Publications by authors named "Boris Fung"

This case series of 4 patients was studied at Queen Mary Hospital, Hong Kong from 2007 to 2011 to evaluate the clinical and radiological outcome of scaphoid fracture non-union treated with Open reduction and internal fixation ORIF supplemented with Bone Graft (BG) from iliac crest and Platelet Rich Plasma PRP. The purpose was to achieve union with pain free adequate range of movement. Patients presenting with scaphoid fracture non-union were included in our study.

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Purpose: Distal radius fractures are associated with a high incidence of triangular fibrocartilage complex (TFCC) tears. This study aims to evaluate the status of TFCC after the healing of distal radius fractures, and its clinical significance.

Methods: Wrist arthroscopies were performed on 43 distal radius fractures, with an average age of 54 years old.

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Objective: To evaluate the clinical outcome of managing distal inter-phalangeal joint arthritis by using excisional arthroplasties with soft-tissue interposition to provide pain-free joint with adequate range of motion and preserving the bone stock.

Methods: The case series was conducted at Queen Mary Hospital, Hong Kong from 2013 to 2015 and comprised patients with distal inter-phalangeal joint arthritis. Excisional arthroplasty was performed for all patients.

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Venous thromboembolism in hand surgery is rare. There is no report in the literature on postoperative mortality from venous thromboembolism following microsurgery in upper limbs. We report the case of a 56-year-old Chinese man who died from pulmonary embolism as a result of bilateral lower-limb deep vein thrombosis following prolonged surgery under general anaesthesia after replantation of a finger.

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Open release remains the gold standard in the treatment of carpal tunnel syndrome in cases where conservative treatment fails. However, the efficacy of carpal tunnel release in the elderly has been debated in the literature throughout the years. This review aims to review the current evidence pertaining to the efficacy of carpal tunnel release in the elderly.

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Enchondromas are benign bone tumours originating from cartilages. It is mainly discovered incidentally in radiographs or due to symptoms like pathological fracture or pain. Conservative treatment through regular check-up and surgical excision using curettage are the two major treatment methods for enchondromas.

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Distal Radioulnar Joint (DRUJ) dislocation is a commonly missed injury. A high clinical suspicion is required as the dislocation may not be obvious in the conventional views of radiographs. Volar DRUJ dislocations are far less common than the dorsal ones.

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Even with the invention of locking plates, intra-articular fractures of distal radius with extreme comminution remain a challenge for orthopaedic surgeons. Osteochondral graft is a potential choice to reconstruct the articular defect. We report a patient who had a fracture of distal radius with costo-osteochondral graft for articular reconstruction which has not yet been described in the English literature.

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Article Synopsis
  • The review focuses on the management of acute scaphoid fractures, emphasizing the need for accurate diagnosis through patient history, physical exams, and imaging.
  • There is a tendency to over-treat suspected scaphoid fractures, as many cases are often missed despite clinical evaluations.
  • The management approaches vary among institutions, highlighting ongoing controversies and differing practices in treating these fractures.
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Introduction: To identify the strongest peak load resistance among four mallet finger fracture fixation methods (Kirschner wire, pull-out wire, tension-band wiring and the JuggerKnot™ (Biomet) soft anchor fixation).

Methods: Fixation techniques were assigned among 24 specimens from six cadaveric human hands in a randomized block fashion. Peak load resistance was tested at 30°, 45° and 60° of flexion of the distal interphalangeal joint.

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Article Synopsis
  • Schwannomas are the most common tumors affecting peripheral nerves, but many cannot be fully removed without affecting nerve fascicles.
  • A study over 10 years showed that 75% of schwannomas in 8 patients occurred in the distal upper limb, predominantly in mixed nerves.
  • The authors recommend discussing nerve graft options with patients before surgery since there’s currently no reliable method to predict whether fascicular involvement will occur during the removal.
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Glomus tumours are vascular hamartomas that are commonly found in the hand, particularly the subungual region. They appear as solitary or multiple tumours, and often present as a bluish discoloration of the nail plate. Different diagnostic tests are outlined, as well as imaging studies such as magnetic resonance imaging and ultrasound.

