Letter to the Editor
Automated Cobb angle measurement in scoliosis radiographs: A deep learning approach for screening
Dear Editor,
Adolescent idiopathic scoliosis is the most common paediatric spinal deformity, impacting 1 in 300 children.1 In Singapore and other countries, national screening programmes have been established to detect scoliosis early, with the aim of using bracing to prevent progression to moderate or severe scoliosis, which may require surgical...
Letter to the Editor
The emergence of otter attacks in Singapore: A case series and strategies for management
Dear Editor,
Singapore is experiencing an unprecedented increase in the number of smooth-coated otters (Lutrogale perspicillata). Since 2017, the local otter population has more than doubled to at least 170. This has led to an increase in the number of otter-human attacks since 2021.1,2 While common animal attacks like dog...
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 and beverage operators that caused a loss of 16,197 man-hours in 2021 alone.2 Commonplace in Singapore and in parts of South and Southeast Asia is...
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 considered in patients with refractory symptoms.2 While there are multiple studies analysing short- and long-term follow-ups, there are no clear consensus regarding the minimum follow-up...
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 rehabilitation play an important role in determining the final outcome.
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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 and most important of all iatrogenic radial nerve palsy led many to favour a conservative approach.
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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 joint with the calcaneum and talonavicular joint with the navicular bone.
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Others
The Sixth SGH Lecture—Singapore: A New Venice of the 21st Century
Venice is one of the legendary cities of the world. Its beauty and physical setting make Venice unique. For almost 800 years, from 1000 AD to 1797, the Venetians were a separate people.
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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.
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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 extended the technique from stable diaphyseal fracture patterns to nearly all fractures of the femur except for fractures at the very end of the bone...
Others
Medicine and Surgery—History, Change and Challenge
Mr Koh Yong Guan, guest-of-honour; Dr Tan Ser Kiat, Master, Academy of Medicine; Dr K C Tan, Chairman, Chapter of Surgeons; Dr Robert Jalleh from Malaysia; Dr Idral Darwis from Indonesia; Dr P B Chacha, my esteemed partner; Dr John Isaac, Master of Ceremonies; fellow academicians, practitioners and friends,...
Others
Current Continuing Medical Education Provision in Singapore
It was in 1994 that as an overseas fellow of the College, I received a letter from Dr Peter Toghill, Director of Continuing Medical Education (CME), Royal College of Physicians of London, stating that the three Royal Colleges of Physicians in the UK have agreed to joint recommendation on...
Others
Early 21st Century Professional Practice: Change and Challenge
Today is a day of rejoicing for all of you, graduates, parents, relatives and loved ones. I can share in your joy and also a sense of relief that you have passed the first and for some, the second professional exam in your career.
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Others
9th Seah Cheng Siang Memorial Lecture: Gastric Cancer—Where are we now?
The last two decades have witnessed dramatic changes in the understanding of gastric cancer: a rapid decline in global incidence, its association with Helicobacter pylori gastritis, and the new information regarding its molecular biology. Nevertheless, gastric cancer remains the second commonest cancer in the world in terms of morbidity...
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 over his left leg and there was no trauma.
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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.
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Others
New Treatment and Research Strategies for the Improvement of Care of Cleft Lip and Palate Patients in the New Millennium
I have chosen as the title of my keynote address “New Treatment and Research Strategies for the Improvement of the Care of Cleft Lip and Palate Patients”. The reason for this is that despite the tremendous strides we have made over the past 50 years in the management of...
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 was 1.8 patients per million population.
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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.
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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 a ratio of 15 to 1.
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Others
Young Investigator’s Award: Induction of Apoptosis Following Traumatic Head Injury in Humans
The outlook for sufferers of severe head trauma is extremely poor. Some 20% of patients died before significant treatment can be administered, and nearly one quarter of patients end in a vegetative state with little potential for further progress.
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Others
8th Seah Cheng Siang Memorial Lecture: New Antithrombotic Agents
The tremendous interest in finding new anti-aggregating agents stems from the preeminent role that platelets play, not only in haemostasis and thrombosis, but also in atherogenesis and, be it less definitive, in arterial spasm. Compelling data from large-scale trials have established the role of platelet inhibitors in reducing coronary...
Others
3rd Yahya Cohen Lecture: The Role of the Myofibroblast-Like Cell in Hepatocellular Carcinoma—Host Defence?
It is indeed a great honour for me to be named the third Yahya Cohen lecturer and I would like to express my deepest thanks and appreciation to the Academy of Medicine Singapore for having selected me for this award. At this lecture, I would like to share with...
