10^th Global Orthopedicians Annual Meeting July 03-04, 2017 Kuala Lumpur, Malaysia

Biography:

Professor Doctor Joao Manuel D. A. Rollo has a degree in Materials Engineering, Master’s degree and PhD in Sciences, is currently a Professor at the University of Sao Paulo (USP) in Brazil.

Abstract:

Osteoporosis is an osteometabolic disease characterized by the loss of bone mass and an increase in fracture risk. The evaluation of microarchitecture resistance of the trabecular bone may contribute in determining the risk and preventing fractures associated to osteoporosis. A total of 90 human trabecular vertebrae were dried (dehydrated), distributed proportionally by the regions T12, L1 and L4 in a total of 30 vertebrae segments extracted from individuals (human cadavers of Brazilian nationality) and classified through a bone quality index (BQI) as normal, osteopenic and osteoporotic bones through the ultrasonometry of the calcaneous bone. The nanoindentation technique allowed the evaluation of the elastic module (E) and nanohardness (H) in one single trabecula in the respective groups. The results obtained from the groups do not show any meaningful differences when analyzed by the ANOVA Test (p = 0.682 for E and H) or in multiple comparisons by Turkey Kramer HSD (p = 0.915 between normal / osteopenic, p = 0.932 between normal / osteoporotic and p = 0.999 between osteopenic / osteoporotic for E, and p= 0.939 between normal / osteopenic, p = 0.690 between normal / osteoporotic and p = 0.878 between osteopenic / osteoporotic for H) and the Spearman Test did not show any correlation between the BQI and E and H. Therefore, it was not possible to classify the quality of the microarchitechture in the trabeculae of human vertebrae through the mechanical properties of the bone matrix in one single trabecula in order to evaluate the bone quality and fracture risk associated to osteoporosis.

Biography:

Mohammed K M Ali is a Junior Clinical Fellow of Trauma and Orthopaedics at Royal Derby Hospital, UK

Abstract:

Aim: The aim of the study was to evaluate the management approach in treating ulnar shaft fractures

Method: We retrospectively reviewed patients’ clinical notes, physiotherapy letters and radiographs.

Patients: Our study included 46 patients with isolated ulnar shaft fractures between September 2010 and December 2015 with a mean follow-up of 36 months. This included 10 females and 36 males, with a mean age of 34 years.

Main Outcome Measurements:  Measures include radiographic healing, post-operative range of motion, complications and patient satisfaction.

Results: Six patients were treated non-operatively, four were fixed using RECON plates and 36 patients had DCP fixation. All the surgeries were carried out ASAP with average wait of two days. Mobilisation was commenced immediately after the surgeries non weight bearing. Thirty six patients had no complications post-operatively with good outcome and average of four visits follow-up. One patient complained of metal work irritation, one patient had a delayed union and two patients went into nonunion which required revision. No stiffness was reported in all these cases. Those who were treated non-operatively had mean follow-up of nine visits and three patients (out of six) developed non-union and required fixation.

Conclusion: High non-union and stiffness rates with non-operative management due to the nature of the injury and prolonged immobilization were observed. All the night stick fractures should be treated with open reduction and internal fixation regardless the degree of the displacement.

Level of Evidence: The level of the evidence was from Level IV, Case Series, and Treatment Study.

Biography:

Abstract:

Background:

The objective of this study is to find out the relationship between the  Kellgren and Lawrence system for knee Osteoarthritis (OA) and the functional limitation in the daily activities in the elderly patients using WOMAC Questionnaire.

Methods:

This study was a cross-sectional study. The subjects were 160 patients  (131  Females and 29 Males) who were diagnosed with knee OA at an orthopedic clinic using the Kellgren and the Lawrence system  with no history of knee joint surgery. Outcome indices were functional limitations in 17 living activities (descending stairs, Ascending stairs, Rising from sitting, Standing, Bending to floor, Walking on flat surface, Getting in/out of car, Going shopping, Putting on socks, Lying in bed, Taking off socks, Rising from bed, Getting in/out of bath, Sitting, Getting on/off toilet, Heavy domestic duties, Light domestic duties) obtained from a WOMAC questionnaire.

