SUMMARY:Clinical practice in our country showed a lack of suitable implants that perfectly match the anthropometry of the local population. However, there have been no reports or comprehensive studies conducted to substantiate this argument. We therefore prospectively studied 120 hips from sixty subjects with an average age of 25±5.18 years old. The average weight and height were 61.48±13.84 kg and 1.65±9.63 m respectively. The exclusion criteria were pregnant woman, those who had injury to the hip joint, and those with implant or prosthesis. Four parameters were measured -the femoral head diameter (FHD), femoral neck length (FNL), femoral neck width (FNW) and collo-diaphyseal angle (CDA). Statistical analysis showed no significant differences between left and right femora but significant differences were found between male and female subjects. The results for the male and female femurs are as follows -FHD: 43.6±3.1 mm and 38.9±2.2 mm; FNL: 91.1±5.7 mm and 81.8±4.3 mm; FNW: 28.9±3.4 mm and 26.0±4.3 mm; CDA: 132.3°±3.4° and 129.9°±4.0°. This data could be used as a guideline to design a more suitable implant for the Malay population which covers most of the South East Asian countries.

OBJECTIVE:The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function.METHODS:Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique.RESULTS:There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion).CONCLUSION:This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes.

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A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angle, bowing angle, anteversion, and medullary canal diameters from the osteotomy level to 150 mm below the osteotomy level to determine the position of the isthmus. Other indices and ratios for the endosteal canal, metaphyseal, and flares were computed and examined. The results showed that Asian femurs are smaller than Western femurs, except in the metaphyseal region. The canal flare index (CFI) was poorly correlated (r < 0.50) to the metaphyseal canal flare index (MCFI), but correlated well (r = 0.66) with the corticomedullary index (CMI). The diversity of the femoral size, particularly in the metaphyseal region, allows for proper femoral stem design for Asian patients, improves osseointegration, and prolongs the life of the implant.