Minimally Invasive Surgery Transpedicular Intrabody Cage Technique for the Management of Kummell Disease.

Background: The treatment of Kummell disease remains controversial, with a wide variety of options proposed in the literature. This study aims to introduce a unique and minimally invasive approach for the treatment of Kummell disease and present the clinical results of this technique.

Methods: Twenty patients underwent surgery using the minimally invasive surgery transpedicular intrabody cage (MISTIC) technique from 2014 to 2016.

Direct medial approach in surgical fixation of fractures in the posterior aspect of the medial malleolus.

Fractures in the posterior aspect of the medial malleolus form an important subset of ankle fractures and the indications for fixation include involvement of > 25% of the articular surface or an articular step off by > 2 mm. Several approaches have been described but there has been no recent study on the direct medial approach. Five fresh frozen cadaveric ankles were dissected using the direct medial approach.

Reverse shoulder arthroplasty: The Singapore General Hospital experience and a simple method of measuring change in the center-of-rotation.

Introduction: This study reviews the outcomes of reverse shoulder arthroplasty (RSA) and introduces a novel method of measuring changes in the center-of-rotation (COR) of the shoulder joint post-operatively.

Methods: We performed 10 reverse shoulders in 2011. Patients were evaluated pre-operatively and post-operatively using the Constant Score.

Reducing allograft contamination and disease transmission: intraosseous temperatures of femoral head allografts during autoclaving.

Introduction: The Singapore General Hospital Bone Bank, which exclusively stores femoral head allografts, relies on flash sterilisation to prevent allograft-related disease transmission and wound infection. However, intraosseous temperatures during autoclaving may be lower than required to eliminate human immunodeficiency virus, and hepatitis B and C viruses. The aim of this study is to determine the intraosseous temperatures of femoral head allografts during autoclaving and to assess the adequacy of autoclaving in preventing disease transmission.

Simple novel bone bank storage: the Singapore General Hospital experience.

Introduction: Since 1981, the Singapore General Hospital (SGH) bone bank has proven to be a safe, reliable, and economical source of bone allografts. Femoral heads are used exclusively and are procured from patients undergoing hip arthroplasty. Screening for HIV, hepatitis B, and hepatitis C is carried out prior to surgery.

A fan-shaped axillopectoral muscle: an unusual variant of the axillary arch.

The axillary arch is a vestigial muscle in the axilla, which originates from the latissimus dorsi and inserts into the pectoralis major tendon. The aim of this article is to describe a fan-shaped variant of the axillary arch and its clinical implications. We present a patient who underwent an axillary node dissection during which, a fan-shaped axillopectoral muscle measuring 8 cm by 6 cm was encountered.