subjected to a non invasive ultrasonic imaging. Results: A total of 63 patients were seen with 25 diagnosed to have CTS (39.7%) and 38 patients had none (60.3%) based on a screening tool. Age ranged from 20-42 years old with the highest range in the 28-30 year old group (34.9%). In patients with CTS, the cross sectional area of the median nerve inside the tunnel was a mean of 0.908 cm ie larger, while non-CTS patients had a mean of 0.797 cm inside the tunnel. The transverse carpal ligament (TCL) measured a mean of 0.0988 cm in the CTS group (ie thinner) and 0.1058 cm in the non-CTS group. Median nerve mobility at equal to or less than one tendon width was 80% in pregnant women with CTS and 92.1% for those without. No fluid was present within the carpal tunnel of all patients. The results were sta- tistically not significant. Conclusion: Ultrasonographic evidence in pregnant women with CTS shows a larger median nerve, a more mobile median nerve and a less thick transverse carpal ligament. There is absence of fluid retention and synovitis ruling out extrinsic compression of the median nerve as cause of CTS in pregnancy.

Matched MeSH terms: Ligaments
Fulltext Wandering spleen as a cause of acute abdomen: a surgical conundrum from acute appendicitis to splenic torsion and ischemic small bowel volvulus

Fatimah Najid, Sanjeev Sandrasecra, Mohd Zuki Asyraf, Chang Haur Lee, Nornazirah Azizan, Andee Dzulkarnaen Zakaria, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):336-338.
MyJurnal

Wandering spleen is renowned as a surgical enigma due to its diverse presentations. Due to lack of its attaching ligaments which would usually place it at the left hypochondrium region, the spleen ‘wanders’ and may be located anywhere within the abdominal cavity. This condition has been associated with many complications such as splenic torsion, pancreatitis and portal hypertension. We report a case of a wandering spleen presenting as acute appen- dicitis in an 18-year-old young active sportsman. The patient developed post-operative ileus and later intestinal obstruction which necessitated exploratory laparatomy onto which the final diagnosis of splenic and small bowel infarct due to splenic torsion with small bowel volvulus was made. Splenectomy, small bowel resection and primary anastomosis were performed and the patient made a full recovery.

Matched MeSH terms: Ligaments
Fulltext Two-Year Outcome of Synthetic Annular Ligament Reconstruction in the Elbow: A Case Report

Kesu Belani L, Abdullah S, Harun MH, Narin Singh PSG, Sapuan J

Cureus, 2020 Nov 19;12(11):e11564.
PMID: 33364091 DOI: 10.7759/cureus.11564

Monteggia fracture is commonly treated with open anatomical reduction and fixation of the ulna fracture. The radial head will be automatically reduced once anatomical fixation of the ulna is achieved. However, it is occasionally associated with an irreducible radial head dislocation requiring an open reduction and reconstruction of the torn annular ligament. We describe a case of traumatic Monteggia fracture which underwent initial plating, however post-operative radiograph denoted an irreducible radial head secondary to a ruptured annular ligament. We reconstructed the annular ligament with a synthetic graft sling around the radial neck with an anchor suture. The radial head was stable in all directions after annular ligament reconstruction. A two-year follow-up shows full range of motion of the elbow joint with osteolysis of the radial head, no other operative morbidity was observed.

Matched MeSH terms: Ligaments
Fulltext Osteochondromyxoma of Talus

Balakrishnan, Yogambigai, Nor Hasnina Mohd Hassan, Wan Najwa Zaini Wan Mohamed

Borneo Journal of Medical Sciences, 2019;13(3):65-70.
MyJurnal

Osteochondromyxoma is a rare bone tumour. Bone tumours of the talus are also uncommon, and accounts to be between 8% to 23% in tumours of the foot. A 28-year-old man presented with chronic right ankle pain. He had underlying left knee ligament and meniscal injury. Special examination tests for ligament injury were negative. Magnetic Resonance Imaging (MRI) revealed a benign bone lesion of talus with reactive oedema of sinus tarsi. Excision of lesion was done and subsequent histopathological examination confirmed the diagnosis of ostechondromyxoma.

