Displaying publications 1 - 20 of 34 in total

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  1. Fulltext A simple method for removal of the distal segment of a broken femoral intramedullary nail: a case report
    Pan K, Reuben P
    Malays Orthop J, 2012 Nov;6(3):66-8.
    PMID: 25279064 MyJurnal DOI: 10.5704/MOJ.1207.011
    We report a method for removing the distal segment of a broken locked intramedullary nail secondary to nonunion of the femur following radiotherapy for fibromatosis. A Kirschner wire with one tip fashioned into a hook was used to remove the distal segment without opening with the nonunion site. Details of the procedure are described.
    Matched MeSH terms: Bone Wires
  2. Experiments on deformation behaviour of functionally graded NiTi structures
    Shariat BS, Meng Q, Mahmud AS, Wu Z, Bakhtiari R, Zhang J, et al.
    Data Brief, 2017 Aug;13:562-568.
    PMID: 28706965 DOI: 10.1016/j.dib.2017.06.017
    Functionally graded NiTi structures benefit from the combination of the smart properties of NiTi and those of functionally graded structures. This article provides experimental data for thermomechanical deformation behaviour of microstructurally graded, compositionally graded and geometrically graded NiTi alloy components, related to the research article entitled "Functionally graded shape memory alloys: design, fabrication and experimental evaluation" (Shariat et al., 2017) [1]. Stress-strain variation of microstructurally graded NiTi wires is presented at different heat treatment conditions and testing temperatures. The complex 4-way shape memory behaviour of a compositionally graded NiTi strip during one complete thermal cycle is demonstrated. The effects of geometrical design on pseudoelastic behaviour of geometrically graded NiTi plates over tensile loading cycles are presented on the stress-strain diagrams.
    Matched MeSH terms: Bone Wires
  3. Fulltext Investigation on the Curvature Correction Factor of Extension Spring
    Tan PS, Akhavan Farid A, Karimzadeh A, Rahimian Koloor SS, Petrů M
    Materials (Basel), 2020 Sep 21;13(18).
    PMID: 32967330 DOI: 10.3390/ma13184199
    The curvature correction factor is an important parameter in the stress calculation formulation of a helical extension spring, which describes the effect of spring wire curvature on the stress increase towards its inner radius. In this study, the parameters affecting the curvature correction factor were investigated through theoretical and numerical methods. Several finite element (FE) models of an extension spring were generated to obtain the distribution of the tensile stress in the spring. In this investigation, the hook orientation and the number of coils of the extension spring showed significant effects on the curvature correction factor. These parameters were not considered in the theoretical model for the calculation of the curvature correction factor, causing a deviation between the results of the FE model and the theoretical approach. A set of equations is proposed for the curvature correction factor, which relates both the spring index and the number of coils. These equations can be applied directly to the design of extension springs with a higher safety factor.
    Matched MeSH terms: Bone Wires
  4. Fractures of the femoral neck
    Monro JK
    Journal of the Malaya Branch of the British Medical Association, 1940;3:422.
    Matched MeSH terms: Bone Wires
  5. 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.
    Matched MeSH terms: Bone Wires
  6. Fulltext Biomechanical Analysis of Crossed Pinning Construct in Supracondylar Fracture of Humerus: Does the Point of Crossing Matter?
    Hanim A, Wafiuddin M, Azfar MA, Awang MS, Nik Abdul Adel NA
    Cureus, 2021 Mar 22;13(3):e14043.
