Letter to the Editor
Managing and preventing severe hand injuries among sugarcane juicer operators
Dear Editor,
Of all hand injuries encountered at an emergency department, 54% are sustained in the workplace,1 in part contributed by occupational injuries among food...
Letter to the Editor
Optimum follow-up period of arthroscopic and mini-open rotator cuff repairs
Dear Editor,
Rotator cuff disorders are the most common cause of disability related to the shoulder,1 and rotator cuff repairs—via mini-open or arthroscopic techniques—are...
Original Article
Anthropometry of Anterior Cruciate Ligament in Singaporean Chinese
Anterior cruciate ligament (ACL) reconstruction is a technically precise and demanding operation. Attention to factors such as the tunnel position, graft selection, fixation and...
Original Article
Surgical Results of Open Reduction and Plating of Humeral Shaft Fractures
Management of humeral shaft fractures has been the subject of controversy (Böhler, Ekkernkamp and Muhr, Nast-Kolb and Schweiberer). The problem of non-union, wound infection...
Original Article
Operative Treatment of Displaced Talar Neck Fractures
Talus is a weight bearing bone with peculiar anatomy and blood supply. It forms the ankle joint with the medial and lateral malleoli, subtalar...
Others
A Case Report of Atasoy Antenna Procedure
The hook nail deformity is a relatively common problem after fingertip amputations. It is usually ignored but can be quite disabling.
This article is available...
Original Article
Double Level Fractures of the Femur Treated with Closed Intramedullary Nailing
Closed locked intramedullary nailing of the femur has become the accepted means of treating fractures of the femur. The use of locking nails has...
Others
Osteoid Osteoma after a Stress Fracture of the Tibia: A Case Report
A 24-year-old man complained of left leg pain following 3 months of infantry training 6 years ago. There was no previous complaint of pain...
Others
Reconstruction of a Supinated Hypoplastic Thumb with Combined Huber Transfer and Derotation Osteotomy: A Case Report
A 6-year-old Chinese girl presented with a deformity of the left thumb since birth. Her father has a similar deformity.
This article is available only...
Original Article
Transscaphoid Perilunate Fracture/Dislocations—Results of Surgical Treatment
Transscaphoid perilunate fracture/dislocations are relatively uncommon injuries of the wrist, constituting about 3% of all carpal injuries. However, it accounts for more than half...
Others
Extraarticular Villonodular Synovitis of the Tendoachilles: A Case Report
Pigmented villonodular synovitis is a progressive synovial lesion of uncertain aetiology associated with synovial-lined tissues of the joints, tendon sheaths and bursae. The incidence...
Others
Embolisation of a Leaking Pseudoaneurysm of the Main Artery Supplying a Replanted Arm: A Case Report
Pseudoaneurysms are conventionally treated by surgery. In recent years, non-surgical methods are being considered, including embolisation with wires, coils or gelfoam and anticoagulation.
This article...
Others
Comparison of First Carpometacarpal Joint Arthrodesis with Contralateral Excision Arthroplasty in a Patient with Bilateral Saddle Joint Arthritis: A Case Report
The carpometacarpal joint (CMCJ) of the thumb is commonly afflicted with degenerative arthritis. Of the patients seeking surgical treatment, post-menopausal women outnumber men by...
Others
9th Chapter of Surgeons’ Lecture: The Orthopaedic Surgeon: Historical Perspective, Ethical Considerations and the Future
The legacy of caring and humanitarianism has been the mission of the medical profession since the founding of Singapore by Sir Stamford Raffles in...
Original Article
A Study of Joint Mobility in a Normal Population
Joint mobility varies between individuals and factors such as age, sex, race and heredity influence the range of motion of a joint. Excessive mobility...
Original Article
Delayed Amputation in Lower Limb Trauma: An Analysis of Factors Leading to Delayed Amputation
The decision whether to amputate or to attempt a limb salvage procedure in a mangled extremity is a difficult one. Numerous protocols have been...
Original Article
Establishment of Animal Models Using Experimental Rats for Allogeneic Tissue Transplantation and Quantitative Flow Cytometric Detection of Immunochimera
Allogeneic tissue and organ transplantation has long been an important medical issue, as it provides an effective treatment alternative for a broad spectrum of...
