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Biomedical subjects

Jimmy W K Wong

Publications and source records attributed to Jimmy W K Wong.

7 recordsLinked to original sources

Hemangioendothelioma with an epithelioid phenotype arising in hemangioma of the fibula.

The classification of certain vascular bone tumors that show an epithelioid cytologic appearance remains confusing, with overlap in features of epithelioid hemangioma, hemangioendothelioma and epithelioid hemangioendothelioma. Radiographs of a 27-year-old woman who presented with ankle pain showed an expanded lytic-sclerotic lesion in the distal left fibula. Magnetic resonance imaging showed an intramedullary lesion with a small lateral intracortical component. The lesion was hypo- to isointense to muscle on T1-weighted images and heterogeneously hyperintense on T2-weighted images. Initial incisional biopsy was inconclusive. Open biopsy showed hemangioendothelioma with epithelioid morphology, and the lesion was completely resected with reconstruction using a peroneal fibular rotation graft. Examination of the resected specimen showed focal hemangioendothelioma with an epithelioid phenotype arising in a hemangioma. This case illustrates the difficulty and pitfalls of making the correct diagnosis on the basis of a small biopsy specimen.

Adult↗

A simple device in shoulder arthroscopy: the suture assistant.

Arthroscopic reconstructive surgery in the shoulder is an extremely demanding. The advent of suture anchors, arthroscopic knot-tying techniques, and new arthroscopic instruments has greatly facilitated its development. Knowledge of the anatomy and surgical principles alone are not enough. Good visualization is critical. We describe a simple home-made device that can be very useful in improving visualization and in helping to retrieve sutures during the knot-tying stage, especially in smaller shoulders. We introduce the concept of "bringing the suture" to the instrument rather than "taking the instrument to the suture."

Arthroscopy↗

How to use cuff suture instruments: the concept of "concave in and concave out".

Arthroscopic reconstructive surgery of the shoulder is extremely demanding. The advent of suture anchors and knot-tying instruments has greatly facilitated its development. Knowledge of the anatomy and surgical principles alone is not enough. Familiarity with specific instruments is also important. We describe our experience with the Elite Cuff Stitch Suture Relay (Smith & Nephew, London, U.K.). We describe a new concept on how to use this suture passer or similar instrument. We advocate this new concept of "concave in and concave out."

Arthroscopy↗

Patellar clunk syndrome after posterior stabilized total knee arthroplasty.

Two hundred thirty-six posterior stabilized total knee arthroplasties (TKAs) were performed consecutively. Twenty-seven patellar clunk syndromes were identified in 25 patients. Insall-Salvati ratio, position of joint line, postoperative patellar height, and anterior-posterior position of tibial tray were measured. It was found that postoperative low-lying patella (P<.001) and anterior placement of tibial tray (P=.011) was associated with patellar clunk syndrome. Thirteen patients had bilateral TKAs of the same prosthesis (5 bilateral AMK knees and 8 bilateral Insall Burstein knees) but unilateral patellar clunk syndrome. The nonclunk sides were used as control for comparison with the clunk sides. The congruency and tilting of the patellar button in the skyline view were documented. It was observed that the congruency of the patellar button was less satisfactory in the clunk side (P=.019).

Aged↗

Why are we still using pre-operative skin traction for hip fractures?

We performed a prospective randomised trial to evaluate the efficacy of pre-operative skin traction for proximal femoral fractures in 311 patients. We found a significant difference in pain score on the evening of admission and the first morning after admission between the groups with traction compared the group without. However, there was no corresponding increase in analgesic requirement during this period. The peak pain score pattern also was different in our population. No other objective benefit can be shown from using skin traction, and its routine use should be abandoned.

Adult↗