Results:

A significant correlation with p value <1 was seen between increase in knee OA stages in x-rays and the severity of limitation in physical function .

Biography:

Abstract:

Fractures of the distal tibia can be challenging to treat because of the limited soft tissue, the subcutaneous location, and poor vascularity. Minimal invasive locked plate aims to reduce surgical soft tissue trauma and preserve periosteal blood supply. This study included 26 patients between 20 and 53 years (mean 34 years), with both open and closed distal tibia pilon fractures that were intraarticular or extra articular. All fractures were fixed using minimally invasive plate osteosynthesis under Image control using a precontoured locking compression plate – distal tibial plate. There were 11 AO 43 A, 7 AO 43 B, and 8 AO 43 C fractures including 18 closed and8 open fractures. Fracture union was achieved in 23 patients (88%), while 3 cases (12%) showed delayed union. Four cases suffered from late infection, and plate removal was necessary, whereas 6 cases had minor wound problems and responded to conservative treatment. Twenty two patients (85%) returned to their work within I year, however 17 patients ( 85%) had not returned to their preinjury sporting or leisure activities .Seven patients(27%) had angular deformities, all less than 7 degrees. The final ankle – hind foot score was 84.4 points. The conclusion is that short term results for treating distal pilon fractures using minimally invasive locked distal tibial plates to reduce surgical soft-tissue trauma and to help preserve periosteal blood supply and fracture hematoma appears encouraging, with union rates similar to that of ORIF techniques, but avoiding the usual associated drawbacks.

Biography:

Dr. Ayman Al-Bedri is a pioneer trainer and a board member in Exercise Is Medicine Malaysia (EIMM). My advanced training in family medicine give me the opportunity to deal directly with chronic disease patient and offering then exercise prescription. I assisted in training many general practitioner, physiotherapist and exercise profession during the process of acquiring their EIMM certificates.  Currently I am heading the exercise prescription clinic in the National University of Malaysia Medical Center. 

Abstract:

Osteoporosis is defined as a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. With only one study available on hip fracture in Malaysia in 1997, the incidence of osteoporosis remains under-diagnosed and under-treated.  The incidence rate was about 140 per 100,000 for females and 65 per 100,000 for males making it as twice common in females compare to males.  The average hospital costs for a hip fracture event are estimated 6,000 USD, and in the public sector the patient would be responsible for approximately half of this cost. In general, patients remain in hospital for about 7 days.

As estrogen level is a key factor that determines the health of the skeleton, other factors play a role in maintaining bone health. Among those factors are the physical activity and nutrition. Physical activity plays a prominent role in primary and secondary prevention of osteoporosis. Physical activity may reduce the risk of osteoporotic fractures by enhancing the Bone Marrow Density (BMD) during growth and by slowing the bone loss with aging. Physical Activity can play indirect role in reducing the risk of falls by muscle strengthening and balancing.

This topic will shed the light on exercise prescription for osteoporosis using FITT principle. Weight-bearing aerobic activities are recommended together with other activities that involve jumping and resistance exercise.

Biography:

James Stoxen DC, FSSEMM (Hon), Team Doctors® President, has been inducted into the
prestigious National Fitness Hall of Fame, the Personal Trainers Hall of Fame and appointed to the Advisory Board for the American Board of Anti-Aging Health Practitioners. He developed the new advanced model of biomechanics, the integrated spring-mass model and the approach to the earliest detection, intervention and prevention of age related diseases. In 2015, he was presented with an Honorary Fellowship award by the member of the Royal Family, the Sultan of Pahang, at the World Congress of Sports and Exercise Medicine in Kuala Lumpur Malaysia for his distinguished research and contributions to the advancement of Sports and Exercise Medicine at an international level. He is a sought after speaker internationally lecturing at over 50 medical conferences on treatment, training and progressive preventive approaches.

