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...

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top to...

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. This article is available only as a PDF. Please click...

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. This article is available only as a PDF. Please click on “Download PDF” on top...

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 only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view...

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 as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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 is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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,...

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. This article is available only as a PDF. Please click on “Download PDF” on top...

Colour image analysers have been extensively used in medical research since 1970 for histomorphometric studies. Image analysis gives more information and a better understanding of relative morphological changes in histological tissue sections. This is especially pertinent when different morphological areas are immunohistologically stained and present in contrasting colours or...

The understanding of blood supply is the cornerstone of successful tissue transfer in reconstructive surgery. This understanding has been derived largely from cadaveric dissections, combined with injections to outline the blood supply. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Metastatic spread is the principal reason of treatment failure in solid tumours. Surgery, radiation therapy and chemotherapy have not manifestly altered the prognosis for metastatic tumours. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Bacterial infections are devastating and potentially lethal complications of acute pancreatitis, responsible for up to 80% of deaths in the condition. Pathogenetic studies of acute pancreatitis imply that the disease is initially a non-bacterial insult and that secondary sepsis frequently occurs during the progression of pancreatitis, concomitant with the...

From a historical perspective, the first experimental pancreatitis was induced by Claude Bernard in 1856 by the injection of bile and olive oil into the canine pancreatic duct, thus producing an acute necrotising pancreatitis. Since that time, acute experimental pancreatitis has attracted thousands of researchers, who employ animal models...

Despite intensive research and intervention, trauma continues to be the leading cause of death during the first three decades of life in the USA, and currently ranks as the fourth leading cause of mortality with over 160,000 deaths each year. Mortality following trauma occurs in three distinct periods. This article...

In the evaluation of any new cancer treatment, the use of appropriate experimental animal tumour models to bridge the gap between in vitro discovery and its eventual clinical testing is an important step. In vitro experimentation does not take into consideration the complex biological interplay among the host tissues,...

Hepatic fibrosis and cirrhosis of the liver are complex diseases which, in man, may be caused by such varied factors as alcohol, hepatitis, schistosomiasis, biliary atresia, malnutrition and exposure to carcinogens and hepatotoxins. Although hepatic fibrosis is characterised by the massive deposition of extracellular matrix components in the liver...

The development of the human biliary system has been studied extensively. This knowledge is essential to the understanding of the pathogenesis of a spectrum of diseases termed “ductal plate malformation” (DPM). This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

The pancreatic islets of Langerhans were described by Paul Langerhans in 1869. They are distributed throughout the entire pancreas forming in adults approximately 1% of the pancreatic mass. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Hepatic stellate cells (HSC) are mesenchymal cells that are prominent in various forms of liver injury, in particular with cirrhosis or carbon tetrachloride-induced fibrosis. HSC are also being increasingly reported around and within hepatocellular cancers (HCC), and have been thought to be responsible for the capsule formation in these...

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...

Hypoxic tissue injury is not only caused by lack of oxygen as was previously believed. Now it is clear that tissue injury associated with hypoxia occurs to a large extent in the post-hypoxic reoxygenation period. This article is available only as a PDF. Please click on “Download PDF” on top...

Although a number of data support the notion that mast cell (MC) degranulation Is an important component of the tissue response elicited by ischaemia-reperfusion, the role of the gastrointestinal MC system in the pathophysiology of postischaemic mucosal barrier lesions is still poorly understood. The mucosal MCs (MMCs) of the...

Despite the recent developments of minimally invasive surgery, most cardiac surgery procedures still include ischaemic cardioplegic arrest and cardiopulmonary bypass. For decades the efforts of many researchers aimed at improvement of cardioplegic solutions to minimise ischaemic injury of the myocardium. This article is available only as a PDF. Please click...

Primary hepatocellular carcinoma (HCC) is one of the commonest cancers in some parts of the world including several areas in China. The geographically distinct distribution of HCC indicates there are some special factors which play key roles in hepatocarcinogenesis. This article is available only as a PDF. Please click on...

Hepatocarcinogenesis is a multistage and multifunctional process. Epidemiological studies indicate that contamination of food with aflatoxin B, (AFB,) and chronic infection with hepatitis B virus (HBV) are the major risk factors for human primary liver cancer. This article is available only as a PDF. Please click on “Download PDF” on...

Nitric oxide (NO) has been recognised as a nonadrenergic noncholinergic (NANC) inhibitory neurotransmitter at various sites in the nervous system. Its function as a NANC inhibitory transmitter has been documented in muscular and sphincter relaxation in the cardiovascular, digestive and urogenital system. This article is available only as a PDF....

Osteoarthritis is a common joint disease that involves destruction of articular cartilage. Magnetic resonance imaging (MRI) provides a sensitive imaging modality for the diagnosis of osteoarthritis. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The direct intraluminal (IL) administration of drugs into the intestine may have an important regional action and therefore clinical implications in the effective management of functional bowel disorders. We have previously published findings in the anaesthetised in vivo pig, that cisapride and mebeverine when infused IL into the sigmoid...

Liver transplantation (LTx) is the treatment of choice for many patients with end stage liver disease. However liver allograft availability prevents its widespread application. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

Blood pressure is an important parameter commonly measured in experimental studies using animal models. Various non-invasive techniques to monitor blood pressure have been described in the literature but most of these are applicable only to small animal models like the rat. This article is available only as a PDF. Please...

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...

Although the lung is mostly referred to as a respiratory organ it also exhibits a variety of metabolic functions, e.g. uptake, storage and/or synthesis and metabolism of compounds as different as biogenic amines, prostaglandins and angiotensin I. In spite of this vast metabolic capacity and the respiratory role of...

The application of the experimental approach to Science and Medicine has its roots in the 16th century. William Harvey (1578-1657), who demonstrated the passage of blood through the veins unidirectionally towards the heart as evidence for circulation of blood, was generally credited as one of the earliest physicians who...

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 article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top...

Before I go on to the scientific aspects of my talk, I would like to pay tribute to Dr Yahya Cohen. Dr Cohen was born in Singapore of Jewish parents. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top...

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view...

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...

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 as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF....

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...

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. This article is available only as a PDF. Please click...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top to...

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...

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. This article is available only as a PDF. Please click on “Download PDF” on...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download...

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. This article is available...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top...

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...

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 is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to view...

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...

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 is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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...

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. This article is available only as a PDF....

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...

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. This article is available only as a PDF. Please click on “Download...

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...

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,...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

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...

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...

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. This article is available only as...

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 article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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 PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view...

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 article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as...

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. This article is available only as a...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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...

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. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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. This article is available only as a PDF. Please click on “Download PDF” on top to...

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...

Cold therapy has been used for thousands of years by the ancient Egyptians and later Hippocrates. The beginning of cryosurgery in modern medicine was originally proposed by an English physician, James Arnott between 1819 and 1879 who described the use of extreme cold to cause tissue destruction. Arnott combined...

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...

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...

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...

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...

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...

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...

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. This article is available only as a PDF. Please click on “Download PDF” on...