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 1819. To this small fishing village in the Riau Archipelago on the southern tip of the Malay Peninsula came traders and entrepreneurs from China, India...
Others
1998 Distinguished Academician Lecture: Hepatic Resection— A Western Perspective
Although debridement of portions of liver that prolapsed through war wounds was recorded from distant times, attempts at resection of a solid liver tumour were first reported in the latter part of the 19th century. When one considers the enormous challenges faced by surgeons of the time, without the...
Others
1998 Runme Shaw Memorial Lecture: Somatic Evolution of Cancer
The interpretation of cancer as a somatic evolutionary process involving genetic mutation followed by selection, goes back to the early years of this century. Boveri’s hypothesis put forward in 1914 that cancer was associated with abnormalities of the chromosomes and Tyzzer and Strong’s experiments of transplantable tumours in 1916...
Others
14th Gordon Arthur Ransome Oration: Continuity and Change
Deputy Prime Minister Lee Hsien Loong, Datuk Dr Yeoh Poh Hong, Dr Chee Yam Cheng, distinguished guests, ladies and gentlemen, I am deeply honoured to be invited to deliver the 14th Gordon Arthur Ransome Oration, following in the footsteps of previous illustrious speakers. I am particularly honoured that you...
Others
The Future of Medicine from the Standpoint of the Practising Paediatrician
From the time of recorded history of medicine, the doctor whether he be the ancient healer or the modern medical practitioner, the doctor had practised the art and science, on the basis of curing the patient when he has an illness. The doctor is sought out when the patient...
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 of a joint(s) or hypermobility is a feature found in normal individuals as well as in patients with connective tissue disorders such as Ehlers-Danlos syndrome,...
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 published in the literature to help surgeons in the decision making.
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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 medical problems. It is essential to establish the animal models used for a specific type of allogeneic tissue or organ transplantation prior to its clinical...
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 allografts, this is thought to be due to the relatively avascular structure and that low-freezing or freeze-drying for periods beyond three months reduces cellular immunogenicity.
This...
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 a fracture. The gold standard today is still the autogenous graft, though other solutions are the allograft, bone cement fashioned as a block, ceramics and...
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 studies on the healing of such defects, the ability to regenerate mature hyaline cartilage capable of withstanding daily functional stresses in the knee remains a...
Others
Address by the Master, Academy of Medicine, Singapore at the 2000 Annual Induction Dinner—Learn the Past, Ensure the Future
I am delighted to share this celebratory occasion with you. It is a time for congratulations all round not only to our new Fellows but also to their families and friends. No specialist trains by himself.
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Others
Response by the Representative of Inductees, Academy of Medicine, Singapore at the 2000 Annual Induction Ceremony—A Call to Patient Advocacy
I count myself fortunate to be allowed to join the ranks of the Academy. On behalf of my fellow inductees, may I extend a word of thanks for this honour. Thank you, also, for allowing me the privilege of delivering this Reply.
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Others
Address by the Master, Academy of Medicine, Singapore at the 2000 Annual Induction Ceremony—The EQ & IQ of Specialist Doctors
First, let me warmly welcome you to this pristine auditorium with its well preserved ceiling architectural details. Probably none of the new Fellows is old enough to remember that this was the old Allen and Farris Lecture Theatres of the Faculty of Medicine when it was at Sepoy Lines...
Others
8th SGH Lecture: Genomics, Talent and the Development of the Life Sciences Industry in Singapore
In a few months’ time, one of the most significant advances, possibly the most significant advance ever in the history of biology and medicine, will be achieved with the rolling out of the first draft of the map detailing the entire Human Genome.
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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.
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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, its incidence is quoted between 46% and 84% in various studies.
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Others
3rd Tan Tock Seng Hospital Oration: The Changing Fabric of Medicine—An Ethical and Social Revolution
The legacy of Tan Tock Seng Hospital began with the founding of the Pauper Hospital in Pearl’s Hill in 1844.
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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 articular surfaces, making them a complex group of injuries to treat.
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Others
10th Chapter of Surgeons’ Lecture: The Challenges in Surgery—Past, Present and Future, and in Search of the 4Cs
Firstly may I thank the Academy of Medicine and the Chapter of Surgeons for giving me this great privilege and honour to deliver the final lecture of the century for our series of Chapter of Surgeons lectures to close the 20th century and begin a new dawn in the...