Abstract:

The team physician role is to provide treatment not only for the medical management of injuries and illnesses but also to provide for appropriate education and counseling regarding nutrition, strength and conditioning, and ergogenic aids maximize the athletes human performance in sport. Efficient, stress and strain free movement with efficiency is an essential aspect of survival for living things. Therefore understanding normal movement and how the human organism accomplishes normal movement is vitally important for physicians to understand so they can determine what is normal and what is abnormal movement. In this presentation I will reveal ways the physician can improve human performance of patients in sport by selecting the most advanced model of locomotion that better describes the biomechanics of locomotion, the integrated spring-mass model. This model integrates the upper half of the body onto the spring-mass model developed in 1989-90. It is advanced because it integrates the spine as a torsion spring, the discs as compression springs and the head as the non-spring 8-10 pound mass. In this model, the entire body is a giant torsion spring. This is to my knowledge the most advanced model and most accurate model of biomechanics today. If your goal is to provide clinical management of the athlete that is intended to insure or improve human performance you must know the earliest detection and intervention of the over modulation by examining for abnormal movement patterns with gait evaluation and through table examination for the changes in the muscles, tendons, and joints. By evaluating patients this way, a physician can fairly accurately predict where these compressive forces will be, thus predicting where compressive injuries will occur before the onset of symptoms.

Biography:

Van Eeckhout K is an Anesthesiology Resident at University Hospital Brussels, Belgium. 

Abstract:

Objective: To compare the anaesthetic characteristics of prilocaine 1% and 1.5%   in terms of onset and offset time of sensorimotor block and methemoglobinemia levels, when used for ultrasound guided axillary brachial plexus blocks.

Methods: The prospective, randomised, double-blinded trial was conducted at the University Hospital Brussels on 60 patients (ASA I-III, age range 19–86) scheduled for ambulatory hand surgery. The axillary brachial plexus blocks were performed with ultrasound alone with selective injection of 5 ml of 1% prilocaine or 1.5% prilocaine around each nerve (20 ml in total). Onset time and duration of sensory and motor block were assessed, as well as peak methemoglobinemia levels 2 hours after injection.

Results: Mean onset time for sensory block in the 1% prilocaine group was 15 min for the median nerve and 12 min for ulnar and musculocutaneous nerve compared to 15 min for the median nerve and 9 min for ulnar and musculocutaneous nerve in the 1.5% group. Mean duration of sensory and motor block was 265 min and 247 min respectively for the 1% group versus 255 min and 245 min for the 1.5% group. The average methemoglobinemia level was 2.25% for the 1% group compared to 3.03% for the 1.5% group.

Conclusion: We conclude that there is no statistically significant difference between 1% and 1.5% prilocaine in terms of onset and offset times of the sensorimotor block. However significantly higher levels of methemoglobinemia were found in the 1.5% group.

Biography:

Mohammed K M Ali is a Junior Clinical Fellow of Trauma and Orthopaedics at the Royal Derby Hospital, UK.

Abstract:

Purpose: Steroid injections are routinely done as non-operative management for foot and ankle conditions; however there is no strong evidence in the literature about the effectiveness of foot and ankle injections. The aim of our study was to assess the effectiveness of the foot and ankle injections.

Methods: We retrospectively studied the results of 64 foot and ankle injections done over a period of 12 months from July 2013 to June 2014. The most common indication for the injections was arthritis of the joint involved. 0.5% bupivacaine and 40 mg of kenolog was used for the injection. A visual analogue score was used to determine the efficacy of the injection.

Results: The mean follow up was 12 months. 84% patients had significant pain relief following the foot and ankle injection. 16% went on to have further procedures at six months. Most of the failed injections were ankle injections. Some went on to have further injection; some were listed for fusion and the others had an ankle arthroscopy. The ones who had good symptom relief were either discharged or given an open appointment.

Conclusions: Our study has demonstrated that intra-articular injections provide significant pain relief for foot and ankle conditions.