MyMedR

Fulltext Hypertrophic nonunion of the ulna in a child: treatment with an elastic stable intramedullary nail without bone graft

Abd Rashid AH, Ibrahim S

Strategies Trauma Limb Reconstr, 2010 Dec;5(3):145-7.

PMID: 21286359 DOI: 10.1007/s11751-010-0089-5

Nonunion following diaphyseal forearm fracture is an uncommon complication in children. Compression plate fixation with bone grafting has been the standard method to treat this complication. We report a case of hypertrophic nonunion of the ulna in a child who was treated surgically using an elastic stable intramedullary nail (ESIN) without bone grafting. The nonunion healed 4 months after surgery.

Fulltext Paediatric Femur Fractures: A Plea for Minimally Invasive Surgery to Prevent Osteomyelitis

Mansor N, Abdul-Rashid AH, Ibrahim S

Malays Orthop J, 2018 Jul;12(2):73-74.

PMID: 30112136 DOI: 10.5704/MOJ.1807.014

Tibia vara and slipped upper femoral epiphysis: is there an association?

Jamil K, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2015 Jan;24(1):46-9.

PMID: 25192368 DOI: 10.1097/BPB.0000000000000101

Tibia vara and slipped upper femoral epiphysis (SUFE) share a common risk factor, but their relationship is unclear. In both conditions, the patients are usually obese. To the best of our knowledge, there have been only two previous reports in the literature that have described the occurrence of tibia vara and SUFE in three patients. We report a child who was treated for bilateral tibia vara at the age of 3 years and subsequently developed a SUFE at the age of 13 years.

Clostridium perfringens surgical site infection after osteotomy for knee deformity correction in a non-immunocompromised child

Abd Rashid AH, Ramli R, Ibrahim S

Surg Infect (Larchmt), 2014 Oct;15(5):656-8.

PMID: 24828080 DOI: 10.1089/sur.2012.192

Clostridium perfringens myonecrosis following an elective surgical procedure in a previously healthy child is a rare incident.

Successful closed reduction after adductor tenotomy in a 14-year-old boy with chronic hip dislocation in Down syndrome

Sadeghilar A, Rashid AH, Ibrahim S

J Pediatr Orthop B, 2014 May;23(3):244-6.

PMID: 24445537 DOI: 10.1097/BPB.0000000000000033

Dislocation or subluxation of the hip is considered as the most common hip problem in patients with Down syndrome. Recommended treatment of chronic dislocation treatment is open reduction combined with femoral and/or pelvis osteotomies. We report a Down syndrome child with chronic hip dislocation who was successfully treated with adductor tenotomy and closed reduction, which has not been reported previously.

Hip dislocation in Down syndrome

Jamil K, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2014 Mar;23(2):204.

PMID: 24447939 DOI: 10.1097/01.bpb.0000434259.00524.7f

Guided growth implants for low-income to middle-income countries

Jamil K, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 Nov;22(6):608.

PMID: 24056210 DOI: 10.1097/BPB.0b013e328364b65c

Nerve injuries in supracondylar fractures of the humerus in children: is nerve exploration indicated?

Khademolhosseini M, Abd Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 Mar;22(2):123-6.

PMID: 23222035 DOI: 10.1097/BPB.0b013e32835b2e14

A retrospective study of nerve injuries with displaced supracondylar fractures of the humerus in children younger than 12 years of age, treated in Hospital Universiti Kebangsaan Malaysia. Our objectives were to determine the incidence of primary and iatrogenic nerve injuries in supracondylar humerus fractures Gartland types II and III and to determine the outcome of nerve recovery. A total of 272 patients with displaced supracondylar humerus fractures who required admission to Hospital Universiti Kebangsaan Malaysia from January 2000 to December 2007 were reviewed. There were 182 boys (67%) and 90 girls (33%). The mean age was 6.0 years, ranging from 1 to 12 years. Of 272 supracondylar fractures, 79 were type II and 193 were type III. Fifty-one (19%) patients had closed reduction, 160 (59%) had closed reduction and percutaneous crossed Kirschner (K) wires, and 61 (22%) had open reduction and crossed K-wires. Associated nerve injuries involving the median, radial, and ulnar nerves were observed in 48 (18%) patients. Nerve injuries were observed in nine (3%) patients upon admission. Thirty-nine (14%) patients developed nerve injuries following treatment. Of these 39 patients, 34 had ulnar, three had radial, and two had median nerve injuries. Nerve exploration was performed in five patients (in four patients following debridement of open fracture and in one because of unacceptable postoperative radiographs, and they subsequently underwent open reduction and exploration). Except for these five patients, the K-wires were not removed earlier nor were the nerves surgically explored in others. The nerve injuries resolved clinically on an average time of 3.5 months (range from 3 weeks to 8 months). Our study found complete resolution of all patients with nerve injuries confirmed by clinical assessment. On the basis of our study, we believe that there is no indication to remove the K-wires immediately or to explore the nerve surgically following a mini-open technique, which reduces the risk of penetrating a nerve during pinning.

