MyMedR

Description of WALANT technique in open bone and ligament wrist surgery

Brutus JP, Chang MC, Ahmad AA, Apard T

Hand Surg Rehabil, 2024 Feb;43(1):101610.

PMID: 38393765 DOI: 10.1016/j.hansur.2023.10.004

The gold-standard for bone, ligament and joint surgery in the wrist is locoregional anesthesia in most countries. Wide-Awake Local Anesthesia No Tourniquet (WALANT) is commonly used for simple soft-tissue hand surgery procedures such as carpal tunnel or trigger finger release, and can now also be safely used in procedures such as proximal row carpectomy, scapholunate ligament repair or partial wrist fusion, to name but a few. This article describes the use of WALANT for complex surgery in the wrist. WALANT surgery offers many known benefits, such as enhanced patient safety and comfort, simplified perioperative process and avoidance of anesthesia-related risks, and also allows the surgeon to perform intraoperative testing of the repaired structures. Thus, the surgeon can tailor the rehabilitation program and shorten recovery time. We describe detailed guidelines for performing WALANT procedures safely and effectively, making it a favorable option for complex surgeries in the wrist.

Matched MeSH terms: Wrist; Wrist Joint/surgery

Hand movements classification for myoelectric control system using adaptive resonance theory

Jahani Fariman H, Ahmad SA, Hamiruce Marhaban M, Alijan Ghasab M, Chappell PH

Australas Phys Eng Sci Med, 2016 Mar;39(1):85-102.

PMID: 26581764 DOI: 10.1007/s13246-015-0399-5

This research proposes an exploratory study of a simple, accurate, and computationally efficient movement classification technique for prosthetic hand application. Surface myoelectric signals were acquired from the four muscles, namely, flexor carpi ulnaris, extensor carpi radialis, biceps brachii, and triceps brachii, of four normal-limb subjects. The signals were segmented, and the features were extracted with a new combined time-domain feature extraction method. Fuzzy C-means clustering method and scatter plot were used to evaluate the performance of the proposed multi-feature versus Hudgins' multi-feature. The movements were classified with a hybrid Adaptive Resonance Theory-based neural network. Comparative results indicate that the proposed hybrid classifier not only has good classification accuracy (89.09%) but also a significantly improved computation time.

Matched MeSH terms: Wrist

Fulltext Novel method to estimate the length of the palmaris longus tendon

Manohar, A., Ramal, L.

Malaysian Journal of Medicine and Health Sciences, 2013;9(2):19-24.

MyJurnal

Palmaris longus is tendon of choice in reconstructive, plastic and cosmetic surgeries. Thus, a suitable length is required and it would be more convenient if the length of the tendon of the palmaris longus could be estimated before harvesting. This study was carried out to determine the relationship between the length and width of the palmaris longus tendon and the length of forearm and hand, the relationship between the length and the width of the palmaris longus tendon and wrist width and wrist circumference, as well as to identify a technique to estimate the length of the tendinous part of palmaris longus before harvesting it. A standardized proforma was used to collect the data of each of the 31 cadavers upper limbs. These data were analysed using SPSS software version 17. It is important to note that p value less than 0.05 is considered as statistically significant in this study. Out of the 31 upper limbs, palmaris longus tendon was absent in 3 (9.68%). Meanwhile, the mean length and width of the palmaris longus tendon was found to be 16.20 cm and 0.48 cm, respectively. The mean length of the forearm and hand was 26.6 cm and 21.2 cm, respectively. The mean width of the wrist and wrist circumference was 8.2 cm and 14.82 cm, respectively. These indicate a significant and moderate relationship between the length of palmaris longus tendon and the length of forearm (r = 0.49, r2 = 0.24, p < 0.01). In addition, there was also a significant relationship between the length of palmaris longus tendon and the length of hand (r = 0.56, p < 0.01). This paper presents the technique used to estimate the length and width of the tendinous part of palmaris longus before harvesting. The length of palmaris longus can be estimated pre-operatively by measuring the length of the hand by using the technique explained in this paper.