Original Article
The Effect of Storage at -70°C and -150°C on the Torsion Properties of the Canine Femur
Allograft transplantation of bone has been established as a viable and useful reconstructive procedure when limb salvage is the option of choice. For bone...
Original Article
Use of Titanium Prosthesis to Bridge a Vertebral Gap in the Spine—A Preliminary Experimental Study
Bridging a vertebral gap in the spine is one of the commonest problems facing the spine surgeon after dealing with a tumour, infection or...
Original Article
The Results of Autogenous Tibial Periosteal Transplants for Full Thickness Cartilage Defects in the Knee Joints of Pigs
Articular cartilage injuries to the knee are commonly seen by team doctors, sports physicians and orthopaedic surgeons. Despite many clinical as well as experimental...
Original Article
Use of Low Molecular Weight Heparin for Prevention of Deep Vein Thrombosis in Total Knee Arthroplasty—A Study of its Efficacy in an Asian Population
The role of thromboprophylaxis in total knee replacement (TKR) remains controversial. In several reports, the incidence of deep vein thrombosis (DVT) has been significant.
This...
Original Article
Deep Vein Thrombosis after Total Knee Replacement
Western literature reports a very high incidence of deep vein thrombosis in its population especially after orthopaedic surgery. In total knee replacement without prophylaxis,...
Others
Management of Growth Arrest with Tissue-engineered Cells
Before I go on to the scientific aspects of my talk, I would like to pay tribute to Dr Yahya Cohen. Dr Cohen was...
Original Article
Surgical Results of Intercondylar Fractures of the Adult Femur
Fractures of the intercondylar region of the femur often resulted from high velocity accidents. This would lead to increased comminution and involvement of the...
Others
A Case Report of Total Finger Joint Replacement Arthroplasty After Traumatic Amputation
A 41-year-old Chinese man had his dominant thumb, index and middle fingers caught by a wood-cutting machine while at work. He sustained a near-amputation...
Others
Re: Rikhraj I S, Tan C T, Tan S K, Teoh S H, Hastings G W. Use of Titanium Prosthesis to Bridge a Vertebral Gap in the Spine–A Preliminary Experimental Study. Ann Acad Med Singapore 1999; 28:20-4
In a recent issue of the Annals, Academy of Medicine, Singapore the above-mentioned paper was published. Figures 6 and 7 of the paper plot...
Original Article
Biomechanical Study of C2 (Axis) Fracture: Effect of Restraint
In human, the occipito-atlanto-axial (C0-C1-C2) joint complex is an important region of the spine and often susceptible to impact injury in trauma. Traffic accidents...
Original Article
Results of Distal Radial Fractures Treated by Intra-focal Pin Fixation
Unstable fractures of the distal radius remain a challenge to orthopaedic surgeons. Unsatisfactory results are often associated with significant malunion.
This article is available only...
Review Article
An Introduction to Biodegradable Materials for Tissue Engineering Applications
The concept of tissue engineering arises from the need to develop an alternative method of treating patients suffering from tissue loss or organ failure....
Others
Galeazzi-Equivalent Fracture in Children Associated with Tendon Entrapment—Report of Two Cases
A 12-year-old boy fell whilst running. On examination, there was swelling and deformity of the wrist and there was local tenderness of the distal...
Original Article
The Posterior Cruciate Ligament: An Anthropometric Study in Asians and Evaluation of Safe Limits for Bony Tunnel Creation During Reconstruction
The posterior cruciate ligament (PCL) provides the main restraint to posterior translation of the tibia on the femur and is stronger than its anterior...
Original Article
Advances in Surgical Treatment of Osteoporotic Fractures of the Spine
Osteoporosis is an important cause of fractures in the elderly. In the USA alone, at least 1.3 million fractures are attributed to osteoporosis a...
Commentary
The Bone and Joint Decade 2000-2010
With the ageing population, degeneration of joints and osteoporosis and the resultant disability pose big public health problems in many countries of the world....