Missed proximal radioulnar joint translocation with ulnar nerve entrapment: an unusual injury in a child

Najid H, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2019 Jan;28(1):79-84.

PMID: 30252793 DOI: 10.1097/BPB.0000000000000556

Traumatic elbow dislocation in a child is rare, and it is usually associated with fractures. Simultaneous proximal radioulnar joint (PRUJ) translocation with ulnar nerve palsy is even rarer. We report an unusual case of a missed PRUJ translocation with ulnar nerve entrapment in a 10-year-old child. The key to diagnosing the translocation is the position of the proximal radius, which lies medial to the ulna. This was treated by open reduction and release of the entrapped nerve. The ulnar nerve palsy recovered fully at the 1-year follow-up. Although PRUJ translocation with ulnar nerve entrapment is a rare injury, a successful outcome is possible with timely open reduction and release of the ulnar nerve.

Through-knee amputation for a patient with proximal femur focal deficiency and tibial hemimelia: surgical anatomy and clinical implications

Lloyd S, Rashid AH, Das S, Ibrahim S

Anat Sci Int, 2014 Mar;89(2):122-5.

PMID: 24158808 DOI: 10.1007/s12565-013-0211-0

Tibial hemimelia is a rare anomaly of unknown etiology. This condition can occur sporadically or may have a familial inheritance. It is characterized by deficiency of the tibia with a relatively intact fibula. The anomaly may be unilateral or bilateral. We report a case of a 2-year-old girl who presented with right lower limb deformity since birth. She was diagnosed with proximal femur focal deficiency with absence of the ipsilateral tibia. She presented with a shorter right lower limb and a deformed foot. She was treated with a through-knee amputation. Anatomical dissection of the amputated limb was carried out to verify the anomalies. The dissection showed that the distal phalanx of the great toe was trifid. The anatomical and clinical significance of this interesting case is discussed.

Congenital pseudoarthrosis of the tibia: healing by lengthening over a rod without compression of the nonunion. A preliminary report

Muhammad Abdul Jamil MK, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 May;22(3):207-12.

PMID: 22182834 DOI: 10.1097/BPB.0b013e32834ecc01

This preliminary report is on two patients with congenital pseudoarthrosis of the tibia who had a persistent nonunion following intramedullary rodding and bone grafting. We do not advocate repeated surgery to achieve union. When limb length discrepancy becomes greater than 5 cm, we proceeded with an Ilizarov procedure with the primary aim of equalizing limb length rather than achieving union. Healing of the pseudoarthrosis occurred in both patients after lengthening over the intramedullary rod without compression of the nonunion site. We believe that union occurs because of hyperaemia during the lengthening. This approach minimizes the repeated surgeries that are usually needed and thus ensures a more normal childhood without frequent hospitalizations.

A rare case of diplopodia and syndactyly: anatomical and surgical considerations

Kadir KH, Abdul Rashid AH, Das S, Ibrahim S

J Foot Ankle Surg, 2011 Mar-Apr;50(2):252-6.

PMID: 21354013 DOI: 10.1053/j.jfas.2010.10.017

Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.

Partial anterior interosseous nerve palsy: isolated neuropraxia of the branch to flexor pollicis longus

Haflah NH, Rashid AH, Sapuan J

Hand Surg, 2010;15(3):221-3.