Matched MeSH terms: Wrist; Wrist Joint

Fulltext Tuberculosis of the Left Wrist Joint and Spine

Sivasamy P, Bajuri MY, Ghani AW

Cureus, 2019 Nov 19;11(11):e6203.

PMID: 31890405 DOI: 10.7759/cureus.6203

The incidence of wrist tuberculosis is rare. Clinical features and radiographs are not conclusive in the beginning, happen to delay the achievement of the diagnosis, and thus result in poor treatment. We present a case report of wrist tuberculosis that had delayed diagnosis. Hence, the initiation of antituberculous treatment was delayed, as the initial investigations were not conclusive of tuberculous infection. The patient was treated surgically multiple times before tuberculosis was diagnosed. Antituberculous chemotherapy was started for the patient for one year until she became afebrile and infective markers returned to normal. However, the patient developed left wrist stiffness due to arthrofibrosis and bony destruction of the wrist joint.

Matched MeSH terms: Wrist; Wrist Joint

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: Wrist Injuries/complications*; Wrist Injuries/radiography; Wrist Injuries/surgery; Wrist Joint*

Characterization of surface electromyography using time domain features for determining hand motion and stages of contraction

Bin Ahmad Nadzri AA, Ahmad SA, Marhaban MH, Jaafar H

Australas Phys Eng Sci Med, 2014 Mar;37(1):133-7.

PMID: 24443218 DOI: 10.1007/s13246-014-0243-3

Surface electromyography (SEMG) signals can provide important information for prosthetic hand control application. In this study, time domain (TD) features were used in extracting information from the SEMG signal in determining hand motions and stages of contraction (start, middle and end). Data were collected from ten healthy subjects. Two muscles, which are flexor carpi ulnaris (FCU) and extensor carpi radialis (ECR) were assessed during three hand motions of wrist flexion (WF), wrist extension (WE) and co-contraction (CC). The SEMG signals were first segmented into 132.5 ms windows, full wave rectified and filtered with a 6 Hz low pass Butterworth filter. Five TD features of mean absolute value, variance, root mean square, integrated absolute value and waveform length were used for feature extraction and subsequently patterns were determined. It is concluded that the TD features that were used are able to differentiate hand motions. However, for the stages of contraction determination, although there were patterns observed, it is determined that the stages could not be properly be differentiated due to the variability of signal strengths between subjects.

Matched MeSH terms: Wrist/physiology*

Fulltext Metastatic malignant schwannoma of orbit: a case report

Jaais F, Sivanesan S

Med J Malaysia, 1986 Dec;41(4):356-60.

PMID: 3670161

A case of metastatic malignant schwannoma of the right orbit is presented here. Although the patient had disseminated disease, it was the eye problems which were striking and most symptomatic.
The orbital lesion was at first thought to be the primary tumour until a history of an excised right wrist mass was probed into and the histology traced.
This report is written as malignant schwannoma is an uncommon tumour. The difficulty in diagnosing malignant schwannoma is mentioned. The importance of diagnosis of an orbital metastatic lesion is also pointed out as this is often misdiagnosed.

Matched MeSH terms: Wrist*

Fulltext Single-Bone Forearm Salvage Procedure for a Child with Acquired Radial Clubhand in a Resource Limited Centre: A Case Report

Sahdi H, Chan WH, Dollah NB, Entri A

Malays Orthop J, 2018 Nov;12(3):43-46.

PMID: 30555646 MyJurnal DOI: 10.5704/MOJ.1811.011

Acquired radial clubhand deformity can be a consequence of large bone gap left by premature extensive radius osteomyelitis sequestrectomy. Single-bone forearm reconstruction is a salvage procedure when other motion-preserving techniques are not feasible. Here we present a child who developed radial clubhand deformity after an untimely sequestrectomy of radius diaphysis. In view of limited microsurgical expertise in our centre, single-bone forearm procedure was done utilising simple Kirshner wires to achieve radio-ulnar fusion. The procedure resulted in pain-free stable wrist, restoration of hand function and improved cosmesis.

Matched MeSH terms: Wrist; Wrist Joint

Fulltext Distal radius morphometry in the Malaysian population

Chan CYW, Vivek AS, Leong WH, Rukmanikanthan S

Malays Orthop J, 2008;2(2):27-30.

