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Biomedical subjects

A B Tan

Publications and source records attributed to A B Tan.

9 recordsLinked to original sources
PubMed2001

Early remodeling in children's forearm fractures.

The forearm fracture is a fracture of the upper limb between the elbow and the wrist. It is a common injury in children, accounting for more than half of all children's fractures, and mostly occur when a child falls on the outstretched arm. A difficult clinical problem that often arises is how much angulation can be accepted in the child and how much remodeling will occur. One hundred consecutive cases of forearm fractures that were admitted at Childrens Orthopaedic Ward, Institute of Paediatrics at Hospital Kuala Lumpur between 1st January 1997 to 31st December 1998 were studied. We found that all fractures united 3 to 6 weeks, with a remodeling rate of about 2.5 degrees/month: the proximal fractures having the most potential to remodel. We conclude that the early remodeling potential of forearm fractures in children is 1.5 degrees/month in midshaft fractures and 2.5 degrees/month in distal and proximal fractures. We recommend accepting a 10-20 degree angulation in midshaft fractures, and a 20-30 degree angulation in metaphyseal fractures; based on our study of early remodeling potential.

Age Factors↗
PubMed1995

Congenital perforations of the triangular fibrocartilage of the wrist.

A cadaveric study of the triangular fibrocartilage of the wrist in the foetus and infant revealed a high incidence of congenital perforation. In the second half of the study, wrist arthrography in foetal and infant cadavers with crown-rump length of more than 20 cm followed by dissection of the wrist joints showed good correlation between the two. In 60 cadavers there were 11 with bilateral perforations and five had unilateral perforation. This gave a total of 27 perforations in 120 wrist joints studied.

Arthrography↗
PubMed1995

Upper limb digital replantation and revascularisation in children.

Amputations in children are not common and experience in microvascular digital replantation in children is not extensive. We report our experience of ten digital replantations in eight children over a two-year period. Paediatric replantation with its minute anatomy is technically very demanding. Joints should be reconstructed, epiphyses preserved and bone shortening kept as minimal as possible. Complications are not more than those in adults. All the replanted digits in our series survived. Seven of the ten replanted digits were normal in size. Six of the eight patients regained good to excellent functional use of the replanted digits. All but three of the joints at and distal to the level of injury regained active motion ranging from 10 degrees to 70 degrees with an average of 42 degrees. One had primary fusion of the distal interphalangeal joint of his amputated index finger. All the preserved epiphyses had remained open at the last follow-up. Replantation in children may be technically difficult but is very rewarding. We had a high success rate with good functional return and continuing growth.

Amputation, Traumatic↗
PubMed1991

Rodless end-loop stomas. Seven-year experience.

The rodless, end-loop stoma was developed as an alternative to the more traditional loop stoma to minimize patient management problems. A retrospective review of our seven-year experience in 229 patients with end-loop colostomies (135), ileocolostomies (70), and ileostomies (24) is presented. A total of 30 stoma-related complications were observed in 27 stomas, for an overall complication rate of 13.1 percent. The most common complications were skin excoriation secondary to leakage (3.5 percent), retraction (3.5 percent), partial necrosis (2.6 percent), and peristomal sepsis (1.8 percent). Mucocutaneous separation, prolapse, and stenosis were each seen in less than one percent of patients. No cases of stomal herniation, obstruction, or hemorrhage were encountered. Twelve deaths occurred, but none was attributed to stoma-related complications. The rodless, end-loop stoma is a simple and safe procedure with many advantages and a low incidence of complications.

Adolescent↗
PubMed1985

Early local complications from intestinal stomas.

A retrospective review of 610 consecutive patients with intestinal stomas constructed at Cook County Hospital, Chicago, was carried out to analyze early local complications with respect to stoma type and to compare complication rates by surgical specialty. A total of 197 complications were recognized in 158 patients for a corrected complication rate of 25.9%. Peristomal skin irritation (42.1%) was the most frequently recognized early complication in this study. Ileostomy was associated with the highest morbidity (40%) of any type of stoma. Emergency stoma formation seems to be associated with the highest complication rates, probably because of suboptimal stoma placement. The morbidity of stoma formation seems to be related to the amount of formal training in gastrointestinal tract surgery. Technical guidelines for stoma construction are presented to help minimize these complications.

Adolescent↗
PubMed1985

A survey of technical considerations in the construction of intestinal stomas.

Reported complications rates for the construction of intestinal stomas are high. Many of these complications result from improper construction, improper location, or other technical errors. In order to sample the techniques of stoma construction currently in use, a survey was conducted at the 69th Annual Clinical Congress of the American College of Surgeons in Atlanta in conjunction with our scientific exhibit "Complications of Intestinal Stomas." A total of 245 surgeons completed the questionnaire with a mean age of 47.8 years. The routine use of fascial-seromuscular tacking sutures and primary maturation of a loop colostomy in the presence of distal obstruction were among the most controversial technical points considered. Many other subtle but important principles of stoma construction were also discussed. In addition, the authors contend that many of the techniques currently in use result from an underemphasis on the importance of proper stoma construction in many surgical training programs.

Adult↗
PubMed1984

Perianal abscesses and fistulas. A study of 1023 patients.

In a five and one-half year period, 1023 patients with anorectal abscesses and fistulas were treated. Under regional anesthesia the abscesses were unroofed and debrided and a primary fistulotomy was performed whenever a low fistula was identified. In 355 (34.7 per cent) an internal fistulous opening was demonstrated at the time of abscess drainage. Thirty-two patients had suprasphincteric fistulas and underwent two-stage fistulotomy using a seton. Perianal abscesses were encountered in 42.7 per cent of the patients, followed by ischiorectal (22.7 per cent), intersphincteric (21.4 per cent), and supralevator (7.33 per cent). The patients with supralevator and intersphincteric abscesses had a high incidence of fistula identified during abscess drainage. The recurrence rates were 3.7 per cent in the group with abscess drainage only and 1.8 per cent in the group that had primary fistulotomy along with abscess drainage. The follow-up period averaged 36 months. To accomplish adequate drainage and identify the deeper components and associated fistulous opening (34.7 per cent of the entire group), careful examination under regional anesthesia is recommended. Early aggressive treatment of an anorectal abscess and fistula significantly reduces the possibility of recurrent abscesses and/or the need for further surgery.

Abscess↗