    PMID: 33898129 DOI: 10.7759/cureus.14043
    Introduction This appears to be the first biomechanical study that compares the stability of various locations of the crossing points in crossed pinning Kirschner wiring (K-wire) construct in treating pediatric supracondylar humerus fracture (SCHF). Additionally, this study compared the biomechanical stability between crossed pinning K-wire construct and the three-lateral divergent K-wire construct. Methods For the study purpose, 30 synthetic humerus bones were osteotomised at mid-olecranon fossa, anatomically reduced, and pinned using two 1.6-millimeter K-wires in five different constructs. A total of six samples were prepared for each construct and tested for extension, flexion, valgus, varus, internal rotation, and external rotation forces. Results As for crossed pinning K-wire construct, the center crossing point emerged as the stiffest construct in both linear and rotational forces, in comparison to the lateral crossing point, superior crossing, and medial crossing point Conclusion Based on this analysis, it is highly recommended that, if the crossed pinning construct is selected to treat supracondylar humerus fracture, the surgeon should aim for center crossing point as it is the most stable construct. Nevertheless, if lateral and superior crossing points are obtained during the initial attempt of fixation, the fixation may be accepted without revising the K-wire as the stability of these two constructs are comparable and portrayed no significant difference when compared to that of the center crossing point. Additionally, it is essential to avoid the medial crossing point as it is significantly less stable in terms of rotational force when compared to the center crossing point.
    Matched MeSH terms: Bone Wires
  7. Fulltext Retrospective Review of Kirschner Wire Fixation andCasting for Displaced Lateral Condylar Fracture of theHumerus in Children
    Gooi, S.G, Chee, E.K., Wong, C.L., Mohana, R., Khoo, E.H., Thevarajan, K.
    Malays Orthop J, 2008;2(2):17-20.
    MyJurnal
    This study was conducted to assess the optimum period for Kirschner wire fixation and cast immobilization for displaced lateral condylar fracture of the humerus in children. We retrospectively reviewed 12 patients with displaced lateral condyle humerus fracture, ranging in age from 3-9 y, with injuries that occurred between Jan 2005 and Dec 2006. All patients were treated with two Kirschner wire fixation and elbow immobilization. In all except 2 patients, the Kirschner wires were maintained for 3 to 4 weeks. Mean time for union was 3.78 weeks and mean humeroulnar arch motion at last review was 138.7 degrees. Only one patient had a 5 degree increased carrying angle in valgus as compared to the non-injured side, and 50% had prominent scars > 4mm. We conclude that fracture union can be expected within three to four weeks for most children after open reduction and fixation with 2 Kirschner wires.
    Matched MeSH terms: Bone Wires
  8. Fulltext Kirschner Wire Migration to the Cervical Spine: A Complication of Clavicular Fixation in a Child
    Tan, K.K., Ibrahim, S.
    Malays Orthop J, 2007;1(1):45-46.
    MyJurnal
    We report a case of a broken K-wire migrating to the cervical spine from the right clavicle in a 9-year-old child. The initial diagnosis, fracture of the clavicle with an acromioclavicular joint dislocation, was treated by open reduction and K-wiring. One K-wire broke and migrated to the neck, posterolateral to the C6 vertebra. The K-wire was removed percutaneously under image intensification. Acromioclavicular joint dislocation in children is rare since the distal clavicle does not ossify until the age of 18 or 19 years meaning that almost all closed fractures of the clavicle in children can be treated nonoperatively.
    Matched MeSH terms: Bone Wires
  9. Fulltext Surgical Fixation and Inter-phalangeal Arthrodesis of Symptomatic Non-union of Fracture of a Lesser Toe Distal Phalanx: A Case Report
    Foo GL, Wee L
    Malays Orthop J, 2019 Nov;13(3):69-71.
    PMID: 31890114 DOI: 10.5704/MOJ.1911.012
    Distal phalanx fractures of the toes are common injuries. The majority of them are treated conservatively with good outcome. We present the case of a painful non-union fracture of the distal phalanx of the 4th toe in a 60-year-old female patient with symphalangism of the 4th and 5th toes. She underwent surgical fixation of the fracture with concomitant inter-phalangeal joint (IPJ) arthrodesis for better stability. A transverse dorsal incision was made just distal to the IPJ to allow preparation of both the fracture site and IPJ. Fibrous tissue at the fracture non-union site was removed and the opposing surfaces drilled with a 0.88mm K-wire. Cartilaginous tissue at the IPJ was removed and similarly drilled with the 0.88mm K-wire. Stabilisation was achieved with a percutaneous headless compression screw. Radiographic union was achieved and the patient had resolution of symptoms 16 weeks after the surgery. The patient continued to be symptom-free at one year follow-up. This is the first case report of a surgically treated symptomatic non-union of distal phalanx fracture of a lesser toe in the literature.
