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Biomedical subjects

R W H Pho

Publications and source records attributed to R W H Pho.

7 recordsLinked to original sources
PubMed2005

Central column reconstruction following total resection of a third metacarpal giant cell tumour.

A wide resection of a giant cell tumour involving the entire middle metacarpal is presented. Reconstruction preserving the central column and metacarpophalangeal joint was achieved using autologous iliac crest bone as a spacer and structural support. The fibro-osseous cartilage portion of the iliac graft was used as a "hemi-joint" replacement. By using a bridging bone graft and screw to fuse the adjacent proximal phalanges of the middle and index fingers, a stable "internal syndactyly" was achieved. Although independent index and middle finger motion was sacrificed, the approach allowed wide resection for local tumour control, re-established structural integrity, preserved metacarpophalangeal joint motion and allowed early motion. The aesthetic result was also good.

Bone Neoplasms↗
PubMed2005

Report of an unusual case of trigger finger secondary to phalangeal exostosis.

Trigger finger is commonly secondary to stenosing tenosynovitis. Space occupying lesions in the tendon bed, although uncommon, may prevent smooth tendon gliding. These include lipoma, anomalous muscle insertions, tumours of the tendon sheath and haemangiomas. We describe a patient who had triggering of the left middle finger at the proximal interphalangeal joint due to an exostosis blocking the flexor tendons gliding. Removal of the exostosis relieved the problem. The clinician must be aware that there are other causes for triggering. These may be identified with pertinent findings in the history and physical examination.

Adult↗
PubMed2003

Continuous local anaesthesia for post-operative mobilization of injured digits.

We have studied the effects of sustained local anaesthesia on postoperative mobilization of the injured hand. Small epidural catheters were placed adjacent to the peripheral nerves providing sensation to the involved part of the hand under direct vision in the distal forearm. Repeated doses of 0.5% bupivacaine were then administered during mobilization therapy to relieve pain. Fourteen out of 24 digits (60%) recorded 30 degrees or more increases in active range of motion after bupivacaine injection. The cases that failed to improve had suffered severe injuries. Complications were few and were easily managed as the catheters were distal, superficial and accessible. This is an effective, specific and safe method of providing sustained postoperative analgesia for mobilization.

Adolescent↗
PubMed2002

Colourfast pigments in silicone hand and maxillofacial prostheses.

This study addresses the clinical problem of long-term discolouration of silicone hand and maxillofacial prostheses. Seven (7) pigment hues, considered essential for achieving a suitable tissue colour-matched prosthesis, were compared for their colourfast property, across three selected proprietary formulations. In all, a series of 21 pigments, were tested for colourfastness. The pigments, presenting as suspensions (PS), pastes (PP) and dry pigments (PD), were exposed, over nine months, to ultraviolet light, elevated temperatures and varying concentrations of salinity. Colour change of the pigments was measured and expressed as Commission International de l'Eclairage (CIE) (L*, a*, b*) units. Pigment discoloration was significantly attributed to ultraviolet light. Pigmented and clear silicone samples showed a "yellowing" (+delta b*) effect. Lighter pigments became darker (-delta L*) in shade. Pigment samples at the elevated temperature of 50 degrees C showed significant but small colour change (delta E, 0.77 to 3.63). Only the master blue pigment (PS-4) recorded a higher delta E, 6.26 at 50 degrees C. At a moderate temperature of 35 degrees C, both pigmented and clear silicone test samples remained relatively colourfast. Comparison was made to control samples, stored in darkness, at 26 degrees C. The pigments were generally colourfast (deltaE<6 units) to saline solutions of 0.15 M and 5.0 M concentrations. Only the monastral red (PD-3) pigment recorded a delta E of 9.33, in 0.15 M normal saline, simulating the vulnerability of this pigment to the salinity of human sweat. Pigment hues were systematically ranked according to colourfastness. Pigment suspensions were more colourfast than pigment pastes.

Artificial Limbs↗
PubMed2002

Extremity osteosarcoma--a Southeast Asian experience.

INTRODUCTION: We present our experience with limb salvage emphasising the use of vascularised bone grafts in combination with autoclaved tumour bone for limb salvage in osteosarcoma. MATERIALS AND METHODS: Thirty-six cases with extremity osteosarcoma, all of which were managed at a single institution between 1980 and 1999, were reviewed at a mean follow-up of 9 years (range, 10 months to 200 months). There were 26 patients who underwent limb salvage surgery and 10 patients who had amputation. RESULTS: In the limb salvage group, 12 bone defects were bridged using vascularised bone grafts alone while autoclaved tumour bone was used for reconstruction in the remaining 14 patients. In these 14, there were 10 with autoclaved tumour bone and vascularised bone, 2 with autoclaved bone and non-vascularised bone and 2 with autoclaved bone alone. The joint was preserved in 13 of the 26 reconstructions. Of these, 11 involved preservation of the knee joint contributing to a quantum gain in function with 84% good and excellent results. The actuarial survival was 64% at 2 years and 48% at 5 years, with no significant difference between ablation and limb salvage. CONCLUSION: The use of the autoclaved bone provided yet another effective alternative for bridging large defects following resection of high grade tumours.

Adolescent↗