ATC-Advanced Trauma Consortium JB

06/09/2021

Madam S. H. (58 years old active lady) presented to my clinic with a complain of on and off left knee pain that worsening for the last sixth months. Her clinical and radiological assessment revealed severe osteoarthritis (OA) of the left knee.

After detailed explanation regarding the option of management and risks madam S. H. decided to undergo Total Knee Replacement procedure.
Preoperatively she underwent through assessment by my medical consultant colleague including blood investigation along with chest x ray, ECG and Echo and found to have low risk.
she was admitted the night before surgery and given antiseptic shower gel to reduce the risk of infection. And post operatively wound closed using vacuum PICO dressing which helps to reduce the risk of wound breakdown and infection.

Post operatively she was able to ambulate using walking frame on day 3 with minimal pain. Currently after 6 weeks she was able to regain her mobility without any assistant.

Osteoarthritis is the most common form of arthritis, affecting millions worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine.
Osteoarthritis symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:
• Pain during or after movement.
• Stiffness most noticeable upon awakening or after being inactive.
• Loss of joint flexibility “not be able to move through its full range of motion”.
• Grating sensation while moving the joint, can be felt or even heard sometimes.
• Swelling and joint deformity resulted from bone osteophyte (bone overgrowth) or synovial tissue hypertrophy.

Cartilage is a firm, slippery tissue cushions the ends of bones in your joints that enables nearly frictionless joint motion, when gradually deteriorates symptoms start and eventually bone will rub on bone resulting in worsening of symptoms.
Worth to mention that OA management depends on the stage of the disease at time of presentation and patients’ factors including (Hobbies, body build and symptoms). In general, for early stage of the disease I will advice my patients to start gradual physical activity along with pain control medication and lifestyle adjustment. However, if not improved within six week or patient presented with more advanced stage of the disease, he/she may require intraarticular injection of Hyaluronic acid or steroid. In case of advanced stage of OA few options available for the patient including alignment procedure with arthroscopic debridement especially for younger ager group below 60 or Total Knee Arthroplasty as with Mrs S.H.
Most important to remember is that every person is unique and management plan should be custom to her/his need and associated morbidities. For example intraarticular injection may help to reduce the pain but if advanced stage of OA may not even last for couple of months, hence money wasted.

膝盖关节炎
S.H女士（58岁活跃的女士）来到我的诊所，是因为左膝时断时续的疼痛，并且在过去的六个月中不断恶化。 她的临床和放射学评估（XRAY）显示左膝严重骨关节炎 (OA)。
左膝 X 线显示关节间隙缩小，边缘骨赘提示 IV 期 OA

S. H. 女士在详细解释了管理选项和风险后，决定进行全膝关节置换手术。
术前她接受了内科医学顾问的评估，包括血液检查以及胸部 X 光、心电图和回声，发现风险很低。
她在手术前一晚入院，并给予消毒沐浴露以降低感染风险。 术后伤口使用真空 PICO 敷料闭合，有助于降低伤口破裂和感染的风险。

术后她能够在第 3 天使用步行架走动，疼痛较小。 目前，在 6 周后，她无需任何辅助即可恢复活动能力。

骨关节炎是最常见的关节炎形式，影响全球数百万人。当缓冲骨骼末端的保护性软骨随着时间的推移而磨损时，就会发生这种情况。虽然骨关节炎会损害任何关节，但这种疾病最常影响手、膝盖、臀部和脊柱的关节。
骨关节炎症状通常发展缓慢并随着时间的推移而恶化。骨关节炎的体征和症状包括：
• 运动中或运动后疼痛。
• 醒来或不活动后最明显的僵硬。
• 关节灵活性丧失“无法在其全部运动范围内移动”。
• 移动关节时有刺痛感，有时可以感觉到甚至听到。
• 由骨赘（骨过度生长）或滑膜组织肥大引起的肿胀和关节畸形。

软骨是一种坚硬、光滑的组织，可以缓冲关节中骨骼的末端，使关节几乎无摩擦地运动，当症状逐渐恶化时，骨骼会与骨骼摩擦，导致症状恶化。
值得一提的是，OA 管理取决于发病时的疾病阶段和患者的因素，包括（爱好、体型和症状）。一般来说，在疾病的早期阶段，我会建议我的患者开始逐渐进行体育锻炼，同时服用止痛药和调整生活方式。然而，如果在六周内没有改善或患者出现更晚期的疾病，他/她可能需要关节内注射透明质酸或类固醇。在 OA 晚期的情况下，患者可用的选项很少，包括关节镜清创术的对齐程序，特别是对于 60 岁以下的年轻年龄组或全膝关节置换术，如 S.H.
最重要的是要记住，每个人都是独一无二的，管理计划应该根据她/他的需要和相关的发病率定制。例如，关节内注射可能有助于减轻疼痛，但如果 OA 晚期可能甚至无法持续几个月，因此浪费金钱。