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Fractures of the proximal phalanges of the hands can be treated by many methods. With surgical intervention, a loss in proximal interphalangeal joint movement is common. Using the stabilizing effect of the zancolli complex-metacarpophalangeal retention apparatus and an external device such as a thermoplastic metacarpophalangeal block splint, proximal phalangeal fractures can be stabilized in terms of axis, length, and rotation.

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The triangular fibrocartilage complex (TFCC) has an important role in the stability of the distal radioulnar joint (DRUJ) stability. We designed a new method of TFCC tear repair that has satisfactory post-operative DRUJ stability. From May 2004 to August 2010, 14 patients who underwent this operation were reviewed.

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Mallet finger is a common injury involving either an extensor tendon rupture at its insertion or an avulsion fracture involving the insertion of the terminal extensor tendon. It is usually caused by a forceful blow to the tip of the finger causing sudden flexion or a hyperextension injury. Fracture at the dorsal aspect of the base of the distal phalanx is commonly associated with palmar subluxation of the distal phalanx.

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Purpose: To review records of 166 patients who underwent treatment for Mycobacterium marinum tenosynovitis of the hand and wrist to identify factors associated with functional outcome.

Methods: Records of 97 men and 69 women aged 13 to 85 (mean, 50) years who underwent treatment for suspected M marinum tenosynovitis of the hand and wrist were retrospectively reviewed. All underwent open biopsy; synovectomy was performed when florid synovitis was present.

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Article Synopsis
  • This study examined the epidemiology of occupational hand injuries, focusing on the social and industrial factors contributing to them.
  • A total of 250 patients treated for such injuries were analyzed from 1999 to 2001 to gather data on personal details, injury types, and work conditions.
  • Key findings highlighted that workers with less than a year of experience and immigrants faced a higher risk of injury, with male gender, smoking, alcohol use, and inadequate safety training identified as significant risk factors.
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Article Synopsis
  • The review covers the epidemiology, pathophysiology, clinical signs, diagnosis, and treatment options for gouty arthritis specifically in the hand and wrist, emphasizing surgical methods.
  • While prevalence studies are limited, one in Taiwan reported a 3.1% incidence, with common symptoms including severe wrist pain and the formation of tophi.
  • Medical treatments like NSAIDs and allopurinol are primary, but for about 5% of patients who don't respond, surgical options may be necessary, though they often lead to unsatisfactory results, highlighting the need for further research.
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The diabetic hand infection is less reported in the literature. Therefore, it is easily ignored and underestimated resulting in increased morbidity among the diabetic population. Diabetic hand is a rapid in progression, extensive and severe tissue destruction.

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The technique of pedicled vascularized fibular graft for lateral tibial condyle reconstruction after en bloc resection of aggressive giant cell tumours was described by SP Chow et al. Early follow-up of two patients was presented in 1986. We present the 25 years follow-up of one patient with a literature review of alternative present day treatment options.

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Introduction: The distal radioulnar joint (DRUJ) is commonly affected in rheumatoid arthritis and is associated with significant functional morbidity. The aim of our study is to review our results with matched hemi-resection interposition arthroplasty in patients with DRUJ arthritis.

Methods: This was a retrospective study of 39 patients with 51 wrists that were treated at Queen Mary Hospital in Hong Kong from 1989 to 2007.

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Mycobacterium marinum infection could have various presentations, from superficial skin infection to deep structure destruction. The prognosis is relatively poor when deep structure is involved as it is more destructive. The prognosis is even worse when operation is required.

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Article Synopsis
  • The report discusses a case involving multiple triggering in a patient with Ehlers-Danlos syndrome, suggesting that tendon degeneration and repetitive microtrauma may contribute to this condition.
  • The authors propose that the fraying of tendon fibers due to these factors can lead to triggering issues in affected patients.
  • In this particular case, a surgical approach that involved debriding the tendons rather than removing the A1 pulley resulted in a positive long-term recovery two years post-surgery.
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Article Synopsis
  • Misdiagnosis and delayed treatment of Mycobacterium marinum infections are common due to their varied symptoms, leading to serious complications like tendon loss.
  • Clinicians should be vigilant, especially for high-risk groups (like fishermen and aquarium hobbyists), and consider biopsies for accurate diagnosis.
  • Prompt anti-mycobacterial treatment, often a combination of rifampicin, ethambutol, and clarithromycin, along with debridement for severe cases, is essential for a better prognosis.
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