PMID: 21089198

Anterior interosseous nerve palsy is rare. Isolated neuropraxia of its branch to the flexor pollicis longus is even rarer. We present a case of a 24-year-old man who presented with weakness of his left thumb flexion after sustaining closed fracture of the proximal third of his left radius. On exploration, the anterior interosseous nerve and its branches was found to be intact as was the flexor pollicis longus. Electrophysiological studies demonstrated acute left anterior interosseous nerve neuropathy. Electromyography showed discrete motor unit at the flexor pollicis longus. Two months later the patient had full recovery of the flexor pollicis longus. We would like to highlight this rare occurrence and present a detailed history of this case to increase awareness amongst clinicians regarding this condition.

Fulltext Sporotrichosis atypical presentation as a soft tissue tumour

Ramli R, Abd Rashid AH, Phang KS, Khaithir TM

Malays J Pathol, 2009 Dec;31(2):143-5.

PMID: 20514859 MyJurnal

Sporotrichosis is a mycosis caused by a saprophytic dimorphic fungus named Sporothrix schenckii. Infections occur following traumatic inoculation of fungus from plants and infected cat bites and scratches. We report a case of a farmer who presented with a solitary subcutaneous nodule initially diagnosed as a soft tissue tumour. A history of agricultural activity and feline contact should draw the clinician's attention to sporotrichosis, as the diagnosis can be easily missed in atypical cases. The diagnosis, microbiology and management of the case are discussed.

Fulltext Cubitus Valgus with Tardy Ulnar Nerve Palsy - Is Anterior Transposition of the Ulnar Nerve Always Necessary? A Case Report

Anuar-Ramdhan IM, Remli R, Abdul-Rashid AH, Ibrahim S

Malays Orthop J, 2020 Jul;14(2):126-129.

PMID: 32983387 DOI: 10.5704/MOJ.2007.010

Tardy ulnar nerve palsy is a known complication of cubitus valgus. The options for treating the ulnar neuropathy include anterior nerve transposition or neurolysis. We report on an 11-year-old boy who had a tardy ulnar nerve palsy due to cubitus valgus resulting from a non-union of a lateral condyle fracture of the humerus. Anterior transposition of the ulnar nerve was not done after the closing wedge osteotomy of the distal humerus. The close wedge osteotomy relieved the tension on the nerve and not transposing the ulnar nerve anteriorly prevented an iatrogenic nerve injury. The patient had no restriction with activities of daily living at the six years follow-up although neurological recovery was incomplete.

Fulltext Subcapital Femoral Neck Tension Stress Fracture - A Rare Injury in A Child: A Case Report

Hayyun MF, Jamil K, Abd-Rashid AH, Ibrahim S

Malays Orthop J, 2021 Mar;15(1):132-134.

PMID: 33880161 DOI: 10.5704/MOJ.2103.021

Femoral neck stress fractures are rare in children. To the best of our knowledge, the tension type stress fracture has been reported only twice in the English language literature. We report on a five years follow-up of a 10-year-old boy with this injury which was initially missed. The fracture healed after screw fixation. We highlight the importance of considering stress fracture as a differential diagnosis in a child with chronic hip pain. A careful physical examination and the appropriate imaging will avoid missing the diagnosis.

Fulltext Anxiety Reaction in Children During Cast Removal using Oscillating Saw versus Cast Shear - A Randomised, Prospective Trial

Mohamed-Zain NA, Jamil K, Penafort R, Singh A, Ibrahim S, Abdul-Rashid AH

Malays Orthop J, 2021 Jul;15(2):122-128.

PMID: 34429832 DOI: 10.5704/MOJ.2107.018

Introduction: To compare the anxiety levels demonstrated by children during cast removal procedure between oscillating saw vs cast shear methods.

Material and methods: A randomised prospective study of 102 children (mean age 8.3 ± 3.5 years) with fractures involving upper or lower limbs. Children undergoing removal of cast were divided into 2 groups; either by an oscillating saw or a cast cutting shear. The level of anxiety was assessed by recording the heart rate with a portable fingertip pulse oximeter before, during and after removal of the cast. Objective assessment was performed by documenting the fear level on Children's Fear Scale (CFS).

