Stage Protocol in the Management of Infection Following Plating of the Tibia

Introduction: Anterior border of the tibia is covered only by a thin layer of protective tissue. Plating of the tibia often results in wound complication and infection if the injury to this area is not recognized. We review our results of managing infection following plating of the tibia using a protocol base on the status of bone healing and the presence of bone or soft-tissue defect. Methods: Eight cases of infection following plating of the tibia were managed according to stage procedures protocols and classification, which is based on the state of bony union and the defect following wound debridement. The soft-tissue defects were managed with local flaps, and the bone defects were managed with Illizarov bone transport. Results: Three patients had more than one bacterium isolated. Gram negative organisms were isolated from seven patients. Methicillineresistant Staphylococcus aureus was isolated in two patients. All patients achieved union with a mean union time of seven months. The infections were controlled in seven patients. One patient had minimal sinus discharge but refused further treatment. Conclusions: The stage protocol for the management of infection following plating of the tibia is practical and produces excellent results

Allergic Reaction Following Insertion of Vancomycin Loaded in Bone Cement

Vancomycin bead is an important ancillary treatment for osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA). However, red-man syndrome, which can be a life-threatening complication of vancomycin, may occur from the use of vancomycin beads albeit rarely. We report our first case of red-man syndrome caused by vancomycin bead's insertion for chronic osteomyelitis. Symptomatic treatment was not effective and removal of the vancomycin beads seems to be the best treatment for this condition

Early Functional and Radiological Outcomes Between Plaster Cast and Fiberglass Cast in Stable Thoracolumbar Burst Fracture

Introduction: Burst fracture results from compression failure of both the anterior and middle columns under substantial axial loads. Conservative treatment was a method of treatment for fractures without neurological deficit. This cross sectional study was designed to evaluate the functional and radiological outcome of patient with thoracolumbar burst fracture treated conservatively. Methods: 40 cases were recruited from January 2013 till December 2015. They were followed-up with minimum period of 1 year and evaluated for the functional (Oswetry Disbility Index) and radiological outcomes (kyphotic angle deformity and anterior body compression). Results: 20 patients were treated with body cast made form plaster of Paris and remaining 20 patients with fiberglass cast. In plaster of Paris group, mean kyphotic angle deformity at last follow up was 16.60 ± 2.95 with a mean improvement 4.45 degree and anterior body compression at last follow up was 30.35% ± 10.2 with mean improvement of 9.30%. In fiberglass group, mean kyphotic angle deformity at last follow up was 15.55 ± 3.38 with a mean improvement 7.25 degree and anterior body compression at last follow up was 25.90% ± 7.81 with mean improvement of 3.45%. The functional outcome showed Oswetry Disability Index (ODI) score in plaster of Paris group was 23.70 (SD = 7.82) and in fiberglass group was 18.50 (SD = 5.94). Conclusions: Application of body cast using a fiberglass material give better radiological outcome hence less pain, more functional and higher patient’s satisfaction as compared to plaster of Paris

Primary Fixation of AO Type-C Fracture of the Distal Radius with Volar Locking Plates. A Cross-Sectional Study of Patient Rated Outcomes at Hospital Tengku Ampuan Afzan

Introduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate. Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire. Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score. Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes

Stage Protocol in the Management of Infection Following Plating of the Tibia

Introduction: Anterior border of the tibia is covered only by a thin layer of protective tissue. Plating of the tibia often results in wound complication and infection if the injury to this area is not recognized. We review our results of managing infection following plating of the tibia using a protocol base on the status of bone healing and the presence of bone or soft-tissue defect. Methods: Eight cases of infection following plating of the tibia were managed according to stage procedures protocols and classification, which is based on the state of bony union and the defect following wound debridement. The soft-tissue defects were managed with local flaps, and the bone defects were managed with Illizarov bone transport. Results: Three patients had more than one bacterium isolated. Gram negative organisms were isolated from seven patients. Methicillineresistant Staphylococcus aureus was isolated in two patients. All patients achieved union with a mean union time of seven months. The infections were controlled in seven patients. One patient had minimal sinus discharge but refused further treatment. Conclusions: The stage protocol for the management of infection following plating of the tibia is practical and produces excellent results.</jats:p

Allergic Reaction Following Insertion of Vancomycin Loaded in Bone Cement

Vancomycin bead is an important ancillary treatment for osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA). However, red-man syndrome, which can be a life-threatening complication of vancomycin, may occur from the use of vancomycin beads albeit rarely. We report our first case of red-man syndrome caused by vancomycin bead's insertion for chronic osteomyelitis. Symptomatic treatment was not effective and removal of the vancomycin beads seems to be the best treatment for this condition.</jats:p

Utilization of Ultrasonic Waves for Insect Control: A Systematic Review and Meta-Analysis

Ultrasonic waves refer to sound waves with a frequency higher than the upper limit of human hearing. Ultrasonic waves are currently being explored to control insect pests. The idea is to use ultrasonic frequencies that are annoying or unpleasant to certain insects, causing them to die, become damaged, change their behavior, or avoid certain areas. Different insects may respond to ultrasonic frequencies differently. Ultrasonic frequencies ranging from 20 to 65 kHz are often studied for insect control, if not more. The effectiveness of ultrasonic devices in controlling insects can be limited by factors such as the type of insect, the surrounding environment, and the range and device of the ultrasonic waves