Double Trouble Post-Femoral Fracture – A Rare Case Report

been discussed extensively. Nevertheless, the simultaneous manifestation of FES and ACS after a single long bone fracture has never been reported. FES results from the extensive inflammatory response to fat emboli in the systemic microcirculation. The diagnosis is made with a set of specific clinical criteria. Treatment of FES is supportive. ACS ensues when a closed Osseofascial compartmental pressure exceeds the capillary perfusion pressure, leading to microvascular compromise. Fasciotomy is the only proven mode of treatment. We present a case of an 18 year-old-gentleman with closed traumatic femoral fracture, who then developed tense swelling of the ipsilateral thigh, Type I respiratory failure and axillary petechiae. A diagnosis of concurrent fat embolism syndrome and acute compartment syndrome of the thigh was made. High index of suspicion is essential for prompt diagnosis of concurrent FES and compartment syndrome as multiple complications that arise can be overlooked by unsuspecting practitioners who may be sidetracked by the multitude of presentations

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

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

A NOVEL NEWBORN CLUBFOOT SCREENING CHECKLIST TO IMPROVE DISEASE DETECTION : A PILOT STUDY

Clubfoot also known as Congenital Talipes Equino Varus (CTEV) is a common foot deformity with the prevalence rate of 4.5 per 1000 live birth in Malaysia. Early initiation of treatment has shown to have favorable outcome. Screening for foot deformities including clubfoot is often done by non-orthopaedic trained personnel during routine neonatal checkup. Hence, early detection plays an important role in treatment and outcome of this disease. In this study, we examined the detection of clubfoot with and without an objective assessment screening tool. This study has the potential to raise awareness regarding clubfoot amongst health care personnel and provide a guide to diagnose clubfoot especially in primary health care centers. This prospective study was conducted in Sarawak General Hospital, Kuching from November 2020 till June 2021. A total of 596 new-borns (n (number of foot) = 1192) were recruited in this study. 306 (n=612) were screened with Newborn Clubfoot Screening Checklist (NCSC) and 290 (n=580) were screened without checklist. 2 cases (n=2) of clubfoot were detected using the checklist and no case of inaccurate diagnosis in the checklist group. 14 cases (n=28) of inaccurate diagnosis in the group without checklist was identified with no cases of true positive clubfoot. Sensitivity of the NCSC was 100% (95% Confidence Interval (CI) 15.81% to 100%) and specificity was 97.7% (95% CI 96.69% to 98.47%). Newborn Clubfoot Screening Checklist aids in detecting CTEV and reduce inaccurate diagnosis

A rare case of unilateral postaxial duplicated foot in a developmentally normal child

Diplopodia, being a rare congenital disorder, is infrequently discussed in published texts. Most reported cases have accounted the involvement of duplicated preaxial digits with other associated organ system and physical deformities. Here, we present an unusual case of isolated diplopodia involving postaxial toes in a child with no other organ and physical abnormalities. Radiological studies revealed a set of 10-digit-duplicated foot over the lateral aspect of the native foot, complete with phalanges and its corresponding metatarsals as well as tarsals, supplied by an anomalous posterior branch of the popliteal artery. Definitive surgery was performed just before the child was learning to walk

A rare case of unilateral postaxial duplicated foot in a developmentally normal child

Diplopodia, being a rare congenital disorder, is infrequently discussed in published texts. Most reported cases have accounted the involvement of duplicated preaxial digits with other associated organ system and physical deformities. Here, we present an unusual case of isolated diplopodia involving postaxial toes in a child with no other organ and physical abnormalities. Radiological studies revealed a set of 10-digit-duplicated foot over the lateral aspect of the native foot, complete with phalanges and its corresponding metatarsals as well as tarsals, supplied by an anomalous posterior branch of the popliteal artery. Definitive surgery was performed just before the child was learning to walk

Modified French Osteotomy for Humeroradial Synostosis in a Child with Multiple Synostoses Syndrome: A Case Report

Congenital humeroradial synostosis can occur as an isolated clinical entity or as part of a syndrome. Bilateral elbow fixed flexion deformity is very incapacitating and challenging to treat. Here we present the case of a boy with fixed flexion deformity of both elbows due bilateral humeroradial synostosis. Other characteristic features of multiple synostoses syndrome were also present in this child, his elder brother and mother. We elected to improve the position of the right elbow by adapting the modified French osteotomy described by Bellemore et al

A nationwide, multihospital, cross-sectional, self-reported study: Knowledge, attitude and behaviour concerning the use of personal protective equipment among healthcare workers during the COVID-19 pandemic in Malaysia

Introduction: Personal protective equipment (PPE) is crucial in reducing the risk of hospital-acquired COVID-19 as health care workers (HCW)s are highly exposed to the virus during the management of patients with COVID-19. This study assesses the knowledge, attitude and behaviour of the HCWs towards the use of PPE during the COVID-19 pandemic in Malaysia. Materials and methods: This is a nationwide, online-based cross-sectional study utilising a self-administered questionnaire that was distributed to tertiary hospital HCWs in Malaysia, conducted between June and August 2020. Results: Forty-eight physicians, 66 nurses and 79 medical assistants participated in this study. 73.6% correctly recognised PPE components while 40.4% revealed correct hand hygiene practices and approximately 20% had misconceptions about the proper usage of PPE. Although 78.8% disclosed high compliance, 37.3% perceived that PPE protocol interferes with patient care. HCWs have suboptimal knowledge levels of hand hygiene. Age and poor behaviour were the independent predictors of good compliance with PPE. Conclusion: This study highlights the necessity to analyse discrepancies in PPE practice among HCWs and its contributing elements. Recognised barriers should be addressed to narrow the gap between knowledge, attitude and behaviour to improve compliance. The study findings would assist in developing an improved disease transmission control and prevention training protocols for HCWs as a preparation for possible infectious outbreaks in the future