Background: Injury following proximal interphalangeal joint fracture dislocation is determined by the direction of force transmission and the position of the joint at the time of impact. Dorsal dislocations with palmar lip fractures are the most frequently encountered. The degree of stability is directly determined by the amount of middle phalangeal volar lip involvement and the degree of commination of the base of the middle phalanx.
Methods: Case series of five patients who presented between Jan to June 2015 with pilon fracture of the middle phalanx. Mechanism of injury was axial loading onto to the proximal interphalangeal joint, while playing Australian football. All of them presented within 3 days of their initial injury with fracture of the volar lip of base of middle phalanx with dorsal subluxation along with commination of the base of middle phalanx appreciated on CT scan. All of them underwent open reduction via the shot gun approach and fixation with 1.3 mm lag screw. Also bone graft from the Lister`s tubercle of distal radius was used to realign the joint congruity in cases with severe comminution.
Results: Post operatively they underwent early mobilisation within the volar plate protocol and good outcome in terms of proximal interphalangeal joint function and stability.
Conclusion: Early intervention in the form of open reduction and internal fixation with or without bone graft in cases of pilon fractures restores the joint congruity and helps in achieving good functional outcome.
Background: Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) offers the possibility of cure for hematological malignancies, various complications have been described. Capillary leak syndrome (CLS) has been previously observed in HSCT patients. CLS is a rare disease characterized by recurrent episodes of generalized edema and severe hypotension along with hypoproteinemia.Case Report: A 27-year-old Chinese man, diagnosed with refractory acute myeloid leukemia, was treated with a haploidentical stem cell transplant combined with an unrelated umbilical cord blood unit. The patient developed fatal CLS during the 9th day of the conditioning therapy. Conclusion: Since it is difficult to distinguish between CLS and other early complications during allo-HSCT, our report highlights the need for rigorous investigation of identifying CLS and the increasing need of insightful diagnosis to manage any incidence of CLS.
Introduction: In Singapore, the donation of tissues is governed by the Medical (Therapy, Education and Research) Act. For past years, our tissue banks have engaged in various publicity methods. The objective of this study is to evaluate the effectiveness of our publicity strategies among healthcare professionals.
Method: A 6-questions survey was conducted among doctors, nurses, allied health and support services staff from Singapore General Hospital and National Heart Centre Singapore. Sample size was calculated in accordance to the occupation ratio.
Results: Of the 450 respondents who completed the survey, most did not see, read or heard about tissue donation. Newspaper articles were their main source of information amongst those who encountered tissue donation message. All categories of staff concurred that presentations by tissue banking experts is the best way to convey the message. All occupations except doctors, reported that information on how tissue donation improved a recipient’s life will interest them. On contrary, statistics and facts will interest doctors more.
Conclusion: Results highlighted our publicity methods have not been effective in conveying tissue donation message to healthcare audiences. Hence, there is a need to re-strategise its publicity efforts, so that information on tissue donation can be effectively delivered to them.
Laparoscopic living donor nephrectomy is the standard of care at high volume transplant centers. Despite this there is still reticence to harvest the right kidney laparoscopically because of concerns regarding the shorter renal vein, higher complexity of dissection and potentially higher complication rates and worse renal allograft outcomes. The aim of this single-center study of 72 consecutive laparoscopic donor nephrectomies was to compare left versus right-sided laparoscopic donors in terms of surgical difficulty, complication rates and outcomes.
There were 56 left-sided and 16 right-sided donors. There was no significant difference in surgical outcomes or complication rates. Similarly, the recipient surgery complication rates and allograft outcomes were no different between kidneys procured laparoscopically from the left or the right. This single center study shows comparable donor operative parameters and recipient post-operative outcomes in left and right laparoscopic donor nephrectomies. Procuring the right kidney laparoscopically is safe and does not have a negative impact on donor recovery or long term graft function in the recipient.