For more inquiry with regards to any similar injury or other fractures or joint pain you may kindly contact us.
Clinic phone number: 0187919020

25/08/2021

您会时常感到头晕？头疼？视线模糊？肢体或脸部麻痹？
来自柔佛州美迪尼鹰阁医院 德华拉之医生（神经及脊椎外科专科医生）表示如果头痛的情况持续一个星期都没有改善，一定要尽快到医院进行检查，寻求医生的协助。

Do you feel dizzy from time to time? Headache? Blurred line of sight? Limb or facial paralysis?
Dr. Devaraj (Specialist in Neurosurgeon and Spine Surgeon ) from Gleneagles Hospital Medini Johor said that if the headache does not improve for a week, be sure to go to the hospital for examination as soon as possible and seek the assistance of a doctor.

25/08/2021

大多数人都知道骨科创伤专科，但并不是所有人都听说过先进高级骨科创伤手术。总的来说，骨科包括七个主要亚专科，即“脊柱外科、关节成形术、关节镜和运动损伤科、手外科、小儿骨科、骨科肿瘤和高级创伤”。先进高级骨科创伤是骨科七大专科之一。它涉及所有形式的骨折，无论是简单的还是复杂的，并且在完成硕士课程后的三年内需要最少的培训，总共需要 4 年(consultant顾问)+3年(advanced先进)来获得知识和专业知识。
是的，简单的骨折可能很常见；尽管如此，处理晚期骨科创伤将是最合适的，因为他/她已经接受了正确的培训并获得了相应的专业知识，并且能够处理不幸发生的并发症。
最后但并非最不重要的一点是，高级创伤还结合了所有微创手术方案，以实现最佳结果，包括老年（老年人）和小儿骨折。

Most people know about Orthopaedic Trauma speciality but not all heard about Advanced Orthopaedic Trauma Surgery. In general, Orthopaedic surgery includes seven major subspecialities namely “Spine Surgery, Arthroplasty, Arthroscopy and Sports Injury Unit, Hand Surgery, Pediatric Orthopedic Surgery, Orthopedic Oncology and Advance Trauma”. Advanced Orthopaedic Trauma is one the seven major subspecialty in orthopaedic surgery. It involved all forms of fracture whether simple or complex and minimal training required is three years after completing the master programme which in total is 4 plus 3 years to get the knowledge and expertise.
Yes, simple fracture may be common; never the less, handling with advanced orthopaedic trauma will be most appropriate as he/she had undergone the right training and gain expertise accordingly and will be able to deal with complication if unfortunately happened.
Last but not least to mention is that advanced Trauma also corporate all the minimally invasive surgical protocol to achieve the optimal results including geriatric (elderly) and paediatric fractures.

Sebilangan besar orang tahu mengenai kepakaran Trauma Ortopedik tetapi tidak semua mendengar mengenai Pembedahan Trauma Ortopedik Advanced. Secara amnya, pembedahan Ortopedik merangkumi tujuh subspesialiti utama iaitu “Bedah Tulang Belakang, Arthroplasti, Arthroscopy dan Unit Kecederaan Sukan, Pembedahan Tangan, Pembedahan Ortopedik Pediatrik, Onkologi Ortopedik dan Trauma Lanjutan”. Trauma Ortopedik Advanced adalah satu daripada tujuh subspesialiti utama dalam pembedahan ortopedik. Ia melibatkan semua bentuk keretakan sama ada latihan sederhana atau kompleks dan minimum yang diperlukan adalah tiga tahun setelah menyelesaikan program sarjana yang secara keseluruhannya adalah 4 years consultant dan ditambah 3 tahun advanced trauma untuk mendapatkan pengetahuan dan kepakaran.
Ya, keretakan sederhana mungkin biasa; namun, menangani trauma ortopedik yang maju akan sangat sesuai kerana dia telah menjalani latihan yang betul dan memperoleh kepakaran yang sewajarnya dan akan dapat menangani komplikasi sekiranya kecederaan buruk berlaku.
Yang paling penting sekali ialah Trauma yang advanced juga menggunakan semua protokol pembedahan invasif minimum untuk mencapai hasil yang optimum termasuk patah tulang geriatrik (warga tua) dan pediatrik.