MyJurnal

The goal of treatment in distal radius fracture is to restore the anatomy of the distal radius, however the criteria currently used to evaluate the quality of eduction are based on Western based published figures. This goal of this study was to investigate whether there are variations in the morphology of the distal radius among the multiracial population of Malaysia. Consecutive normal wrist radiographs of patients who presented to the accident and emergency unit in three major hospitals in Malaysia were measured. The palmar tilt of the distal radius averaged 12.6o Â± 3.55o, and the radial inclination averaged 25.1o Â± 3.42o. The ulnar variance averaged â€“ 0.1 Â± 1.31mm, 38.4% of the patients had neutral ulnar variance, 28.8% have negative ulnar variance and 32.9% have positive ulnar variance. Our results indicate that distal radius morphometric parameters in the Malaysian population are comparable to Western figures.

Matched MeSH terms: Wrist; Wrist Joint

Fulltext Pen and paper based observational method to assess postural problems: a review

Sukadarin, E.H., Deros, B.M., Nawi, N.S.M., Rambely, A.S., Bakar, S.A., Tamrin, S.B.M.

Malaysian Journal of Public Health Medicine, 2016;16(20):78-83.

MyJurnal

Posture is one of the most important factor that need to be considered in any postural analysis. Awkward, extreme,
and repetitive postures can increase the risk of musculoskeletal disorders (MSDs). As observational methods are more
widely used than instrumentation-based methods to assess postural problems, this study reviews and assesses the
scientific literature of observational methods and focused on pen and paper based specifically. In order to identify the
published methods, a list of English or Malay articles dating as far back as 1990 was compiled from PubMed, Science
Direct and Google Scholar. The keywords were ergo*, posture*, method*, observational*, postural problems*, pen and
paper*, posture analysis*, indirect* and macro-ergo*. In addition, a secondary search was also performed using
bibliography of retrieved articles so that additional papers for conducting review and evaluations can be collected. A
total of 121 articles that assessed postural problems in working activities were found. However, after intensive
screening process only 6 articles were selected to be further analyzed. Posture of upper arms/shoulder, lower arms/
elbow, wrist, neck, back/trunk and leg were highlighted in this study. The limitations and the strengths of the
published pen and paper based observational method focusing on those postures were also discussed. The finding of
this review will benefit researchers in the process of understanding unsafe posture in workplace. It could also provide
to researcher on how to improve the current pen and paper based observational method for assessing postural
problems.

Matched MeSH terms: Wrist; Wrist Joint

Fulltext Avulsion Fracture of Brachioradialis Muscle Origin: An Exceedingly Rare Entity: A Case Report

Behera G, Balaji G, Menon J, Sharma D, Komuravalli VK

Malays Orthop J, 2016 Jul;10(2):50-52.

PMID: 28435562 DOI: 10.5704/MOJ.1607.010

Avulsion fracture of the brachioradialis origin at its proximal attachment on the lateral supracondylar ridge of the distal humerus is exceedingly rare, and only two cases have been reported in the literature so far. In this article, we present a 38 years old patient who sustained a closed avulsion fracture of the lateral supracondylar ridge of left humerus at the proximal attachment of brachioradialis following a fall backwards on outstretched hand after being struck by a lorry from behind while riding on a two-wheeler (motorcycle). He was managed with above elbow plaster for four weeks followed by elbow and wrist mobilization. At final followup, the patient had painless full range elbow motion with good elbow flexion strength. The unique mechanism by which this avulasion fracture occurred is explained on the basis of the mode of injury, position of the limb and structure and function of the brachioradialis muscle.

Matched MeSH terms: Wrist; Wrist Joint

Fulltext Isolated Tuberculosis of the Wrist: Subtle but Destructive

Manas A, Bajuri MY, Muhammad Nawawi RF

Cureus, 2020 May 03;12(5):e7939.

