Editorial Board

Editorial Board

Editor-in-Chief

Dr Sheung-Tung Ho

Deputy Editor-in-Chief

Dr Tun-Hing Lui

e-Editor

Dr Siu-Bon Woo

DePuty e-Editor

Dr Tsz-Lung Choi

Associate Editors

Dr Wai-Lam Chan

Dr Yee-Man Jackie Chau

Dr Ka Kin Cheung

Dr Chi-Kit Chiu

Dr Ka-Kin Cheung

Prof Leung-Kim Hung

Dr Wing-Lok Kam

Dr Tse Ping Lam

Dr Yuen-Fai Leung

Dr Chun-Man Ma

Dr Kwai-Ming Siu

Dr Kai-Tsun Michael To

Dr Nan-man Raymond Wong

Dr Siu-Fai Yip

Welcome

The Journal of Orthopaedics, Trauma and Rehabilitation is the official peer-reviewed publication of the Hong Kong Orthopaedic Association and the Hong Kong College of Orthopaedic Surgeons. We welcome articles that contribute to orthopaedics, trauma and orthopaedic rehabilitation related knowledge from all countries.

SPECIAL NOTE: New article submission system is now ready. For article submission, please click this link https://www.evise.com/profile/#/JOTR/login to go to the new system. For enquiry, please contact our Editor-in-chief at jotr@ejotr.org.

 

Current Issue

Latest articles

Trial Without a Catheter Programme Improves Urological Management for Retention of Urine After Hip Fracture Surgery: ｢沒有導尿管試驗計劃 ｣改善髖部骨折手術後出現瀦留尿的治理
Description of article

Background

Acute retention of urine (AROU) is commonly occurred in patients with geriatric hip fractures after surgeries. It is common that the catheters cannot be weaned off after insertion.

Objectives

We compared an approach using unified Trial Without Catheter (TWOC) protocol with non-unified management plans in patients with retention of urine after hip fracture surgery, to compare these approaches in terms of (1) rate of successful catheter removal, (2) duration required for successful catheter removal, (3) number of episodes of urinary tract infection, and (4) length of hospital stay.

Methods

We conducted a retrospective cohort study of 250 patients who failed to wean off a urinary catheter. 140 out of 1349 patients between December 2012 and September 2014 formed the intervention group (treated with unified TWOC protocol), and 110 out of 1193 patients between July 2006 and December 2008 were the control group (treated with different AROU management approaches). The efficiency and effectiveness of the urological management in both groups were compared.

Results

As expected, the rate of successful TWOC was higher in intervention group (before discharge, 68.6% versus 38.2%; after discharge, 20.0% versus 18.2%, overall, 88.6% versus 56.4%). Despite trial of weaning off urinary catheters, 16 patients in intervention group and 8 patients in control group failed with permanent catheter required. Forty patients in control group were discharged with permanently catheters without a trial of TWOC.

Conclusion

The TWOC program provides structured and standardized urological management for patients suffered from AROU after geriatric hip fracture surgeries. To reiterate, indwelling urethral catheters must not be placed permanently without carrying out urological assessment in patients with geriatric hip fractures.

中 文 摘 要

背景 留置導尿管是常用於治理老年髖骨骨折併發急性尿瀦留的方法。自2012年起,我們採用了一個多學科的臨床計劃（｢沒有導尿管試驗計劃｣,Trial Without a Catheter - TWOC）,以規範化急性尿瀦留的治理和之後拆除導管的後續處理。

目標 我們從（1）拆除導尿管的成功率,（2）成功拆除導尿管需要的時間,（3）尿道感染的發病率,以及（4）住院時間幾方面,來比較使用與不使用TWOC計劃的果效。

方法 我們回顧性研究了250個在髖部骨折手術後無法拆除導尿管的病人。當中140個病人(出自2012年12月和2014年9月之間接受手術的1349個患者)組成實驗組（使用TWOC計劃）,另110個病人(出自2006年7月和2008年12月之間接受手術的1193個患者) 組成對照組（不使用TWOC計劃）。

結果 實驗組擁有較高的拆除導尿管成功率（88.6％比56.4％,P <0.001）。儘管使用TWOC計劃,16名患者需要使用永久性的導管。在對照組中有40例在出院時使用了永久性導管,而沒有嘗試拔除導尿管。