Others
Opening Address by Dr Chee Yam Cheng, Master, Academy of Medicine, Singapore at the 33rd Annual Combined Surgical Meeting on 4 November 1999 at the COMB Auditorium
It is a pleasure to be present with you all at your 33rd Annual Combined Surgical Meeting for 1999 with less than 60 days to go into the new millennium. I applaud your organising committee under Dr Sarbjit Singh for a comprehensive and exciting programme which I trust you...
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 of his middle finger through the proximal interphalangeal joint (PIPJ), with an intra-articular comminuted fracture of the head of the proximal phalanx (Fig. 1a) and...
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 the displacement of bovine lumbar motion segments under torsion.
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Others
Funding and Future Diagnosis Related Group Development
Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore
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Others
Clinical Pathways or Case Management
Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore
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Others
Getting Clinicians Involved: The Australian Experience
Supplement on Casemix Conference Singapore 2001 held on 17-19 August 2001 in Singapore
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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 frequently produce a distinct variety of fracture (or fracture-dislocation) of the upper cervical spine, characterised by a bilateral avulsion-fracture through the neural arch of C2...
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.
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Others
The 4th Tan Tock Seng Hospital Oration: Challenge for the Medical Profession in the 21st Century
I am greatly honoured to speak at the 4th TTSH Oration following such distinguished luminaries like Dr Chew Chin Hin, Dr Chen Ai Ju and Professor N Balachandran. I also wish to thank all of you who are present this evening.
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Others
Alternate Modes of Financing Health Care Technology
Alternative financing of health care delivery is one of the most vexing problems facing medicine today. Intensive care in many ways is a perfect example of the core problems facing policymakers responsible for financing health care.
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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. Current therapies in use today are not only expensive but often do not adequately fulfil their intended purpose.
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Others
2nd Chapter of Paediatricians Lecture: The Future of Paediatrics in Singapore
When I was first invited to give this 2nd Chapter of Paediatricians Lecture by the Chapter, my obvious answer was no. I could think of quite a few other paediatricians more qualified and appropriate as speakers and hoped that my emphatic no would work.
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Others
10th Seah Cheng Siang Memorial Lecture: Going Places—A Rheumatological Odyssey
I am greatly honoured to deliver the 10th Seah Cheng Siang memorial lecture. I came into direct contact with Professor Seah in January 1965 when I joined the then Thomson Road General Hospital as his senior registrar.
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Others
5th Yahya Cohen Lecture: Angiosomes and Extension of Skin Flaps—Anatomic Study and Clinical Implications
I would like to express my gratitude to the Chapter of Surgeons and the Academy of Medicine, Singapore for the honour of presenting this 5th Yahya Cohen Lecture.
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Others
11th Chapter of Surgeons Lecture—The Art of Letting Go
These observations were made by a Persian mathematician some 900 years ago. His sentiments are self-evident but no less easy to accept especially for operating surgeons.
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Others
15th Gordon Arthur Ransome Oration: A Journey of Care—Mission Impossible?
I am deeply honoured by the invitation to deliver the 15th Sir Gordon Arthur Ransome Oration.
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Others
The Runme Shaw Memorial Lecture 2000—Treating VIPs in Washington
My lecture is about people, power, illness, and the patient-physician relationship. It is the personality of the politician or official, the ego elevation conferred by power, the repression of the thought of illness, and the combination of these factors, which leads to subversion of the patient-doctor relationship when a...
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 third of the radius and the distal end of the distal ulna. Movement of all the fingers and thumb were limited by pain.
This article is...
Others
12th Chapter of Surgeons Lecture: Shifting Paradigms in the Management of Breast Cancer—A Surgical Perspective
The recorded history of breast cancer management spans four millennia. This story about breast cancer management is also one about change, about resistance to and acceptance of change.
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Others
5th Tan Tock Seng Hospital Oration: Advances for Life
I am honoured and privileged to have been invited to deliver the 5th Tan Tock Seng Hospital (TTSH) Oration at the Opening of your 9th Annual Scientific Meeting. When I was invited, I hesitated for a moment as I have not been in active practice for quite a while,...
Others
6th Yahya Cohen Lecture: Visual Experience During Cataract Surgery
What a patient can see during his or her surgery can be a cause of anxiety for the patient. It may cause additional stress to what for most patients is already a traumatic event.
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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 counterpart. Indeed, it has been regarded by some authors as the primary stabiliser of the knee.
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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 year.
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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. These, together with the more disabling infective and inflammatory diseases of joints and the all-pervasive trauma damage joints in hundreds of millions of people in...
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 being an important structural component that contributes to shoulder instability.
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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 any bone formed by endochondral ossification (bones that develop from cartilage) may give rise to osteochondromas. Osteochondromas may arise in a solitary form or in...