PMID: 32499979 DOI: 10.7759/cureus.7939

Tuberculosis is an infection that can occur in every organ of the body, but it rarely affects the wrist joint. We report a rare case of a male patient with wrist tuberculosis with a subtle presentation. Our patient's left wrist had been swollen for four months and progressively worsened, becoming ulcerated one week prior to presentation to our center. He was asymptomatic, but a previous radiograph showed global destruction of the wrist joint. Clinical investigations, that is, polymerase chain reaction test for tuberculosis and histopathological examination, showed classic findings of tuberculosis, which lead to the initiation of anti-tuberculosis treatment.

Matched MeSH terms: Wrist; Wrist Joint

Fulltext Smartphone usage and increased risk of mobile phone addiction: A concurrent study

Parasuraman S, Sam AT, Yee SWK, Chuon BLC, Ren LY

Int J Pharm Investig, 2017 Jul-Sep;7(3):125-131.

PMID: 29184824 DOI: 10.4103/jphi.JPHI_56_17

Objective: This study aimed to study the mobile phone addiction behavior and awareness on electromagnetic radiation (EMR) among a sample of Malaysian population.

Methods: This online study was conducted between December 2015 and 2016. The study instrument comprised eight segments, namely, informed consent form, demographic details, habituation, mobile phone fact and EMR details, mobile phone awareness education, psychomotor (anxious behavior) analysis, and health issues. Frequency of the data was calculated and summarized in the results.

Results: Totally, 409 respondents participated in the study. The mean age of the study participants was 22.88 (standard error = 0.24) years. Most of the study participants developed dependency with smartphone usage and had awareness (level 6) on EMR. No significant changes were found on mobile phone addiction behavior between the participants having accommodation on home and hostel.

Conclusion: The study participants were aware about mobile phone/radiation hazards and many of them were extremely dependent on smartphones. One-fourth of the study population were found having feeling of wrist and hand pain because of smartphone use which may lead to further physiological and physiological complication.

Matched MeSH terms: Wrist; Wrist Joint

WALANT technique for percutaneous pinning of distal radioulnar joint

Azhar S, Abdullah S, Soh E

J Hand Surg Eur Vol, 2023 Mar;48(3):279-281.

PMID: 36691295 DOI: 10.1177/17531934221148115

Matched MeSH terms: Wrist Joint/surgery

Evaluation of Wrist-Worn Photoplethysmography Trackers with an Electrocardiogram in Patients with Ischemic Heart Disease: A Validation Study

Ibrahim NS, Rampal S, Lee WL, Pek EW, Suhaimi A

Cardiovasc Eng Technol, 2024 Feb;15(1):12-21.

PMID: 37973701 DOI: 10.1007/s13239-023-00693-z

PURPOSE: Photoplethysmography measurement of heart rate with wrist-worn trackers has been introduced in healthy individuals. However, additional consideration is necessary for patients with ischemic heart disease, and the available evidence is limited. The study aims to evaluate the validity and reliability of heart rate measures by a wrist-worn photoplethysmography (PPG) tracker compared to an electrocardiogram (ECG) during incremental treadmill exercise among patients with ischemic heart disease.

METHODS: Fifty-one participants performed the standard incremental treadmill exercise in a controlled laboratory setting with 12-lead ECG attached to the patient's body and wearing wrist-worn PPG trackers.

RESULTS: At each stage, the absolute percentage error of the PPG was within 10% of the standard acceptable range. Further analysis using a linear mixed model, which accounts for individual variations, revealed that PPG yielded the best performance at the baseline low-intensity exercise. As the stages progressed, heart rate validity decreased but was regained during recovery. The reliability was moderate to excellent.

CONCLUSIONS: Low-cost trackers AMAZFIT Cor and Bip validity and reliability were within acceptable ranges, especially during low-intensity exercise among patients with ischemic heart disease recovering from cardiac procedures. Though using the tracker as part of the diagnosis tool still requires more supporting studies, it can potentially be used as a self-monitoring tool with precautions.

Matched MeSH terms: Wrist*

Fulltext Two new species of Urothoe (Crustacea, Amphipoda, Gammaridea) from the East Johor Islands Archipelago, Malaysia

Azman BA, Melvin CW

Zookeys, 2011.

