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  1. Hazwan Ab. Wahid, Kow, Ren Yi, Khan, Ed Simor, Komahen, Colin
    MyJurnal
    The occurrence of atlantoaxial rotatory subluxation is fairly uncommon; however, it is
    more common to be encountered in the paediatric population, typically seen after a
    retropharyngeal inflammation or after a minor trauma. Ligamentous laxity, shallower
    and more horizontally oriented facet joints especially at the C1-2 joint making them
    prone to have atlantoaxial subluxation or dislocation. (Copied from article).
  2. Kow RY, Mustapha Zakaria Z, Khan ESKM, Low C
    J Orthop Case Rep, 2019 3 28;8(6):65-67.
    PMID: 30915298 DOI: 10.13107/jocr.2250-0685.1262
    Introduction: Fracture of the ulnar coronoid process is uncommon. It is commonly associated with posterior dislocation of the elbow, but it may also present as an isolated fracture. In general, all ulnar coronoid process fractures with elbow joint instability and large fracture fragments are fixed surgically. We report two cases of the rare isolated Regan-Morrey type III ulnar coronoid process fractures and their outcomes.

    Case Report: Case Report 1: Mrs P, a 27-year-old right-hand dominant female, was involved in a motor vehicle accident (MVA) and sustained an isolated Regan-Morrey type III ulnar coronoid process fracture. In view of the large coronoid process fragment causing elbow joint instability, she underwent an open reduction and internal fixation when the elbow swelling had subsided. An anterior approach was used to identify the fracture fragment and it was fixed with two half-threaded cancellous lag screws with washers to achieve an anatomical reduction. Postoperatively, she recovered with excellent outcome based on the Mayo elbow performance score (MEPS).Case Report 2: Mr M, a 23-year-old right-hand dominant gentleman, was involved in a MVA and sustained an isolated Regan-Morrey type III ulnar coronoid process fracture. During examination under general anesthesia, passive range of the movement of his right elbow was noted to be <90°due to the impaction of the fracture fragment. An open reduction through an anterior approach was performed and Kirschner wires were inserted to fix the coronoid process fracture. Kirschner wires were opted for the ease of post-operative removal as the patient was not keen to have a retained implant after recovery. He recovered with good outcome based on the MEPS.

    Conclusion: Isolated fracture of the ulnar coronoid process is rare. Open reduction and internal fixation is mandatory for patients with coronoid process fracture and unstable elbow joint to achieve good functional outcomes.

  3. Khan ESKBM, Thean CAP, Zakaria ZB, Awang MSB, Karupiah RK, Awang MB
    J Orthop Case Rep, 2020;10(2):101-105.
    PMID: 32953668 DOI: 10.13107/jocr.2020.v10.i02.1718
    Introduction: Spinal schwannoma can occur anywhere along the spinal cord but is predominantly seen in the cervical and thoracic region.It composes mainly of well-differentiated schwann cell and is benign in nature. It is typically seen in the peripheral nerves and is commonly associated with neurofibromatosis. Up to 80% of cases, spinal schwannoma is reported to be intradural in location and 15% of cases have both intradural and extradural components. Spinal schwannoma rarely causes conus medullaris syndrome.

    Case Report: In this case series, all three female patients in their 4th and 5th decades of life presented with conus medullaris syndrome. Lower back pain, radiculopathy, lower limb weakness, and urinary incontinence are their main clinical presentation. Magnetic resonance imaging shows a well-defined intradural, extramedullary mass compressing onto the conus medullary region. These patients undergone microscopic assisted excision of the tumor and had remarkably good early outcome despite the advanced presentation of neurological deficit.

    Conclusion: Despite the late presentation with significant neurological deficit, surgical excision of spinal schwannomas carries a good prognosis postoperatively due to their benign nature and extramedullary location.

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