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 its application as a valuable diagnostic tool in occult hip fracture evaluation.
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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 Southeast Asia.
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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 of the hand.
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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 the main components of the girdle.
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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 spine began more than a hundred years ago and initially consisted of wires, and/or rods attached to the spine.
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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 set up as an orthopaedic subspecialty.
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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 that paediatric orthopaedics was the first discipline within Orthopaedics to develop as a subspecialty.
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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 of Orthopaedic Surgery, National University of Singapore. The event was dedicated to the teachers, past and present, for their commitment to education.
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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, University of Malaya.
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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 the first orthopaedic cases were managed, but it must have been when modern medicine was introduced into Singapore, at the beginning of the twentieth century...
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 of our achievements will be the order of the day. This issue of the Annals carries 13 articles representing the different facets of our achievement.
This...
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 is often associated with osteoporosis due to chronic inflammation and disuse.
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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 need for hospitalisation and surgery, represents an important economic burden to society, in addition to its medical morbidities and social implications upon the patient and...
Others
Is Healthcare Competition Healthy?
There are many problems which all Health Ministers worry about. But we can generally boil them down to one common problem: “money no enough”.
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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.
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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 Mitra first asked me to deliver the lecture, I felt deeply honoured but was rather hesitant about accepting it – honoured as this annual lecture...
Others
Neonatology In Singapore: The Way We Were, The Way Forward
Over a span of 35 years of my working life, I have witnessed the growth of, and also grown together with, neonatology in Singapore. As I look at the present-day status of neonatology, it gives me a sense of achievement and accomplishment.
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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 Asian region.
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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 been clearly understood and therefore the management remains controversial.
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Others
Craniofacial Anomalies: Clinical and Molecular Perspectives
Cleidocranial dysplasia is an autosomal dominant skeletal disorder characterized by short stature, brachycephaly, delayed closure of the fontanelles and sutures, Wormian bones, midface hypoplasia, unerupted teeth, supernumerary permanent teeth, aplasia or hypoplasia of the clavicles, and other skeletal anomalies, such as hypoplastic iliac wings and brachydactyly.
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Others
Autoimmune Liver Disease in Children
Autoimmune liver disorders are inflammatory liver diseases characterised histologically by a dense mononuclear cell infiltrate, including plasma cells, in the portal tract (Fig. 1) and serologically by the presence of non-organ and liver-specific autoantibodies and increased levels of immunoglobulin G (IgG), in the absence of a known aetiology. They...
Others
HIV/AIDS in Children
The human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) epidemic in Asia has grown from a handful of cases to a major public health threat with wide-ranging medical, social and economic consequences. First gaining foothold among intravenous drug users and commercial sex workers, HIV quickly spreads to...
Others
Speech By Mr Lim Hng Kiang, Minister For Health and Second Minister for Finance, at the Opening Ceremony of the 36th Singapore-Malaysia Congress of Medicine on Thursday, 1 August 2002 at 1810 Hours at Raffles City Convention Centre
It gives me great pleasure to join you this evening at the 36th Singapore Malaysia Congress of Medicine and the 36th Annual Combined Surgical Meeting of the Chapter of Surgeons, Academy of Medicine, Singapore.
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Inaugural College of Obstetricians & Gynaecologists Lecture: Recent Developments in Obstetric Care and Maternal Fetal Medicine in Singapore
Has it done any good to pregnancy outcome as promised?
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Citation on Dr Andrew Chew Guan Kuan for Admission to Honorary Fellowship on 19 August 2004
It is indeed a great pleasure and honour to present to you Dr Andrew Chew Guan Khuan, who is already a Fellow of the Academy, for conferment of Honorary Fellowship of the Academy of Medicine, Singapore, the highest honour the Academy can bestow on any of its Fellows. Dr...
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Citation on Sir Donald Irvine – 17th Gordon Arthur Ransome Orator
It is my pleasure and privilege to introduce Sir Donald Irvine as the 17th Gordon Arthur Ransome Orator.
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Address by Master, Academy of Medicine, Singapore at the Opening Ceremony of the 38th Singapore-Malaysia Congress of Medicine and Induction Ceremony
It is my pleasure to welcome you to the Opening Ceremony of the 38th Singapore-Malaysia Congress of Medicine with participation of the Hong Kong Academy of Medicine and Induction Comitia of the Academy of Medicine, Singapore.