    Matched MeSH terms: Bone Wires
  10. Fulltext A Modified Technique of Fixation for Proximal Femoral Valgus Osteotomy in Abnormal Bone: A Report of Two Cases
    Logheswaren S, Sulaiman AR, Munajat I
    Malays Orthop J, 2017 Jul;11(2):82-84.
    PMID: 29021887 MyJurnal DOI: 10.5704/MOJ.1707.014
    The ideal size of intramedullary device to fix corrective osteotomy of proximal femur in abnormal bone in children and small patients may not be easily available. We report the successful use of Rush rod in combination with multiple Kirschner wires to fix the corrective osteotomy of coxa vara and shepherd crook deformity in two patients with osteogenesis imperfecta and fibrous dysplasia. The union was achieved on time, neck shaft angle and rotation were maintained.
    Matched MeSH terms: Bone Wires
  11. Comminuted sternal fracture -- a sternotomy wire fixation: report of 2 cases
    Abdul-Rahman MR, Seong NK, Hee TG, Aljada ME, Reda TA, Sumin JO, et al.
    Heart Surg Forum, 2009 Jun;12(3):E184-6.
    PMID: 19546075 DOI: 10.1532/HSF98.20091016
    Various techniques of sternal stabilization via either metal plates or wires have been described. We describe an alternative technique of simple median sternotomy followed by reduction and wire fixation of the sternal fracture. The 2 patients described in this report had traumatic comminuted and displaced sternal fractures. Even though wire repair was deemed to be tedious and achieved poor approximation of the bone, we performed median sternotomy and achieved simple wire fixation with an excellent result.
    Matched MeSH terms: Bone Wires*
  12. Missed Monteggia fracture dislocation in children
    Devnani AS
    Injury, 1997 Mar;28(2):131-3.
    PMID: 9205580
    Open reduction of the radial head and reconstruction of the annular ligament has been advocated for the Monteggia fracture dislocation in children who present more than a month after injury. Three patients with an anterior Monteggia lesion were treated by open reduction of the radial head which was held in place by a Kirschner wire passed from the humerus to the radius. No attempt was made either to repair or reconstruct the annular ligament. The patients were aged between 2 and 6 years, the delay between injury and reduction was between 6 and 8 weeks, and the length of follow up was 5 years for two patients and 1 year for the third. All three patients were free of pain, had no deformity and the radial head had not subluxated. All had nearly full flexion at the elbow. The forearm had full supination but restricted pronation.
    Matched MeSH terms: Bone Wires*
  13. Simultaneous dislocations of the carpometacarpal and metacarpophalangeal joints of the thumb
    Ibrahim S, Noor MA
    Injury, 1993 May;24(5):343-4.
    PMID: 8349349
    Matched MeSH terms: Bone Wires
  14. Delayed management of fracture of the lateral humeral condyle in children
    Dhillon KS, Sengupta S, Singh BJ
    Acta Orthop Scand, 1988 Aug;59(4):419-24.
    PMID: 3421080
    Thirty-nine displaced fractures of the lateral humeral condyle in children were followed for an average of 5 (2-5) years. The results were evaluated from functional and cosmetic aspects. Patients treated within 2 weeks by open reduction and internal fixation did well. Those operated on after 6 weeks did not do better than nonoperated on cases. Complications included cubitus varus and valgus deformities, osteonecrosis, nonunion and malunion, and loss of motion. We recommend that patients presenting late be left alone and any sequelae evaluated at a late stage.
    Matched MeSH terms: Bone Wires
  15. Fulltext The Effect of Intra-carpal Kirschner Wire Augmentation in Screw Fixation of Scaphoid - A Retrospective Cohort Study
    Leow M, Chung SR, Tay SC
    Malays Orthop J, 2020 Nov;14(3):104-109.
    PMID: 33403069 DOI: 10.5704/MOJ.2011.016
    Introduction: Scaphoid fractures are most often treated with a single headless compression screw. However, intercarpal Kirschner wire (K-wire) might be added to improve stability and fracture outcomes. This study will determine if there is a difference in treatment outcome (union rate and time to union) between scaphoid fracture fixations using a single headless compression screw with and without augmentation using a intracarpal intramedullary K-wire.