Others
Magnetic Resonance Arthrography of the Labral-Ligamentous Complex of the Shoulder: An Update
Shoulder instability is a frequently encountered clinical problem in young active people following injury, particularly in athletes. The labral-ligamentous complex is increasingly recognised as...
Others
A Deceptive Cervical Lymph Node: A Solitary Spinal Osteochondroma
Osteochondromas are cartilage-capped bony exostoses that arise mainly from the metaphyses of long bones from a lateral displacement of the epiphyseal growth cartilage, but...
Original Article
Limited Magnetic Resonance Imaging (MRI) and the Occult Hip Fracture
Worldwide, in the past decade, the application of magnetic resonance imaging (MRI) has increased tremendously in the management of musculoskeletal trauma. Not least is...
Original Article
Extremity Osteosarcoma—A Southeast Asian Experience
Osteosarcoma is a highly malignant bone cancer occurring primarily in young patients. Although rare, it is still the commonest primary bone cancer seen in...
Review Article
Towards a Splint-free Repair for Flexor Tendon Injuries
The most problematic area in flexor tendon injuries is zone two. This zone is prone to injury as it is in the grasping part...
Review Article
Biomechanics of the Shoulder
The shoulder is a complex of 5 articulating surfaces that together form the shoulder girdle. The glenohumeral joint together with the scapulothoracic articulation form...
Review Article
Instrumentation in Spinal Surgery
Spinal instrumentation is defined as the use of mechanical devices that enhance or restore the segmental stability of the spine. Internal fixation of the...
Review Article
The Growth and Development of Orthopaedic Sports Medicine in Singapore
Orthopaedic sports medicine in Singapore took form as a subspecialty of orthopaedic surgery over a number of years. Several individuals contributed to it being...
Review Article
Paediatric Orthopaedics in Singapore
The name “Orthopaedic Surgery” is derived from the words “orthos” (meaning straight or to straighten) and “paido” (meaning child). Thus, it is not unexpected...
Others
Addresses at the 50th Anniversary Celebration of the Department of Orthopaedic Surgery, National University of Singapore on 5 April 2002
Over 200 guests were gathered at the Fullerton Hotel Ballroom on the 5th of April 2002 to commemorate the 50th anniversary of the Department...
Others
History of the Singapore Orthopaedic Association
The University of Malaya in Singapore was established in 1949. With this, the King Edward VII College of Medicine became the Faculty of Medicine,...
Others
History of the Orthopaedic Specialty in Singapore
When the practice of orthopaedic surgery first began in Singapore, it was not a specialty in itself. There are no records as to when...
Editorial
50th Anniversary Celebrations—Golden ……. but all is not gold
On an occasion such as this—the 50th anniversary of the inauguration of orthopaedic surgery as a specialty service in Singapore—acclaim, commendations, praise and endorsement...
Others
A Case Report of Neurologically Unstable Fracture of the Lumbosacral Spine in a Patient with Ankylosing Spondylitis
Ankylosing spondylitis is associated with progressive ossification of the spinal ligaments and ankylosing of the facet joints leading to a totally stiff spine. It...
Original Article
Osteoporotic Hip Fractures in Singapore—Costs and Patient’s Outcome
Singapore is facing a rapidly ageing population. Osteoporosis, which is an age-related illness, will become an increasing problem. Osteoporotic hip fracture, because of the...
Original Article
Outcomes of Acute Arthroscopic Repair and Conservative Treatment Following First Traumatic Dislocation of the Shoulder Joint in Young Patients
Traumatic dislocation of the shoulder is a serious problem especially in active and young patients. Shoulder instability and recurrent dislocation hinder patient activities.
This article...
Others
From Genesis to Genes
I would like to thank the Singapore Orthopaedic Association (SOA) for inviting me to deliver this year’s SOA lecture. When your President, Dr AK...
Others
Book Review
A lot of young orthopaedic surgeons embark on research projects with little guidance. This book is especially directed towards young investigators in the Southeast...
Others
Significance of the Lateral Epiphysis of the Acetabulum to Hip Joint Stability
Developmental dysplasia of the hip (DDH) remains one of the most difficult disorders to understand and treat in Paediatric Orthopaedics. The aetiology have not...