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1st College of Physicians Lecture: The Role of Internal Medicine as a Specialty in the Era of Subspecialisation
It humbles me to accept the invitation to give this lecture, the First College of Physicians Lecture, titled “The Role of Internal Medicine as a Specialty in the Era of Subspecialisation”. I believe I am given this honour as I am one of the few of a seemingly dying...
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15th Chapter of Surgeons Lecture: Surgeon of the New Millennium – Surgeon, Scientist and Scholar
Next year, we celebrate a hundred years of medical education in Singapore. We have come a long way since 1821 – from a small, sleepy medical outpost catering to the British Armed Forces in the Far East, to an excellent state-of-the-art medical hub.
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Standards and Revalidation or Recertification
In my Gordon Arthur Ransome Oration and other papers, I have described the nature and development of patient-centred professionalism, the key features of which are summarised in Figure 1.
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Continuing Professional Development – a Surrogate for Recertification?
The Hong Kong Academy of Medicine is a statutory body set up in 1993 with the objectives of fostering the development of postgraduate medical education and continuing medical education, the study and practice of medicine and its specialties, and medical research. It is concerned with the standard of specialist...
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Teaching and Learning of Professionalism in Medical Schools
There is now worldwide consensus that the elements of medical professionalism need to be enhanced and explicitly taught in medical schools. Medical schools in the United Kingdom (UK) have recently published a model for a core ethics curriculum.
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The Challenge of Teaching Professionalism
For the past 25 years, professionalisation, industrialisation, large-scale infusions of technology into the healthcare system and consumerism, to name a few factors, have definitely contributed to changes in the healthcare environment. At the same time, society has moved from modernity to post-modernity with the adoption of pluralism, relativism and...
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2004 Runme Shaw Memorial Lecture: Professionalism – A Concept in Need of Nurturing
It is a great honour to be invited to deliver the Runme Shaw Memorial Lecture. I am grateful to the Runme Shaw Foundation for their support of this lecture.
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17th Gordon Arthur Ransome Oration: Patient-centred Professionalism
When sickness strikes we all need doctors. People everywhere know that the quality of medical care can affect the outcome and possible consequences of illness, and at times mean the difference between life and death.
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The Role of Public Health and Occupational Physicians in the New Millennium
I want to thank the Chapter and organisers for honouring me with this kind invitation to speak to you. This millennium is only 4 years old, and yet I cannot see beyond the next decade, with things moving so rapidly.
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Flap Prefabrication – The Bridge Between Conventional Flaps and Tissue-engineered Flaps
Flap prefabrication is one of the most exciting areas in Plastic Surgery because of its bridging role between conventional reconstructive surgery and tissue engineering. Using this technique, tissues such as bone, cartilage, skin and muscle can be pre-assembled to form precise composites that will fit any defect.
This article is...
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 the inferior part of the clavicular head. The rarity of this disorder is highlighted by the experience of the senior author (SN Bell).
This article is...
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Refining Clinical Practice: Transforming Science Research into the Art of Medicine
I am humbled by the invitation given to me by Changi General Hospital to deliver this lecture at your 5th Annual Scientific Meeting with the theme “Frontiers of Medicine”. Thank you very much for the honour accorded me. Your CEO, Mr Udairam, and your CMB, Prof Fock Kwong Ming,...
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14th Chapter of Surgeons Lecture: Back to Basics
I am happy to be among old friends. As surgeons, we share a kindred spirit. I wish to thank the Academy for the honour of giving this lecture.
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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.
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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 the rib cage restricts its movement, the thoracic spine is less prone to degenerative changes in the disc and facet joints, which result in loss...
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 in the United States. Noyes et al reported that 78% of all ACL injuries were non-contact in nature and they most often occurred on landing...
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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. These pseudoaneurysms can present in various forms, such as a painful pulsatile mass, or even thigh compartment syndrome.
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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 and the accompanying ageing population, there has been an increase in the incidence of hip fractures from 1.17 per 1000 females >60 years old in...
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 as high as 50% of which 20% to 30% are in the proximal vein.
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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 a report by the American Academy of Orthopedic Surgeons on ACL reconstruction in October 2000, approximately 50,000 ACL surgeries were performed each year in the...
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 injury and increased risk of degenerative joint disease. Reconstruction of the ACL is a frequently performed procedure used to restore functional stability in ACL-deficient knees,...
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3rd College of Physicians’ Lecture – Translational Research: From Bench to Bedside and From Bedside to Bench; Incorporating a Clinical Research Journey in IgA Nephritis (1976 to 2006)
In our quest to pursue knowledge regarding a patient’s illness or seek a cure for the disease, as doctors we have to derive the necessary answers through physical examination of the patient and investigations either at the bedside or the laboratory. We engage in research activities into the patient’s...
