Optimizing Best Practice Advisory alerts in electronic medical records with a multi-pronged strategy at a tertiary care hospital in Singapore.

Objective: Clinical decision support (CDS) alerts can aid in improving patient care. One CDS functionality is the Best Practice Advisory (BPA) alert notification system, wherein BPA alerts are automated alerts embedded in the hospital's electronic medical records (EMR). However, excessive alerts can change clinician behavior; redundant and repetitive alerts can contribute to alert fatigue.

Limb salvage versus primary amputation in Gustilo-Anderson IIIB and IIIC tibial fractures: a systematic review and meta-analysis.

Introduction: The last systematic review on this topic was published in 2008. With advances in surgical techniques, patients with mangled extremities may now be potentially salvageable with comparable outcomes. This review aims to evaluate the outcomes of limb salvage compared to primary amputation in patients with severe open tibial fractures.

Online training module for micro suturing incorporating motor imagery and mental practice: a design and development research study.

Introduction: There have been reduced opportunities for surgical skill acquisition due to the COVID-19 pandemic and the regulated training hours. Despite these challenges, self-regulated learning allows trainees to learn continuously, and one form of this is through mental practice and motor imagery. The study aimed to design and develop an online basic micro suturing training module for skill acquisition for self-regulated learning using a low-fidelity rubber glove model.

Incidence of Radiolucent Lines after Cemented Total Knee Arthroplasty.

Background: Cemented Total Knee Arthroplasty (TKA) provides excellent long-term survival rates and functional results, however, radiolucent lines (RLLs) often appear during early post-operative follow-up and their incidence and clinical significance are unknown. The primary aim was to establish the incidence, location, frequency, and time taken for RLLs to appear within the first year after a primary cemented TKA with an anatomic tibial baseplate (Smith and Nephew, LEGION Total Knee System).

Methods: This was a retrospective analysis of 135 primary cemented TKA in 131 patients over three years.

The Influence of Obesity on Unicompartmental Knee Arthroplasty Outcomes: A Systematic Review And Meta-Analysis.

Obesity is associated with a greater prevalence of symptomatic knee osteoarthritis. Obese patients are thought to have worse outcomes following unicompartmental knee arthroplasty (UKA).The aim is to compare clinical and functional outcomes of UKA in obese to non-obese patients.

Intravascular Papillary Endothelial Hyperplasia: Case Report of a Recurrent Masson's Tumor of the Finger and Review of Literature.

Intravascular papillary endothelial hyperplasia (IPEH), often referred to as Masson's Tumor, is an uncommon yet benign vascular disease of the skin and subcutaneous tissues. It usually arises within a blood vessel, but is considered to be a non-neoplastic reactive endothelial proliferation commonly associated with vascular injury. Although it is rare, knowledge of this disease is important as it may mimic other benign and malignant tumors, especially angiosarcoma, which may lead to unnecessary aggressive management.

Can Open Hand Injuries Wait for Their Surgery in a Tertiary Hospital?

 Open hand injuries are routinely admitted and planned for surgery acutely, competing with other surgical emergencies. This retrospective study aims to evaluate if a delay in timing to surgery for open hand injuries led to an increased rate of infection.  All patients who sustained open hand injuries and underwent semi-emergent day surgery from January 1, 2015 to December 31, 2016 were included.

Diagnosing surgical site infections using telemedicine: A Systematic Review.

Background: Surgical site infections (SSI) are preventable post-operative complications. With the increase in use of telehealth modalities, there is a need to assess if telehealth modalities are safe for assessment of SSI.

Aim: This review aims to assess the accuracy of using telemedicine in the diagnosis of SSI in post-surgical adult patients as compared to in-person assessments.

Return to work after medial unicompartmental knee arthroplasty: A systematic review.

Introduction: This study aims to evaluate the current literature with regard to the average time to and overall rate of return to work (RTW) following medial unicompartmental knee arthroplasty (UKA).

Methods: A systematic search was conducted on MEDLINE (Ovid), Embase, Pubmed, CINAHL, Web of Science, Scopus, and the Cochrane Library to identify studies reporting RTW after UKA. Primary outcomes were the rate and time to RTW after UKA.

Return to work after surgically treated acetabular fractures in an Asian population.

Background: Acetabular fractures are rare but are severe injuries that occur in younger patients with a significant economic impact. There is limited evidence describing the return to work rates in this group of patients. The aim of our study was to examine the rate and time to return to work (RTW) after surgical fixation of acetabular fractures.

Patient and Surgeon Reported Experiences of Locoregional Anesthesia in Hand Surgery.

 Locoregional anesthesia techniques have been increasingly adopted for use in hand surgery in recent years. However, locoregional anesthesia techniques may place patients under significant psychological stress, and there has been limited evaluation of acceptance and satisfaction rates of these techniques.  An observational study was conducted in a single tertiary institution.

Scope of Hand Surgery Using Surgeon Administered Local/Regional Anaesthesia.

Introduction: Hand and wrist surgeries are often carried out under local/regional anesthesia. We describe our experience using Surgeon Administered Local/Regional Anaesthesia (SALoRA) without sedation to deliver acute and elective hand surgery anesthesia in a tertiary public hospital in Singapore. This is in comparison to wide awake local anesthesia no tourniquet, which has been increasing in popularity.

Accessory Palmaris Longus: A Concise Anatomic Review With a Relevant Case Study.

Current medical literature has described many variations of the palmaris longus. One variation that is rarely seen is that of the accessory palmaris longus, which is better known in literature as the "palmaris profundus." This brief review will describe the anatomy and the developmental origins of the palmaris longus, as well as the clinical relevance of an accessory palmaris longus.

Early weight loss after laparoscopic sleeve gastrectomy predicts midterm weight loss in morbidly obese Asians.

Background: Laparoscopic sleeve gastrectomy (SG) is a popular bariatric procedure in morbidly obese Asians.

Objectives: To investigate the effect of initial weight loss on midterm weight maintenance and remission of co-morbidities after laparoscopic SG in morbidly obese Asians.

Setting: University Hospital, Singapore.