Matched MeSH terms: Ligaments
Prevalence of work related musculoskeletal disorder among port workers: Quantitative analysis at the physiotherapy centre of Malaysian shipping industry, Selangor

Izham Zain, Azrul Anuar, Asrina Asri, Shamsul Azhar

Journal of Occupational Safety and Health, 2013;10(2):51-66.
MyJurnal

The objective of this study is to identify the type of occupational related musculoskeletal disorder among Malaysian Shipping Industry workers and to determine the relationship between workers sosio demographic factors with occupational related musculoskeletal disorder and injuries. This is a cross sectional, retrospective study using secondary data that is available at the physiotherapy centre of Malaysia Shipping in Selangor. The study population is the shipping port workers received physiotherapy treatment from 2011 and 2012. A total of 90 samples comprise of 85 male workers and the remaining is female. The mean age is 34.1 (±7.36). Crane operator is the largest number of workers seeks for physiotherapy treatment (68), office (15) and 7 from maintenance. The mean of employment duration is 8.02 (±4.47) years with the maintenance group of workers have longest working duration of 9 years. Muscle and ligament sprain strain known to be the commonest condition (80%) refer for physiotherapy rehabilitation, tendinitis (14%) and fracture (6%). Young age group of workers were significantly 9 times higher (95% CI 1.83 – 40.35) of getting back injuries. The prevalence of musculoskeletal disorder based on work categories vary with office type workers has 4.5 times higher (95% CI 1.06 – 19.7) on hand injuries. This study has revealed that workers age, different type of work categories, working experience, and body mass composition were associates with the occupational related injuries. The training programme emphasise on preventive measures should be tailored to empower the employee on safety measures at work.

Matched MeSH terms: Ligaments
Fulltext A New Technique for Solving Tightrope Cutout during Acromioclavicular Joint Fixation: A Case Report

Ng BW, Abdullah AF, Nadarajah S

Malays Orthop J, 2017 Mar;11(1):57-59.
PMID: 28435576 MyJurnal DOI: 10.5704/MOJ.1703.003

Acromioclavicular joint (ACJ) dissociation is one of the common injuries affecting adults. The stability of ACJ largely depends on the integrity of acromioclavicular ligament, coracoclavicular ligament, capsule, trapezius muscle and deltoid muscle. The injury has been classified by Rockwood into six types and treatment options can be guided by the classification. TightRope fixation is one of the many surgical procedures available to address acromioclavicular joint separation. It consists of tensioning of a no. 5 Fibrewire suture secured at both ends to low-profile metallic buttons. Despite various advantages of using this technique, complications such as suture cut-out, clavicle fracture and suture failure have been documented. The author presents a case of a type III acromioclavicular joint dissociation treated with TightRope which suture cutout was noted intra-operatively. Decision to amend the fixation using a cut one-third tubular plate as an additional anchor for the metallic button on the clavicle was made. Patient's progress was evaluated using the University of California at Los Angeles Shoulder Score (UCLA Shoulder Score) and significant improvement was noted six months post operatively. We propose this technique as a solution to the encountered problem.

Matched MeSH terms: Ligaments, Articular
Form and habit in species of malleus (including the "hammer oysters") with comparative observations on Isognomon isognomon