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16th Seah Cheng Siang Memorial Lecture – The Changing Face of Cardiology Practice, Training and Research in Singapore
Professor Seah Cheng Siang was one of the most illustrious physicians of his era. During his professional career, he held the following positions: Head, Department of Medicine, Thomson Road General Hospital (1960-71); Head, Department of Medicine III at the Singapore General Hospital (1971-87); Master of the Academy of Medicine...
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3rd FY Khoo Memorial Lecture – Education, Professionalism, Outsourcing and the Future of Radiology
Radiology is undergoing unprecedented changes. Not only is the technology evolving rapidly, providing images of breathtaking anatomical clarity, but functional information has also become a reality.
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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 of 4 days’ duration.
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10th Yahya Cohen Memorial Lecture: Clinical Predictors in Obstructive Sleep Apnoea Patients with Computer-assisted Quantitative Videoendoscopic Upper Airway Analysis
Obstructive sleep apnoea (OSA) is a common disease, which is estimated to affect up to 2% of middle-aged women and 4% of middle-aged men.1 Various attempts have been made to obtain predictive indicators of OSA, ranging from clinical predictors using body mass index (BMI), Malampatti score2 and tonsil size...
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New Treatments for Atopic Dermatitis – Facts, Comparisons and Uncertainties
Atopic dermatitis is associated with asthma and allergic rhinitis, and presents with a typical morphology and distribution. Eighty-four per cent of cases of atopic dermatitis are mild, 14% moderate, and 2% severe.1 There are 10 randomised controlled trials, and 1 systematic review addressing the appropriate frequency of application of...
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5th College of Physicians Lecture – A Physician’s Odyssey: Recollections and Reflections
Allow me to thank you Mr President and your Council for asking me to deliver the 5th College of Physicians Lecture. Your President has suggested that with over 50 years of association with Medicine, the title be “In the Service of the Medical Profession”.
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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, correction of deformity and improved functional outcomes.
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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 medical education in the region is to produce doctors who are competent and able to meet the health needs of the community while also being...
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Brachytherapy – One Man’s Meat, A Personal Journey in Radiation Oncology
Dr Tan Kim Ping, Chairman for the Dr FY Khoo Memorial Lecture, Ladies and Gentlemen – It is a signal honour for me to deliver this Lecture, the second since the Inaugural Lecture last year. Sadly, it has been renamed a Memorial Lecture, as Dr FY Khoo passed away...
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Retinal and Cardiovascular Diseases: The “Common Soil” Theory
There is increasing evidence that retinal and cardiovascular diseases share a “common soil”. Risk factors for cardiovascular disease, such as hypertension, diabetes, hyperlipidaemia and cigarette smoking, are known to influence the development of a range of retinal diseases, including hypertensive retinopathy, diabetic retinopathy, retinal vein and artery occlusion, retinal...
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” of the cervical spine, hemivertebrae, and a right rigid convex thoracolumbar scoliosis (Figs. 1 and 2). She was diagnosed with Klippel-Feil syndrome (KFS) with congenital...
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4th FY Khoo Memorial Lecture 2008: Nasopharyngeal Cancer Workgroup – The Past, The Present and The Future
Thank you Madam Chairman. First, I would like to thank the Singapore Radiological Society and the College of Radiologists, Academy of Medicine Singapore for giving me the honor of delivering this the 4th FY Khoo Memorial Lecture, 2008.
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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 is a common problem in adults and it is called “medial” or “lateral epicondylitis” depending on the site of involvement.
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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.
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3rd College of Paediatrics and Child Health Lecture – The Past, the Present and the Shape of Things to Come…
In the post-war days of the 1950s, Singapore children were faced with problems of malnutrition and infectious diseases. There was poverty, overcrowded housing and lack of hygiene, and the social conditions were apparently appalling.
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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.
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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 the most common athletes sustaining the injuries.
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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 return to pivoting sports.
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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 absorption, load transmission, joint lubrication and congruency, nutrition, stability of the knee and facilitating the rotation of the opposing articular surfaces of the joint.
This article...
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 present yielded only 23 reported cases of patellar metastases.
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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.
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The Role of Electrophysiology in the Diagnosis and Management of Cervical Spondylotic Myelopathy
Cervical spondylosis is an extremely common condition managed by both physicians and surgeons in daily clinical practice. Cervical spondylotic myelopathy (CSM), resulting from longstanding degenerative impingement of the spinal cord and nerve roots by osteo-cartilagineous elements, is managed by conservative or surgical methods.1 While surgery is often performed in...
