Search PubMed⌕ Search

Biomedical subjects

K M Yip

Publications and source records attributed to K M Yip.

At least 37 records · Page 2Linked to original sources
PubMed1996

The osteoporotic spine.

With an aging population, osteoporotic vertebral collapse is an increasingly common condition in both the Western and Eastern hemispheres. This review looked into the situation in Hong Kong with the aim of highlighting the major differences in data from the Western. Between 1989 and 1994, 497 patients with osteoporotic vertebral collapse, aged 65 to 94 years old, were admitted under the authors' care, with a female to male ratio of 5:1. More than 1/3 of the patients had fracture involving 1 single vertebra. The mean hospital stay was 5 days, with an additional 6 to 23 days in a convalescent hospital. Complication of spinal cord compression is uncommon and occurred in only 10 patients (2%) in this series who were treated mostly with anterior decompression and iliac crest graft with varying degrees of neurologic recovery. Despite the general benign nature of the problem, the high morbidity and the long hospital stays undoubtedly are significant drains on health care resources.

Aged↗
PubMed1996

Treatment of deformed tibial intramedullary nail: report of two cases.

Fixation of long-bone fractures using high-tensile-strength intramedullary nails is now a well-established form of treatment. A high-energy injury may deform and angulate such nails. Such incidents are rare-only two cases have previously been reported in the literature. We report the cases of two patients with deformed intramedullary tibial nails as the result of second injury to the same leg. The bent nails were removed in the conventional manner despite the straight intramedullary canal.

Adult↗
PubMed1996

The use of customized long stem hemiarthroplasty in ipsilateral femoral neck and pending shaft fracture: case report.

Most orthopaedic units do not have long stem femoral hemiarthroplasty prosthesis in their inventory. Situations that require replacement of the femoral head and internal fixation of the ipsilateral femoral shaft include femoral neck and shaft fracture as a result of either trauma or metastasis. The author reports on one technique of solving this problem by the use of an Austin-Moore hemiarthroplasty in combination with a half sawed Gross-Kempf (GK) intramedullary nail. The length of the GK nail was tailored according to the measured femoral length. The two implants were then impacted with a 4 cm overlap. Additional security was provided by the tension band wire placed between one of the distal locking holes in the nail and the hole in the Austin-Moore' implant and tunneled through the intramedullary nail.

Aged↗
PubMed1996

Brachial plexus injury in association with fracture-dislocation of the shoulder.

Anterior dislocation of the shoulder is generally not associated with neurological compromise. We report three patients in whom a brachial plexus injury was caused by an anterior dislocation of the shoulder. One patient was further complicated by vascular involvement. The forces producing the injury are usually small, and the neurological trauma is likely to be neuropraxia. Conservative management is usually successful, and, in our patients, recovery took place after an average of six months.

Adolescent↗
PubMed1996

Rapid airway access by modified retrograde intubation.

Rapid access to the airway is important to ensure successful resuscitation. However, the establishment of a patent airway by orotracheal intubation is not always easy. This is especially true in patients with upper airway pathology or anatomic variations. A modified retrograde intubation technique was developed using the plastic sheath of the spring guidewire of a central venous pressure (CVP) kit as an introducer. This is considered to be a simple and safe method to provide a secure airway where intubation is difficult or in an emergency. This report presents our clinical experience using this method in 10 patients.

Emergencies↗
PubMed1996

Surgical management of patients with osteogenesis imperfecta: 10 years' experience.

The orthopedic problems of osteogenesis imperfecta (OI) are multiple and formidable, if not untreatable. Controversy surrounds the timing and method of its management and to date, no reports have been published on the orthopedic treatment of these patients in Taiwan. This paper reports the surgical treatment of eight OI patients (average age, 3 yr 5 mo) who were unable to walk before surgery. Preoperatively, the incidence of long bone fracture ranged from once per month to twice per year. The average degree of femoral and tibial bowing as measured from leg radiographs at the first visit were 42 degrees and 32 degrees, respectively. Four patients underwent intramedullary nailing of both the femur and tibia while another four patients underwent intramedullary nailing of the femur only in the primary operation. The implants used were mostly Steinmann pins or Rush nails, and a femoral Kuntscher nail was used in one case. At the mean postoperative follow-up period of 5 years 4 months, five patients could walk independently without support. Two walked with wheel-carts and one could rise and stand with minimal support. We conclude that patients with OI can benefit from early surgical correction and stabilization and experience improvement in their ambulatory status despite the multiple procedures required.

Bone Nails↗
PubMed1996

The second case of Paget's disease (osteitis deformans) in a Chinese lady.

