Hospitalized Muslim Trauma Patients Ibadah Disability Scale (HM[T]-IDS)

The HM[T]-IDS is an assessment tool developed to be used as a standard, objective evaluation scale to determine disability levels of Muslim trauma patients in performing religious physical cleansing and prayer during hospitalization and improve the deliverance of assistance they need. It is constructed based on the patients' and physicians' perspectives on the difficulties in performing religious duties. The use of this assessment tool is to assist physicians and hospital staff in scrutinizing the types of assistance required by the patients. The patients will be assessed based on five major disabilities/ difficulties, which include: A. Pain, B. Mobility, C. Extremity Involvement, D. Bandage/ Cast Application, and E. Toileting. These disabilities/ difficulties are organized in a form of a scoring sheet that utilizes a Linkert scale based on the severity of the disabilities/ difficulties. It was designed in two languages: English and Malay. The total score a patient can be given ranged between 5 and 25. From the total score obtained, the patients are categorized into four categories based on the assistance required by them: Category I (score of 5-8) - patients require least or no assistance, Category II (score of 9-14) - patients require assistance in the form of equipment or aids without the support of an assistant, Category III (score of 15-20) - patients require assistance in the form of equipment or aids with the support of an assistant, and Category IV (score of 21-25) - patients require full support from an assistant as well as supporting equipment. It is hoped that the new assessment tool can provide a new practical measure to evaluate disability among Muslim patients in performing their religious duties. It will provide a balance approach in trauma care

Ipsilateral proximal and distal radius fractures with unstable elbow joint: Which should we address first?

Simultaneous ipsilateral fractures involving radial head and distal end of radius are uncommon. We present our thoughts on which fracture should be addressed first. A 68-year-old lady sustained an ipsilateral fracture of the right radial head and distal end of radius following a fall. Clinically her right elbow was posteriorly dislocated and right wrist was deformed. Plain radiographs showed an intraarticular fracture of the distal end of radius and a comminution radial head fracture with a proximally migrated radius. Magnetic resonance imaging (MRI) showed no significant ligament injuries. We addressed her distal radius first with an anatomical locking plate followed by her radial head with a radial head replacement. Our rationale to treat the distal end radius: first was to obtain a correct alignment of Lister's tubercle and correct the distal radius height. Lister's tubercle was used to guide for the correct rotation of the radial head prosthesis. Correcting the distal end fracture radial height helped us with length selection of the radial head prosthesis and address the proximally migrated radial shaft and neck. Postoperative radiographs showed an acceptable reduction. The Cooney score was 75 at 3 months postoperatively, which was equivalent to a fair functional outcome. Keywords: Simultaneous ipsilateral fractures, Radius fractures, Irreducible elbow dislocation, Radial head, Radial head arthroplast