Yonge CM

Biol. Bull., 1968 Oct;135(2):378-405.
PMID: 28368764 DOI: 10.2307/1539789

1. Study of the structure and mode of life of Malleus regula provides the basis for consideration of the "hammer" species, M. malleus and M. albus.
2. M. regula occurs byssally attached, vertically disposed on rocky substrates associated with mud and is widely distributed in the tropical Indo-Pacific.
3. The distal two-thirds of the elongated shell is exclusively prismatic. By means of special pallial retractors the mantle lobes can be withdrawn within the nacreous region.
4. The massive opisthodetic ligament has a short secondary extension of fusion layer.
5. A promyal chamber on the right side proximal to the adductor increases water flow into the exhalant chamber.
6. The long filibranch ctenidia provide a vertically extended food-collecting surface.
7. The foot is concerned with planting of the massive byssus which emerges through a notch in the right valve but on the under ( i.e., dorsal) surface. There is also a unique and very long accessory foot, ventrally grooved, everywhere ciliated and in constant writhing activity due to blood pressure and intrinsic muscle. Moving freely throughout the lower mantle cavity it can only be concerned with cleansing.
8. Pseudofaeces are ejected from the distal tip of the mantle cavity.
9. M. malleus, the black hammer shell, occurs vertically embedded in coarse sand or sandy gravel. Byssus threads are attached to fragments within the substrate. The great anterior and posterior elongations of the hinge line (also exclusively prismatic) are separated by the byssal notch (now affecting both valves).
10. Shells are usually excessively irregular due to the great exposure to damage and the almost unlimited powers of rapid repair by the three pallial extensions.
11. M. albus, the white hammer shell, is stouter and inhabits muddy sand. During growth it loses the byssus with reduction of the foot and byssal retractors and closure of the byssal notch. The accessory foot is not affected. The animal becomes anchored in the substrate exclusively by the anterior and posterior extensions of the shell.
12. Description of the typically rounded Isognomon ephippium leads to that of the elongated I. isognomon which occupies precisely the same habitat as M. regula.
13. It lacks the pallial retractors, promyal chamber and accessory foot of Malleus, the nacreous region is more extended distally and the ligament is multivincular (the formation of which is discussed), producing some posterior, but never any anterior, extension of the hinge line.
14. A remarkably dense mixed bed of M. regula and I. isognomon in Darvel Bay, Sabah (Borneo), is described. Different spawning periods, by preventing competition during settlement, may account for this complete intermixing of sympatric species, which, however, are generalized herbivores where numbers are not limited by food supply.
15. From a basic epifaunal habit (Pteria, Isognomon, M. regula), members of the Pteriacea have become adapted for infaunal life within sponges (Vulsella, Crenatula) or within soft substrates ( M. malleus, M. alba and the Pinnidae).
16. There is final discussion about elongation in monomyarians, i.e., in the genus Malleus and in I. isognomon.

Matched MeSH terms: Ligaments
Fulltext Acromio-Clavicular Joint Dislocation Types IV to VI: Does the Outcome with the modified Weaver-Dunn Procedure Justify the Treatment?

Kapil-Mani KC, Niroula A

Malays Orthop J, 2018 Jul;12(2):31-36.
PMID: 30112126 DOI: 10.5704/MOJ.1807.006

Introduction: The optimal surgical treatment for acromioclavicular joint (ACJ) injuries remains controversial. The modified Weaver-Dunn (WD) procedure is one of the frequently used techniques. Recently when it was compared with anatomical autogenous tendon graft reconstruction procedures, the results were inferior. However, these anatomical procedures are technically more demanding with small margin of error and they have tendency for postoperative pain because of extra donor site incision. Materials and Methods: Forty patients with type IV to VI ACJ dislocations were treated by modified WD procedure using non-absorbable synthetic suture passed through the base of coracoid process for augmentation of transferred coraco-acromial (CA) ligament. Functional outcome was assessed using the Oxford Shoulder Score, Nottingham Clavicular Score and Visual Analog Score (VAS) at the final follow-up after surgery. Results: The mean pre-operative Oxford Shoulder Score improved from 25.22±2.64 (range 20 to 30) to 44.75±1.99 (range 40 to 48) and mean pre-operative Nottingham Shoulder Score improved from 49.25±4.91 (range 39 to 58) to 87.27±4.39 (range 79 to 96) at last follow-up after surgery with p-value <0.001. Thirty-five (87.5%) patients had excellent outcomes, four (10%) patients had good outcomes and one (2.5%) patient had fair outcome. Thirty-eight (95%) patients had no pain while two (5%) had moderate pain based on VAS score. Conclusion: Modified Weaver-Dunn is a simple well established technique for grade IV to VI ACJ dislocation. We cannot consider this procedure as old and outdated on the argument that the long term functional outcomes are not suboptimal.