19/08/2021

Mr. N (51 years old gentleman) was involved in Motor accident and presented to our emergency department with multiple wound and right shoulder and chest pain with slight shortness of breath along with inability to move his right shoulder due to pain. After physical and radiological examination, he was found to have comminuted right scapula fracture.
After detailed explanation to Mr N regarding the option of management and risks he decided to undergo scapula stabilization
Post operatively he was able to move his shoulder with almost 80% of range and with minimal pain. Currently after 6 weeks he was able to regain his full range of movement.
Scapula fracture is not common and hence its not done on daily or weekly basis. Therefore, its important to select the right orthopaedic subspecialty as it has a major impact on patients’ outcomes and here its “advanced trauma”. Proper handling of the soft tissue during operation and anatomical fixation of the fracture will ensure the best result for the patient.
N 先生（51 岁绅士）发生一场车祸，因多处受伤和右肩以及胸口疼痛，轻微呼吸急促，右肩因疼痛无法活动而到急诊科就诊。 经体格及放射学检查(X光片)，发现右肩胛骨粉碎性骨折。
经过我们向 N 先生详细的解释了治疗选项和风险后，他决定进行肩胛骨稳定术。
手术后，他能够以几乎 80% 的范围移动他的肩膀，并且疼痛较少。 目前，在 6 周后，他能够恢复以往的动作。
肩胛骨骨折并不常见，相对来说此类型的手术并不会每天或每周进行的。 因此，选择正确的骨科亚专科很重要，因为它对患者的预后和此处的“晚期创伤”有重大影响。 在手术过程中正确处理软组织和骨折的解剖固定将确保为患者带来最佳结果。

Pak N (lelaki berusia 51 tahun) terlibat dalam kemalangan Motor dan dikejarkan ke bahagian kecemasan kami dengan beberapa luka dan bahu kanan dan dada dengan sedikit sesak nafas serta ketidakupayaan untuk menggerakkan bahu kanannya kerana sakit. Setelah pemeriksaan fizikal dan radiologi, dia didapati mengalami patah tulang skapula kanan.
Setelah memberi penjelasan terperinci kepada Mr N mengenai pilihan pengurusan dan risiko, dia memutuskan untuk menjalani pembedahan skapula
Setelah menjalani pembedahan, dia dapat menggerakkan bahunya dengan jarak hampir 80% dan kesakitan yang minimum. Pada masa ini setelah 6 minggu dia dapat mendapatkan kembali pergerakannya sepenuhnya.
Fraktur skapula tidak biasa dan oleh itu tidak dilakukan setiap hari atau mingguan. Oleh itu, penting untuk memilih subspesialiti ortopedik yang betul kerana ia memberi kesan besar kepada hasil pesakit dan di sini "trauma lanjut". Pengendalian tisu lembut dengan betul semasa operasi dan pemasangan anatomi fraktur akan memastikan hasil terbaik bagi pesakit.

For more inquiry with regards to any similar injury or other fractures or joint pain you may kindly contact us.
Clinic phone number: 0187919020

12/02/2021

Happy Chinese New Year🍊🍊

02/02/2021

预防胜于治疗😎
结肠镜检查真的很重要‼️
我们也提供该项服务检查

http://www.mzrmyy.com/generalpage/contentpage.aspx?menuid=13&id=1952

梅州市人民医院（黄塘医院），三级甲等医院，粤东地区最大医院。

08/12/2020

FB live by our Colorectal Surgeon Dr Sandip
Stay tuned❤️

Kanser kolon merupakan kanser kedua tertinggi di Malaysia yang membabitkan golongan kaum lelaki. Namun, kanser ini juga berisiko kepada kaum wanita. Sekiranya lambat dikesan, kanser ini boleh menjadi ancaman kepada golongan yang berisiko.

Tonton siaran Bicara Kesihatan Bersama Dr. Sandip Kumar, Pakar Perunding Pembedahan Am dan Pembedahan Kolorektum untuk mengetahui dengan lebih lanjut tentang Bahaya Kanser Kolon.

9 Disember 2020 (Rabu)
1.00 tengah hari

26/11/2020

This operation was done by Dr Suhaeb 👨🏻‍⚕️

A five years old boy sustained injury to his right ankle when his foot stuck in motorbike
Admitted to his nearby hospital and performed wound wash and suturing and found to have Achellis Tendon cut.
一个五岁男孩的脚被摩托车夹着，右脚踝受伤
入住他附近的医院，进行了伤口清洗和缝合，发现筋也被割破（Achellis Tendon）。
Seorang kanak-kanak lelaki berusia lima tahun mengalami kecederaan pada pergelangan kaki kanannya ketika kakinya tersekat dekat motosikal
Dimasukkan ke hospital berhampirannya dan melakukan pencucian luka dan jahitan didapati telah memotong Achellis Tendon.

One week later, wound breakdown and found to be infected
一周后，伤口破裂 伤口也被感染
Satu minggu kemudian, kerosakan luka dan dijangkiti

Achilles’ tendon found reruptured and culture revealed bacterial growth
Achilles’ tendon再一次破裂， 培养（细菌）显示细菌生长.
Tendon Achilles dijumpai semula dan kultur menunjukkan pertumbuhan bakteria

Three weeks after wound cleaning and repair of tendon
External fixator was applied to assure the tendon will not rupture again
三周后的清洗伤口和修复
应用外固定器以确保肌腱不会再次破裂
Tiga minggu selepas pembersihan luka dan pembaikan tendon
Fiksator luaran digunakan untuk memastikan tendon tidak akan pecah lagi

28/09/2020