Original Article
Condensing Osteitis of the Medial Clavicle – An Intermediate-term Follow-up
Condensing osteitis of the clavicle is an idiopathic condition affecting the medial end of the clavicle, and is characterised by sclerosis and expansion of...
Others
Plantar Dislocation of Lateral Tarsometatarsal Joint: A Case of Subtle Lisfranc Injury
Lisfranc fracture dislocations are uncommon injuries and the diagnosis may be easily missed. There are several variations and we present one such variant.
This article...
Others
Thoracic Myelopathy Secondary to Ligamentum Flavum Ossification
Acquired thoracic spinal canal stenosis is an uncommon condition compared to myelopathy and radiculopathy frequently seen in the cervical and lumbar spine, respectively. Because...
Original Article
Rising Trend of Anterior Cruciate Ligament Injuries in Females in a Regional Hospital
Female athletes are at a greater risk for injuries involving the anterior cruciate ligament (ACL) than their male counterparts in high schools and colleges...
Others
Profunda Femoris Artery Pseudoaneurysm Presenting with Triad of Thigh Swelling, Bleeding and Anaemia
Pseudoaneurysms of the profunda femoris artery have been reported following blunt and penetrating trauma to the thigh, and orthopaedic procedures of the proximal femur....
Original Article
Cancellous Screw Fixation for Femoral Neck Fractures: One Hundred and Sixteen Patients
The incidence of hip fractures rises with increasing age, doubling for each decade beyond 50 years of age. With the increase in life expectancy...
Original Article
Deep Vein Thrombosis Following Hip Fracture and Prevalence of Hyperhomocysteinaemia in the Elderly
Western literature reports a high incidence of deep vein thrombosis (DVT) after hip surgery in the absence of prophylaxis. It is reported to be...
Original Article
Septic Arthritis after Arthroscopic Anterior Cruciate Ligament Reconstruction
Arthroscopic-guided reconstruction of the anterior cruciate ligament (ACL) is now recognised as the preferred reconstructive option in restoring anterior knee joint stability. According to...
Original Article
Morbidity Following Anterior Cruciate Ligament Reconstruction Using Hamstring Autograft
Rupture of the anterior cruciate ligament (ACL) impairs the stability of the knee, resulting in difficulty with athletic performance, increased risk of subsequent meniscal...
Others
Necrotising Fasciitis and Traditional Medical Therapy – A Dangerous Liaison
The first case was a 54-year-old lady, with a history of insulin-dependent diabetes mellitus and hyperlipidaemia, who presented with bilateral hand pain and stiffness...
Original Article
A Review of Clinical Pathway Data of 1663 Total Knee Arthroplasties in a Tertiary Institution in Singapore
Total knee arthroplasty (TKA) has been established as an effective treatment modality for patients with symptomatic knee arthritis. It provides predictable decrement in pain,...
Letter to the Editor
Assessment of Medical Graduates Competencies
Medical professional proficiency comprises a set of skills, knowledge, and attitudes necessary to efficiently accomplish the practice of medicine. The major aim of undergraduate...
Images in Medicine
“Bone Block” and Congenital Spine Deformity
A 14-year-old female who presented with a limited range of neck motion with various congenital vertebral anomalies that included improper segmentation or extensive “fusion”...
Original Article
Autologous Bone Marrow Plasma Injection after Arthroscopic Debridement for Elbow Tendinosis
Elbow tendinosis is a term used to describe a syndrome of pain involving the extensor or flexor tendon origin of the forearm musculature. It...
Letter to the Editor
Primary Hydatid Disease of the Humerus
Hydatid disease is a parasitic tapeworm infection caused by Echinococcus species. E.granulosus and E.alveolaris are the most common causes of hydatid disease in humans.
This...
Original Article
Recurrent Patellar Dislocation: Reappraising our Approach to Surgery
Traumatic patellar dislocations affect mainly adolescents and young adults. Up to 44% of patients will develop recurrent dislocation.
This article is available only as a...
Original Article
Triple Endobuttton Technique in Acromioclavicular Joint Reduction and Reconstruction
Acromioclavicular joint (ACJ) dislocation is a common injury often affecting young athletes. Cyclist, ice hockey players, weight lifters, rugby players and martial exponents are...