Matched MeSH terms: Ligaments
Fulltext Ipsilateral proximal and distal radius fractures with unstable elbow joint: Which should we address first?

Akma Kamaludin NA, Ferdaus Kamudin NA, Abdullah S, Sapuan J

Chin J Traumatol, 2019 Feb;22(1):59-62.
PMID: 30745113 DOI: 10.1016/j.cjtee.2018.04.007

Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an anatomical locking plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome.

Matched MeSH terms: Ligaments
Fulltext Coracoid Process Morphology using 3D-CT Imaging in a Malaysian Population

Imma II, Nizlan NM, Ezamin AR, Yusoff S, Shukur MH

Malays Orthop J, 2017 Jul;11(2):30-35.
PMID: 29021876 MyJurnal DOI: 10.5704/MOJ.1707.012

Introduction: The aims of this study are to define the coracoid process anatomy in a Malaysian population, carried out on patients in Hospital Serdang with specific emphasis on the dimension of the base of coracoid process which is important in coraco-acromial (CC) ligament reconstruction, to define the average amount of bone available for use in coracoid transfer, and to compare the size of coracoid process based on gender and race, and with findings in previous studies. Materials and Methods: Fifteen pairs of computed tomography (CT) based 3-dimensional models of shoulders of patients aged between 20 to 60 years old were examined. The mean dimensions of coracoid were measured and compared with regards to gender and race. The data were also compared to previously published studies. Results: The mean length of the coracoid process was 37.94 ± 4.30 mm. Male subjects were found to have larger-sized coracoids in all dimensions as compared to female subjects. The mean tip of coracoid dimension overall was 19.99 + 1.93mm length × 10.03 + 1.48mm height × 11.63 + 2.12mm width. The mean base of coracoid dimension was 18.96 + 3.71mm length × 13.84 + 1.76mm width. No significant differences were observed with regards to racial denomination. The overall coracoid size measurements were found to be smaller compared to previous studies done on the Western population. Conclusion: This study may suggest that Malaysians have smaller coracoid dimension compared to Caucasians. The findings further suggest that the incidence of coracoid fracture and implants pull out in Malaysian subjects may be higher.

Matched MeSH terms: Ligaments
Fulltext Calcification of the Alar Ligament Mimics Fracture of the Craniovertebral Junction (CVJ): An Incidental Finding from Computerised Tomography of the Cervical Spine Following Trauma

Che Mohamed SK, Abd Aziz A

Malays J Med Sci, 2009 Oct;16(4):69-72.
PMID: 22135515 MyJurnal

When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury.

Matched MeSH terms: Ligaments
Fulltext Comparison of outcomes after vaginal reconstruction surgery between elderly and younger women

Tan YL, Lo TS, Khanuengkitkong S, Krishna Dass A

Taiwan J Obstet Gynecol, 2014 Sep;53(3):348-54.
PMID: 25286789 DOI: 10.1016/j.tjog.2013.08.004

The objective of this study was to estimate the association of vaginal sacrospinous ligament fixation with anterior-transobturator mesh repair surgery for advanced pelvic organ prolapse in patients of two different age groups.

Matched MeSH terms: Ligaments/surgery*
Fulltext A modified Blatt dorsal capsulodesis in the treatment of dynamic scapholunate instability

Azura L, Ahmad TS, Kamarul T

Med J Malaysia, 2006 Dec;61 Suppl B:51-4.
PMID: 17600993

We report a case of scapholunate dissociation which was initially missed and presented late. A modification of Blatt dorsal capsulodesis performed using dorsal intercarpal ligament (DICL) and extra tunnel appears not only to add to dorsal stability but also address the volar problem as well. This modification may be a better alternative to the current technique of using a single flap.

Matched MeSH terms: Ligaments, Articular/surgery

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