PMID: 21594101 DOI: 10.3897/zookeys.87.817

Two new species of urothoid amphipods from Pulau Sibu and Pulau Tinggi, Johor are described and illustrated. The specimens of Urothoe sibuensis new species were collected by vertical haul plankton net and is distinctively different from other existing Urothoe species by these combination of special characters; similar gnathopods 1-2 with short and stout propodus expanded into poorly defined palms; large eyes and epimeron 3 smooth. Urothoe tinggiensis new species as collected using an airlift suction sampler at seagrass area is characterized by its different gnathopodal configuration with setose dactylus of 5th pereopod; eyes minute; carpus is wider than merus in the 5th pereopod; subquadrate coxa 4; merus and carpus of pereopods 6-7 are linear.

Matched MeSH terms: Wrist

Fulltext Morphology of distal radius curvatures: a CT-based study on the Malaysian Malay population

Singh TS, Sadagatullah AN, Yusof AH

Singapore Med J, 2015 Oct;56(10):562-6.

PMID: 25814075 DOI: 10.11622/smedj.2015130

The purpose of this study was to examine the differing curves of the volar distal radius of healthy Malaysian Malays, so as to obtain detailed morphological information that will further the understanding of volar plate osteosynthesis in Malaysian Malays.

Matched MeSH terms: Wrist Joint

Fulltext Sweet's syndrome in Crohn's colitis

Anwar S, Hishamuddin A, Khairul AJ, Shamsul AJ, Razlan H, Said MS

BMJ Case Rep, 2009;2009.

PMID: 21687021 DOI: 10.1136/bcr.01.2009.1438

We would like to report a case involving a 38-year-old woman who presented with knee and ankle swellings 2 weeks prior to admission. There were also multiple painful oral ulcers and a few skin sores on the wrist. She also had associated diarrhoea for 2 weeks. There was also marked loss of weight (6 kg in 2 weeks). Colonoscopy examination showed macroscopic and histopathological findings of Crohn's disease; however, skin histology showed extensive neutrophilic infiltration in the dermis, predominantly in the perivascular region. Her final diagnosis was Sweet's syndrome with Crohn's disease.

Matched MeSH terms: Wrist; Wrist Joint

Unusual self-electrocution simulating judicial electrocution by an adolescent

Murty OP

Am J Forensic Med Pathol, 2008 Jun;29(2):167-9.

PMID: 18520487 DOI: 10.1097/PAF.0b013e318177ea88

Electrocution is one of the rarest modes of suicide. In this case, one school going adolescent committed suicide by electrocution using bare electric wire. This is a rare case of suicidal death by applying live wires around the wrists, simulating the act of judicial electrocution. He positioned himself on armed chair and placed the nude wire loops from a cable around both wrists and switched on the current by plugging in to nearest socket by foot. There were linear electric contact wounds completely encircling around the both wrists. In addition to these linear electric burns all around wrists, there were electrical burns over both hands. This death highlights the need of supervision and close watch on children for self-destructing activities and behavior. This case also highlights unusual method adopted by adolescent to end his life.

Matched MeSH terms: Wrist Injuries/pathology

Fulltext Intraarticular fractures of the distal radius in young adults--a review of the outcome of treatment

Pan KL, Masbah O, Ali M

Med J Malaysia, 2001 Jun;56 Suppl C:19-25.

PMID: 11814243

A retrospective review of 30 intraarticular fractures of the distal radius in 27 patients was done. Only young adults aged between 18 and 40 were included. Road traffic accidents accounted for 25 of the cases (23 motorcyclists). Fourteen fractures were treated by closed reduction and a plaster cast. Sixteen fractures were treated by open reduction with internal fixation using a buttress plate or multiple Kirschner wires. At a mean follow-up of 17 months, 63% of the wrists had a satisfactory result and 37% unsatisfactory result. The main adverse factor was intraarticular congruity. The grip strength on the injured side averaged 56% of that of the uninjured side and the pinch strength averaged 73%. Most of the patients were able to return to their former occupation in an average of four months.

Matched MeSH terms: Wrist Injuries/therapy*

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