Paget's disease of the bone is extremely rare in the Chinese population. We report a case of a 91-year-old female patient who presented with a leg ulcer after an injury. On examination, she was incidentally noted to have bowing of the tibia and facial features suggestive of Paget's disease which was later confirmed with plain radiograph. An extensive search of the international literature over the last thirty years, including the use of Medline, has revealed only one other case report of Paget's disease in a Chinese patient in Thailand.

Aged↗
PubMed1995

Limb salvage surgery with microsurgical reconstruction for the treatment of musculoskeletal tumours involving the upper extremity.

Microsurgical reconstructive techniques have been applied in the management of 14 patients with malignant bone and soft tissue tumours as well as for 30 patients with benign but aggressive bone lesions affecting the upper extremity. Vascularised bone grafts were used in 6 patients with malignant bone tumours and 30 patients with aggressive bone lesions. Reconstruction with soft tissue free flap transfer was required in 6 patients with soft tissue defects, primarily following excision of soft tissue tumours in 2 and after excision of recurrent tumours in 4 patients. Microneural dissection and vascular reconstruction were performed in 2 patients with tumours around the major neurovascular bundles. The patients were followed up for varying periods, ranging from 1 to 12 years and assessment of the limb function was performed using Enneking's system of evaluation. There were no local recurrences. In the malignant tumour group, 3 patients died of systemic disease, 7 were alive but with disease and 4 were disease free. Extremity function was excellent in 3 patients, good in 6 patients, fair in 4 patients and poor in 1 patient. In the benign bone tumour group, extremity function was graded as excellent in 12 patients, good in 14 patients, fair in 3 patients and poor in 1 patient. The vascular bone grafts united in all but 3 patients at 4 months following surgery. Minimal donor site complications had been recorded and there had been no failures. Useful limb salvage may thus be achieved with the application of microsurgical techniques for a variety of indications in limb salvage surgery after tumour excision.

Adolescent↗
PubMed1994

Palmar hyperhidrosis in children: treatment with video endoscopic laser sympathectomy.

Palmar hyperhidrosis (PH) often starts in childhood and can be a disabling condition for a significant number of young children at the age they begin primary school. There are few reports regarding the surgical treatment of PH in children. The authors report on 40 PH patients under 16 years of age treated with video thoracoscopic laser sympathectomy; there has been substantial experience with this procedure for the treatment of adults with PH. A satisfactory result, with very low morbidity, was achieved for all 40 children. The surgical technique is described briefly. With the technique, the proper sympathetic segment is visualized in almost all cases and then definitely ablated with a fiberoptic low-power laser while under the aid of sympathetic monitoring. Consequently, an adequate sympathectomy warranting a long-lasting therapeutic effect can be achieved without the need of tissue diagnosis. No case required conversion to open sympathectomy. Neither injury to the lung nor bleeding was encountered. Horner's syndrome did not occur in any case. Bilateral sympathectomy was accomplished generally within 30 minutes. All patients were discharged after an overnight stay and are doing well with normal activities. The most frequent complication was compensatory hyperhidrosis, which was tolerable after reassurance. Based on the accumulated experience, it is justified to recommend early surgery, with this refined technique, in cases of severe PH in children.

Adolescent↗
PubMed1994

Reconstruction of extensor mechanism after trauma and infection by transposition of the Achilles tendon: report of technique and four cases.

High-energy injuries to the knee often involve extensive soft tissue loss as well as fractures. In certain situations, the patellar tendon may be lost due to initial injury or post-injury complications such as infection. Use of the gastrocnemius flap is a popular method of covering the defect as well as controlling infection and promoting healing by increasing local vascularity. We present a method of reconstructing the patellar tendon by extending the use of the gastrocnemius flaps using its Achilles tendon and calcaneal insertion. The distal insertion of the Achilles tendon is fixed to the tibial tuberosity with a cancellous screw, and the proximal end is sutured to the quadriceps muscles. The knee is immobilized for 1 week, after which the knee is mobilized in a hinged brace. Three of the four cases had good results, one a moderate result (the initial injury was extensive, with dislocation of the knee).

Achilles Tendon↗
PubMed1994

Posterior slope angle of the medial tibial plateau.

The overall average of the posterior slope of the medial plateau of the tibia as determined from the lateral radiography of the knee was 10 degrees +/- 4 degrees, with a range from 0 degrees to 20 degrees. This value was independent of age and gender and was unaffected by arthrosis as long as the arcuate contours of the medial socket were not eroded and could be identified by lateral radiography. While the average value of this posterior slope was similar to that of a cadaveric study, the range was much greater. The current practice of neglecting the preoperative posterior tibial slope and arbitrarily setting the tibial component at a predetermined posterior tilt angle failed to take into account the wide variation in posterior tibial slope.