Results: There was a significant increase in the heart rate of children during cast removal while using the oscillating saw compared to cast shear (p<0.05). The noise level produced by the saw exceeded 80 dB (mean 103.3 dB). The fear level was significantly lower in the cast shear group (p<0.05).

Conclusion: The noise produced by the oscillating saw was associated with an increased anxiety level in children undergoing cast removal. Cast shear is a simple and inexpensive instrument that can be used for cast removal in overly anxious children.

The Rubber Stopper: A Simple and Inexpensive Technique to Prevent Pin Tract Infection following Kirschner Wiring of Supracondylar Fractures of Humerus in Children

Santy JE, Kamal J, Abdul-Rashid AH, Ibrahim S

Malays Orthop J, 2015 Jul;9(2):13-16.

PMID: 28435603 MyJurnal DOI: 10.5704/MOJ.1507.006

Percutaneous pinning after closed reduction is commonly used to treat supracondylar fractures of the humerus in children. Minor pin tract infections frequently occur. The aim of this study was to prevent pin tract infections using a rubber stopper to reduce irritation of the skin against the Kirschner (K) wire following percutaneous pinning. Between July 2011 and June 2012, seventeen children with closed supracondylar fracture of the humerus of Gartland types 2 and 3 were treated with this technique. All patients were treated with closed reduction and percutaneous pinning and followed up prospectively. Only one patient, who was a hyperactive child, developed pin tract infection due to softening of the plaster slab. We found using the rubber stopper to be a simple and inexpensive method to reduce pin tract infections following percutaneous pinning.

Urine NMR Metabolomic Study on Biochemical Activities to Investigate the Effect of P. betle Extract on Obese Rats

Abdul Ghani ZDF, Ab Rashid AH, Shaari K, Chik Z

Appl Biochem Biotechnol, 2019 Oct;189(2):690-708.

PMID: 31111377 DOI: 10.1007/s12010-019-03042-w

The present studies are to evaluate the ability of PB to induce weight loss and urine metabolite profile of Piper betle L. (PB) leaf extracts using metabolomics approach. Dried PB leaves were extracted with ethanol 70% and the studies were performed in different groups of rats fed with high fat (HFD) and normal diet (ND). Then, fed with the PB extract with 100, 300, and 500 mg/kg and two negative control groups given water (WTR). The body weights were monitored and evaluated. Urine was collected and 1H NMR-based metabolomics approach was used to detect the metabolite changes. Results showed that PB-treated group demonstrated inhibition of body weight gain. The trajectory of urine metabolites showed that PB-treated group gave the different distribution from week 12 to 16 compared with the control groups. In 1H NMR metabolomic approach analysis, the urine metabolites gave the best separation in principle component 1 and 3, with 40.0% and 9.56% of the total variation. Shared and unique structures (SUS) plot model showed that higher concentration PB-treated group was characterized by high level of indole-3-acetate, aspartate, methanol, histidine, and creatine, thus caused an increased the metabolic function and maintaining the body weight of the animals treated.

Fulltext The Osseous Pathology of Purpura Fulminans in a Two-Year-Old Child: A Case Report

Mohd-Razali S, Ahmad-Affandi K, Ibrahim S, Abdul-Rashid AH, Abdul-Shukor N

Malays Orthop J, 2023 Mar;17(1):180-183.

PMID: 37064633 DOI: 10.5704/MOJ.2303.021

Purpura fulminans (PF) is a severe clinical manifestation of Neisseria meningitides infection that is associated with high mortality rates in children. Survivors are frequently left with debilitating musculoskeletal sequelae. There is a paucity of reports on the musculoskeletal pathology of purpura fulminans. We report on a 2-year-old boy with purpura fulminans due to meningococcemia. The child developed distal gangrene in both the upper and lower limbs. Amputations were done for both lower limbs. Histological examination of the amputated specimens showed an inflammatory process and features of osteonecrosis. The latest follow-up at the age of 6 years showed a right knee valgus due to asymmetrical growth arrest of the proximal tibia. PF and its complications are challenging to treat and may require a multidisciplinary approach to improve patient's functional ability.

Displaying publications 1 - 20 of 35 in total