Original Article
Return to Sports After Anterior Cruciate Ligament Reconstruction – A Review of Patients with Minimum 5-year Follow-up
Complete anterior cruciate ligament (ACL) rupture results in a mechanically unstable knee. ACL reconstruction is recommended in athletes to help restore knee stability for...
Original Article
Clinical Evaluation of Arthroscopic-assisted Allograft Meniscal Transplantation
The menisci of the knee are fibro-cartilaginous structures essential for the normal biomechanic of the knee joint. They play a critical role in shock...
Letter to the Editor
Renal Cell Carcinoma Bony Metastasis Treatment
Patellar metastases are extremely rare, ironically, primary tumours of the patella are more common than metastatic disease. A Medline search from 1960 to the...
Review Article
Osteochondral Lesions of the Talus
Osteochondral lesions of the talus are a known cause of chronic ankle pain. They are frequently found in the active population after ankle sprains.
This...
Original Article
The Natural History and Prognosticative Factors of Adult Extremity Soft Tissue Sarcomas: An Asian Perspective
Soft tissue sarcomas (STSs) are extremely rare tumours, making up about 1% of all malignancies. In Singapore, they accounted for 0.7% of all cancers...
Letter to the Editor
An Unexpected Outcome following Radial Head Excision for Jeffrey Type II Fracture-Dislocation of the Proximal Radius in a Child
We present a case of a 10-year-old child who sustained a traumatic fracture-dislocation of his proximal radius and subsequently underwent surgical removal of the...
Original Article
Effect of Autologous Mesenchymal Stem Cells on Biological Healing of Allografts in Critical-sized Tibial Defects Simulated in Adult Rabbits
Bridging of large bone defects is a challenging problem in orthopedic and reconstructive surgery. Options include vascularised bone autografts, non-vascularised bone autografts, allografts, bioceramics...
Original Article
The Need for a System of Prognostication in Skeletal Metastasis to Decide Best End-of-life Care – A Call to Arms
Decisions regarding potential surgery for metastatic disease are influenced by estimates of patient survival. For example, patients with long life expectancy may be appropriately...
Original Article
Effectiveness of Vacuum-assisted Closure (VAC) Therapy in the Healing of Chronic Diabetic Foot Ulcers
Diabetes mellitus is a common problem in Singapore, with an incidence of 8.2% in the local population aged between 18 and 69 in 2004....
Others
Chronic Achilles Tendon Rupture Treated with Two Turndown Flaps and Flexor Hallucis Longus Augmentation – Two-year Clinical Outcome
Chronic Achilles tendon rupture is a disabling condition resulting in ankle pain, weakened ankle plantarflexion and abnormal gait. Management of chronic ruptures is technically...
Letter to the Editor
Lemierre’s Syndrome: An Unusual Cause of Calf Abscess
Dear Editor,
Lemierre’s syndrome is a rare disease caused by Fusobacterium necrophorum, a Gram-negative anaerobic bacillus that is associated with oropharyngeal infections. We describe a...
Original Article
Electrocardiograph Changes, Troponin Levels and Cardiac Complications After Orthopaedic Surgery
Following orthopaedic surgery, approximately 5% of patients sustain cardiac complications which leads to increased morbidity and mortality. The mortality rate after hip fracture is...
Original Article
Unipolar versus Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly: Is There a Difference?
Hip hemiarthoplasties are commonly performed for displaced femoral neck fractures. The advantages of hemiarthroplasty over internal fixation include earlier mobility, less reoperations and better...
Letter to the Editor
Use of the Sole Flap to Convert an Above Knee Amputation to a Below Knee Amputation in Trauma
Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are performed for decompression of the spine when the primary compressive...
Letter to the Editor
Single-level Anterior Corpectomy with Fusion versus 2-level Anterior Cervical Decompression with Fusion: A Prospective Controlled Study with 2-year Follow-up Using Cages for Fusion
Anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF) are performed for decompression of the spine when the primary compressive...
Commentary
Optimum early orthopaedic surgery in COVID-19 patients
Multiple guidelines have been established regarding the management of COVID-19 patients. However, there remains a paucity regarding specific guidelines on the optimal timing for...