討論和結論 TWOC計劃規範化了老年髖骨骨折併發急性尿瀦留的處理。放置永久性的導尿管前應先由泌尿外科醫生作評估。
Author:

Cheng Kin-Hung William, Chin Ping-Hong Raymond
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Are the Current Size Options of Glenoid Baseplates for Reverse Shoulder Arthroplasty Sufficient for our Local Population? 現有反置式人工肩關節置換術中盂底板組件的大小選項是否滿足我們本 地人口的需要？
Description of article
Abstract

Background/Purpose

Reverse shoulder arthroplasty (RSA) is an effective treatment for patients who suffer from shoulder pain and dysfunction associated with a variety of shoulder pathologies including severe rotator cuff deficiency with or without glenohumeral arthritis. It has been widely used in European countries and the United States and is now gaining popularity in Asia, including Hong Kong. However, there are only limited size options available for glenoid baseplates, with 25 mm being the smallest size in some commonly used systems. The aim of our study is to perform computerized tomography (CT) measurements of the glenoid dimension in the Chinese population and to see if the current glenoid baseplate component size option is sufficient for our local population.

Methods

A total of 70 CT scans of shoulder regions were analysed. Measurements included maximum superoinferior height and the anteroposterior height.

Results

The glenoid dimensions were smaller compared to those from previous studies in Caucasian counterparts. Some 41% of female glenoids had widths measuring < 25 mm (25 mm being the smallest size available in some commonly used RSA systems).

Conclusion

Although there are only limited size options available for the glenoid baseplate in RSA, from our data, it should be able to cover most patients in our local population. However, surgeons should exercise special care when contemplating performing reverse shoulder replacement for small size females in our local population.

中 文 摘 要

簡介

反置式人工肩關節置換術（reverse shoulder arthroplasty, RSA）是一種有效治療由各種肩關節病症所引起的肩膀疼痛和功能障礙，包括嚴重肩袖缺損，或伴隨有盂肱關節炎等。在歐洲國家和美國，它已被廣泛應用，在亞洲包括香港也越來越受歡迎。然而，盂底板組件大小的選擇有限，在常用的系統中最小尺寸為25mm。我們研究的目的，是用電腦掃瞄器來測量在本地中國人中肩關節盂的大小，並查看現有盂底板組件尺寸的選擇是否滿足我們的本地居民的需要。

方法

我們分析了70組肩部區域的電腦掃描。測量包括肩關節盂最大上下高度和前後長度。

結果

我們的結果和其他從高加索人種所作的研究作比較，發現本地中國人的肩關節盂尺寸較小。有41％的女性肩關節盂寬度小於25毫米（25毫米是在一些常用的RSA系統中可用的最小尺寸盂底板組件）。

討論和結論

雖然盂底板組件大小的選擇有限，從我們的數據，現有的盂底板組件應該能夠覆蓋大多數我們本地的患者。然而，基於我們本地女性居民肩關節盂的尺寸較小，外科醫生有進行反置式人工肩關節置換術時，應該特別留意。

Proximal tibiofibular joint is a frequently neglected joint which can be a source of lateral knee pain. Open surgery is the current mainstay of surgical management of proximal tibiofibular joint disorders. The proximal tibiofibular arthroscopy allows access to the joint and adjacent important ligamentous structures. This forms the basis of further development of arthroscopic procedures for a variety of pathologies.

近端脛腓關節是一個經常被忽視的關節。它可以引起外側膝關節疼痛。開放性手術是近端脛腓關節問題的主流手術治療。近端脛腓關節鏡可以檢査近端脛腓關節和鄰近的重要韌帶結構。這是未來近端脛腓關節鏡手術發展的基礎。
Author:

Cheung Yim Ling Amy, Lie Wai Hung Chester, Chow Hung Lit, Chan Wai Lam, Wong Kwun Hung Kevin, Woo Siu Bong, Wong Wing Cheung
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Quiz of the month: A 15-year-old boy presented with right elbow pain and stiffness for few months especially after strenuous exercise. He needs to have regular table tennis training about 4-5 hours per day. The MRI and X-ray of his right elbow are shown.

What is your radiological diagnosis?   MRI of the same elbow is illustrated.   osteochondritis dissecans of right elbow at the capitellum  




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