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Demands and Challenges of Modern Medicine
I am deeply honoured by the invitation to deliver the 16th Tun Dr Ismail Oration and I wish to thank the Master and Council of the Academy of Medicine of Malaysia for this rare privilege of addressing a distinguished gathering such as this, as previous illustrious orators had done...
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Happenings in Histopathology – A Post-World War II Perspective
During the past few decades, there have been many significant developments in the practice of histopathology, the specialty that is also referred to as anatomic pathology, surgical pathology, or simply as pathology without qualification. Those selected for review are grouped under 4 headings: new techniques, organisational developments, ethical and...
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Tumour Interstitial Fluid Pressure May Regulate Angiogenic Factors in Osteosarcoma
Solid tumours have states of raised interstitial fluid pressure (IFP) that cause significant changes to their physiology.1-3 We have previously shown that human osteosarcomas respond to this raised IFP by increasing their proliferative state. This proliferative state results in increased sensitivity to chemotherapy – a finding noted both in...
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Surgical Training – The Challenge of Change
President of the College of Surgeons, distinguished guests, friends, ladies and gentlemen. It is a great honour and a unique privilege for me to be invited to deliver a named lecture for a third time. Twenty years ago, I gave the first overseas Joint Lecture of the Academy and...
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Preparedness for Terrorism: Managing Nuclear, Biological and Chemical Threats
Preparedness for terrorism in the 21st century includes addressing the management of nuclear, biological and chemical (NBC) terrorism events. Understanding the terrorist threat and detecting clues that an attack has occurred are critical to reducing morbidity and mortality in the next decade. While high explosive events (bomb and blast)...
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5th College of Surgeons Lectureship: Surgery beyond Scalpels
The training of surgeons composed of two aspects: (1) Clinical skill and competence; (2) The ‘soft’ skill and ‘art’ of surgery. With the gradual introduction of residency programme into the surgical discipline, hopefully our clinical training will be more systematic, closely supervised, monitored, assessed and reassessed, and structured.
This article...
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The Evolution of Radiology from Paraclinical to Clinical
I would like to thank the Academy of Medicine and the Singapore Radiological Society for giving me the honour of delivering this year’s F Y Khoo’s Memorial Lecture. I believe that I am one of the few radiologists in Singapore who had the privilege of working with Dr F...
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 in males and 0.5% of all cancers in females with 217 case presentations in the period between 1998 and 2002.
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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 radial head. At 3 years of follow-up, he had regained full painless flexion and extension with loss of pronosupination.
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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 and custom-made prostheses.
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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 treated with extensive resection and durable reconstruction to provide long lasting function and mobility; in contrast, a patient with a very short life expectancy may...
Original Article
Vascular Endothelial Growth Factor (VEGF) is Expressed During Articular Cartilage Growth and Re-expressed in Osteoarthritis
Growth factors are polypeptides that direct cells to proliferate, differentiate, migrate or produce matrix. They exert their effects by interacting with specific receptors on the surfaces of cells.
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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. Ten per cent to 25% of diabetics developed foot ulcerations.
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3rd College of Surgeons Lecture — Bringing up Surgeons
I am greatly honoured to be given the privilege of delivering the 3rd College of Surgeons Lecture, especially when I have retired from surgery for 3 years. I am not in a position to contribute anything significant to your knowledge. There is an old Chinese saying that learning is...
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12th Yahya Cohen Memorial Lecture – The Cellular and Molecular Basis of Radiation-induced Sensori-neural Hearing Loss
Radiation-induced sensori-neural hearing loss (SNHL) has long been recognised as a complication of radiotherapy (RT) for head and neck tumours, if the auditory pathways had been included in the radiation fields. In Singapore, nasopharyngeal carcinoma (NPC) is common and the prevalence of SNHL after radiotherapy for NPC has been...
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11th Yahya Cohen Memorial Lecture – An In vivo Comparative Study of the Ability of Derived Mesenchymal Stem Cells in the Treatment of Partial Growth Arrest
It has been my greatest pleasure and honour to accept this, the 11th Yahya Cohen Memorial Lectureship on the anniversary of a half century of the Academy of Medicine.
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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 challenging with generally poorer outcomes and higher complication rates than that of acute repair. Current literature suggests this problem is still better tackled surgically although...