    Material and Methods: We conducted a retrospective review of patients who underwent surgery for isolated scaphoid fractures over a 15 years period from December 2000 to December 2015. Only patients who underwent open surgery with bone grafting were included. They were divided into a group treated with a single screw fixation, and another group treated with screw and K-wire fixations.

    Results: Forty-four (58.7%) patients had single screw fixation and 31 (41.3%) had screw augmented with K-wire fixation. The overall union rate was 88.0%, with an overall mean time to union of 5.3 months. There was no difference in union rate (p=0.84) and time to union (p=0.66) between the single screw group and combined screw and K-wire group. Univariate analysis found that older age (t=-2.11, p=0.04) had a significant effect on union rate. Regression model showed that age had a significant effect on months to union.

    Conclusion: In open fixation of scaphoid fractures with compression screw and bone grafting, union rate and time to union is comparable whether or not screw fixation was augmented with an intracarpal K-wire. There was no increased risk of complications associated with augmented screw. Age of patient affected time to union and union rate.

    Matched MeSH terms: Bone Wires
  16. Fulltext Fixation of Comminuted Patellar Fracture with Combined Cerclage and Tension Band Wiring Technique
    Ong, T.K., Chee, E.K., Wong, C.L., Thevarajan, K.
    Malays Orthop J, 2008;2(2):40-42.
    MyJurnal
    In comminuted patellar fractures, a combination of cerclage wiring and tension band fixation is said to provide good mechanical stability. This is a retrospective review of four patients treated with this method. All fractures described herein were classified as 45-C3 (based on Orthopaedic Trauma Association classification) and were fixed with a 1.25mm cerclage wire and tension band wire proximally looped through the quadriceps tendon and distally through the patellar ligament in a figure-of-eight configuration. The average follow-up period was 10 months. The Activity of Daily Living Scale (ADLS) of the Knee Outcome Survey was used to assess symptoms and functional capability of the knee. In all the cases, fracture union was achieved at an average of 11 weeks. The average ADLS score was good (92.5 %). Full range of knee motion was achieved by end of the third postoperative month. None of the patients had complications, such as infection and implant failure.
    Matched MeSH terms: Bone Wires
  17. Fulltext Treament of tibial plateau Schatzker type VI fractures with the Ilizarov technique using ring external fixators across the knee: a retrospective review
    Ranatunga, I.R., Thirumal, M.
    Malays Orthop J, 2010;4(2):34-39.
    MyJurnal
    This is a retrospective review of 18 patients with tibial plateau fractures Schatzker type VI. These cases were performed in our medical centre from January 2003 to December 2004. The Ilizarov technique (Russian technique) using the ring external fixator was the technique performed. Articular reconstruction and joint alignment were achieved with traction and olive wires with washers. One case required percutaneous elevation of the articular surface and bone grafting through a cortical window. Average clinical union was achieved within 4 months of trauma. Mean final knee flexion was 85°, which is compatible with walking. All patients successfully returned to their previous occupations. In conclusion, the Ilizarov technique has been shown to be a good option and a viable tool in the management of these complex and unstable injuries.
    Matched MeSH terms: Bone Wires
  18. Fulltext Humeral Supracondylar Fractures in Children: A Novel Technique of Lateral External Fixation and Kirschner Wiring
    Kow RY, Zamri AR, Ruben JK, Jamaluddin S, Mohd-Nazir MT
    Malays Orthop J, 2016 Jul;10(2):41-46.
