External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis.

BACKGROUND: It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. MATERIALS AND METHODS: A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. RESULTS: Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25-5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. CONCLUSION: Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures

The Palaeolithic stone assemblage of Kota Tampan, West Malaysia

Archaeological excavations at Kota Tampan in West Malaysia recovered a large stone assemblage dated to 70 kya and believed to be associated with the presence of early Anatomically Modern Humans in Mainland Southeast Asia. New technological analysis demonstrates that almost all these stone artefacts result from early stage reduction through freehand and bipolar percussion

ASEAN Orthopaedic Association Education Committee - Orthopaedic curriculum for residency training 2019

In November 2013, Dr Dohar Tobing, who was the President of the ASEAN Orthopaedic Association at that time, organized a Seminar on Orthopaedic Education in Yogyakarta to discuss residency training in ASEAN. At this initial meeting the training program in each country was presented by representatives from each ASEAN country. Subsequently the ASEAN Orthopaedic Association established the Education Committee under the chairmanship of Professor Lee Eng Hin to develop a common syllabus/curriculum for all ASEAN countries based on minimum standards required to practice competently as a general orthopaedic surgeon. The main objective of having a common curriculum is to facilitate exchanges of residents and fellows amongst the ASEAN countries to increase their exposure to orthopaedic conditions in the region and improve their breadth and depth of knowledge and skills. The first meeting of the Education Committee was held in Cebu in November 2014 and the Committee has since met twice a year in May and November. Training programs in the ASEAN countries were discussed and a consensus was reached on the structure and length of the training program for the AOA curriculum. In May 2016, three workgroups were formed under the leadership of Professor David Choon, Dr Dohar Tobing and Professor Lee Eng Hin to develop the detailed curriculum in the following areas: a) General Orthopaedics/Trauma/Infection/Sports/Pathophysiology/Basic Science Lead: David Choon Members: Arturo C. Canete, Jean Pierre F. Leung, Apipop Kritsaneephaiboon, Maung Mg Htwe, Sabarul A. Mokhtar b) Adult Orthopaedics/Spine/Upper Limb/Foot & Ankle/Biomaterials/Biomechanics Lead: Dohar Tobing Members: Myint Thaung, Peter Lee, Yeo Sing Jin, Kamarul Ariffin Khalid, Khin Mg Myint, Azlina Abbas c) Pediatrics/Oncology Lead: Lee Eng Hin Members: Edward HM Wang, Kanyika Chamniprasas, Pornchai Mulpruek, Istan Irmansyah Irsan, Abdul Razak Sulaiman, Wan Faisham Nu’man Wan Ismail In addition to their contributions as workgroup members, the following individuals made substantial contributions in the following areas: Pathophysiology/Basic Science: Vivek Ajit Singh and David Choon General Ortho: Wan Faisham Nu’man Wan Ismail and Kamarul Ariffin Khalid Trauma: Arturo Cañete and Jean Pierre Leung Sports Medicine: Aung Myo Win Adult-Hip & Knee: Maung Mg Htwe and Myint Thaung Spine: Dohar Tobing Upper limb/Hand: Khin Mg Myint Foot & Ankle: Inderjeet Singh Paediatrics: Lee Eng Hin and Abdul Razak Sulaiman Oncology: Edward Wang and Istan Irmansyah Irsa