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Challenges and Pitfalls in the Introduction of Pharmacogenetics for Cancer
Pharmacogenetics, by definition, refers to the study of genetic differences in metabolic pathways which can affect an individual’s responses to drugs in terms of both therapeutic and adverse effects. In recent years, there have been several success stories such as HER2 for trastuzumab in breast cancer and VKORC1/CYP2C9 for...
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7th College of Physicians Lecture — The Changing Face of Medicine, Medicine – Past, Present and Future
When we think about medicine, just like we do about other things in life in the past and the present, we usually reflect on the good old days. On hindsight, the past always seems brighter than the present. Sometimes, it is worth looking back to see how things have...
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15th Yahya Cohen Memorial Lecture – The Relationship between the Air-bone Gap and the Size of Superior Semicircular Canal Dehiscence
Superior semicircular canal dehiscence (SSCD) can result in a characteristic constellation of vestibular and auditory features, including autophony, oscillopsia, and vertigo, and characteristic eye movements induced by sound and pressure changes. Patients with SSCD also show lowered thresholds for vestibular-evoked myogenic potentials (VEMPs) and a heightened sensitivity to bone-conducted...
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5th Chao Tze Cheng Memorial Lecture—Recent Developments in Informed Consent
The question of informed consent is a concern of recent origin and has engaged the mind of the medical profession here for only some 5 decades now. The term ‘informed consent’ is very much of American origin and the British have termed it as ‘a duty to warn’. This...
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7th Tan Tock Seng Oration: Surgical Excellence at TTSH—100 Years on and onward
Mr SR Nathan, our guest of honour, Mr Gan Kim Yong, Minister for Health, Madam Kay Kuok, Chairman of NHG Board, Board members, colleagues, distinguished guests, friends, ladies and gentlemen, I am greatly humbled by the honour and privilege to deliver the 7th TTSH Oration this evening. The sixth...
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8th FY Khoo Memorial Lecture 2012 —Why Radiologists Need Philosophy
Firstly, I wish to thank the Singapore Radiological Society and the College of Radiologists, Singapore for deeply honouring me with the invitation to give the FY Khoo Memorial Lecture for this year’s Annual Scientific Meeting. Today, I will present you an argument that radiologists should be conscious of philosophy...
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6th College of Surgeons Lecture The Philosophy of Balance: The Art of Healing
With the rise of high tech medicine, and emphasis on the scientific aspects of medicine, there is danger that we may lose the balanced approach to healing, and lose the benefit of the traditional medical wisdom and emotional support to improve the care of our patients.
This article is available...
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 case of a 16-year-old male presenting with acute calf abscess caused by an unusual organism, Fusobacterium necrophorum. Based on our review, this is the first...
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 as high as 10% to 26% at 6 months and cardiac-related death are common. Cardiac injury is potentially treatable and therefore early detection of myocardial...
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2013 Runme Shaw Memorial Lecture: Clinical Applications of Stem Cells in Modern Medicine—21st Century and Beyond
The rapid advancement of biomedical research in the recent years was propelled by a series of groundbreaking technological inventions and breakthrough discoveries. In this lecture, I will discuss about the scientific achievements that led to different eras of intense research with profound impact on biomedicine, focusing on the use...
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22nd Gordon Arthur Ransome Oration: Is Medicine Still an Art?
Distinguished guests and colleagues in medicine, I am deeply honoured to have been invited to deliver this 22nd oration in honour of Sir Gordon Arthur Ransome, and also humbled when I peruse the list of outstanding previous orators.
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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 functional outcome at 1 year.
Considerable differences of opinion exists regarding the choice between unipolar and bipolar designs. The main theoretical advantage of a bipolar over...
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 pathology lies anterior to the spinal cord – prolapsed intervertebral discs (PID), ossified posterior longitudinal ligament (OPLL), spondylodiscitis and retropulsion of fractured bony fragments. More...
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 pathology lies anterior to the spinal cord – prolapsed intervertebral discs (PID), ossified posterior longitudinal ligament (OPLL), spondylodiscitis and retropulsion of fractured bony fragments. More...
Others
24th Seah Cheng Siang Lecture: Seeing Better, Doing Better—Evolution and Application of Gastrointestinal (GI) Endoscopy
Man’s innate curiosity to study the internal organs of the human body dates back to the time of Hippocrates where basic speculums were invented to peer into the buccal cavity and vagina. The first instruments used to intubate the oesophagus and stomach in the 16th and 17th centuries were...
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 surgeries in COVID-19 patients requiring early orthopaedic surgery. This paper aims to provide evidence-based recommendations regarding the timing to proceed with early orthopaedic surgeries in...
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 of perilunate dislocations, the dorsal variant being by far the more prevalent.
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