    PMID: 28435560 MyJurnal DOI: 10.5704/MOJ.1607.008
    Introduction: Supracondylar fracture of the humerus is the most common fracture around the elbow in children. Pinning with Kirschner wires (K-wires) after open or closed reduction is generally accepted as the primary treatment modality. However, it comes with the risk of persistent instability and if the K-wire is not inserted properly, it may cause displacement and varus deformity. We present our two-year experience with a new technique of lateral external fixation and K-wiring of the humeral supracondylar fracture. Materials and Methods: A total of seven children with irreducible Gartland Type III supracondylar humeral fracture were treated with closed reduction and lateral external fixation and lateral Kirschner wiring. Patients with ipsilateral radial or ulnar fracture, open fracture and presence of neurovascular impairment pre-operatively were excluded. All the patients were followed up at one, three and six weeks and three and six months. The final outcomes were assessed based on Flynn's criteria. Results: All the patients achieved satisfactory outcomes in terms of cosmetic and functional aspects. All patients except one (85.5%) regained excellent and good cosmetic and functional status. One patient (14.3%) sustained pin site infection which resolved with oral antibiotic (Checketts- Otterburn grade 2). There was no neurological deficit involving the ulnar nerve and radial nerve. Conclusion: The introduction of lateral external fixation and lateral percutaneous pinning provide a promising alternative method for the treatment of humeral supracondylar fracture. This study demonstrates that it has satisfactory cosmetic and functional outcomes with no increased risk of complications compared to percutaneous pinning.
    Matched MeSH terms: Bone Wires
  19. Fulltext Bilateral Talus and Navicular Fractures accompanied with Unilateral Calcaneal Fracture: A Case Report
    Bulut G, Colak I, Mik G, Kilic Z, Tasdemir Z
    Malays Orthop J, 2018 Jul;12(2):47-51.
    PMID: 30112129 DOI: 10.5704/MOJ.1807.009
    An 18-year old male patient, with a history of paragliding accident, sustaining a coronal shear fracture of the body of the talus, an anterior process fracture of the calcaneus extending to the calcaneocuboid joint and a nondisplaced navicular body fracture at the right foot and a displaced fracture of the navicular body accompanied with posteromedial process fracture of the talus at the left side was referred to our emergency clinic. For the right foot, the coronal plane fracture of the talar body was anatomically reduced and fixed with screws. For the left foot, screw fixation was performed through the lateral aspect to fix the large posteromedial fragment. Small bone fragments were removed from the left navicular fracture, and the main fragments were also fixed with screw. The talo-navicular joint was stabilised with a Kirschner wire. At 36 months follow-up, bilateral foot and ankle functions were satisfactory, Maryland scores of the right and left foot were 85 (good) and 90 (excellent), respectively, and the patient regained his full activity level by the 5th month postoperatively. With reference to the number and types of fractures in this one patient, we present a standard protocol for treatment of isolated talus, navicular and calcaneal fractures presenting together in a single foot injury.
    Matched MeSH terms: Bone Wires
  20. Fulltext Proposal for a Radiological Classification System for Carpo-Metacarpal Joint Dislocations with or without Fractures
    Pundkare GT, Deshpande SS
    Malays Orthop J, 2018 Jul;12(2):42-46.
    PMID: 30112128 DOI: 10.5704/MOJ.1807.008
    Introduction: Though complex injuries like CarpoMetacarpal (CMC) Joint dislocations represent only 1% of all hand injuries, they have disabling impact on the functional status of patient. There are no reports in the literature classifying disabling complex injuries like CMC joint dislocations presumably because of low incidence. We propose a new classification through retrospective analysis of patients, along with literature search. Materials and Methods: A new classification system has been proposed and designed at our clinical unit and applied to eight patients with CMC joint dislocations. All patients were treated with open reduction with Kirschner wire fixation. At follow-up all these patients were analysed for radiographic assessments and functional scores. Results: The proposed classification identifies three types of dislocations and an additional complex category to supplement any basic type. The direction of dislocation describes the types as Type A: Dorsal, Type B: Volar and Type C: Divergent. Among the eight patients in our study, we had two of Type A, two Type B, three Type B.1, one Type C. 1. These patients had average follow-up of 18 months. The quick DASH score improved from 75.76 at 6 weeks to 1.9 at 18 months. We also did intra-observer and inter-observer reliability which scored 1. Conclusion: Our proposal is a reproducible, simple, comprehensive and practical classification, easily remembered and communicated among colleagues. It is clinically relevant as it helps us in planning surgical management and prognostic evaluation.
    Matched MeSH terms: Bone Wires
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