Adolescent↗
PubMed1994

Vibration arthrometry of the knee with torn meniscus: a preliminary report.

Although projects using vibration signals generated by the joint to detect joint disorders are still experimental, vibration arthrometry has been shown to be useful in assessing meniscal pathology. A prospective study using vibration arthrometry to diagnose meniscal tears was carried out in 25 consecutive patients with knee injuries. They comprised 20 males and five females with an average age of 34 years. An arthroscopic examination of the injured knee was given to every patient. Six cases of medial meniscal tear, 12 lateral meniscal tear, and two torn discoid menisci were found. The remaining five cases had normal menisci. By correlating the vibration arthrography of the patients to their corresponding arthroscopic findings, 15 were found to be true-positive, five true-negative and five false-negative. There were no false-positive readings. The accuracy, sensitivity and specificity of the vibration arthrometry in diagnosing meniscal tear was 80%, 75% and 100%, respectively. Vibration arthrometry was shown to be a reliable, non-invasive diagnostic tool in diagnosing meniscal tear of the knee.

Adolescent↗
PubMed1994

Patellar thickness in total knee replacement.

The question of patellar thickness after total knee replacement (TKR) is an important issue. From November 1989 to June 1993, a total of 294 TKR were performed on 219 patients (34 males, 185 females) with an average age of 67 years. Tricon-M prostheses were used in TKRs performed before October 1992, and PCA prostheses were used after that date. In each TKR, all polyethylene patellar components used on patellar resurfacing were cemented in place. The average preoperative patellar thickness was 21.2 +/- 1.8 mm. The thickness was preserved in 106 knees, while for 53 knees, a slight increase in thickness (mean, 1.5 +/- 0.9 mm) was recorded, and for 120 knees, a slight decrease in thickness (mean, 1.5 +/- 0.8 mm) was recorded. Lateral retinacular release was performed in 96 knees (40%) of the 238 TKR with a Tricon-M prosthesis, but in only seven knees (17%) among the 41 TKR using the PCA prosthesis. Patellar subluxation and dislocation after TKR occurred in 13 knees of 11 patients (10 females, one male, mean body weight 63.5 kg) with the Tricon-M prosthesis. The mean time from arthroplasty to occurrence of patellar instability was eight months. Six knees were treated by proximal realignment procedure while seven knees were given conservative treatment, with good results and no recurrence reported. The use of a patellar cutting jig allows better control of patellar thickness when performing patellar resurfacing for small patella. No complications such as patellar fracture, infection or patellar component-loosening were encountered in the 294 TKRs performed.

Aged↗
PubMedDate not supplied

Antenatal sonographic diagnosis of clubfoot: a six-year experience.

In the period 1988 through 1993, 6351 pregnant women were referred to the Department of Obstetrics and Gynaecology, University "La Sapienza", Roma, for suspected fetal anomalies or maternofetal problems. All underwent serial transabdominal and/or transvaginal ultrasound scanning, which revealed a total of 235 fetuses with hydrocephalus, cardiac, or musculoskeletal malformations. Forty-one clubfeet were detected in 27 pregnancies in the early part of the second trimester of pregnancy. Of these, 14 feet in eight patients were isolated, and were classified as idiopathic. A clubfoot was associated with neural tube defects in six patients, with anomalies of the urinary and/or digestive system in a further six, with a cystic hygroma in two, and with other musculoskeletal abnormalities in the other six patients. Amniocentesis revealed an abnormal karyotype in six fetuses (22.2%). In only two cases was oligohydramnios present. In both these patients, a fetal urinary tract malformation was present Polyhydramnios was found in 18 cases, and a normal amount of amniotic fluid was found in the remaining seven cases. Polyhydramnios was present in six of the eight idiopathic clubfoot fetuses. Clubfoot is associated with musculoskeletal and visceral anomalies in a high proportion of cases. The association of clubfoot with polyhydramnios in a high proportion of cases does not support the hypothesis of intrauterine moulding as an etiological factor in its development. Ultrasonographical prenatal detection of a clubfoot should prompt amniocentesis, as the condition is associated with an abnormal karyotype in a significant proportion of cases.

Abnormalities, Multiple↗
PubMedDate not supplied

Long survival with metastatic clear cell sarcoma of the Achilles tendon.

Clear cell sarcoma of tendons and aponeuroses is a rare tumor with a predilection for the lower extremities, particularly the foot. Although it is claimed to have a poor prognostic outlook, it is sometimes characterized by a slow clinical course. The authors report a case with a prolonged survival period of 7 years--5 years in the presence of multiple lung metastases.

Achilles Tendon↗