Tuesday, 22 January 2008

Distal Radioulnar Joint Subluxation

A video of the wrist of a martial arts exponent who had a fall on his right hand 2 years ago during competition. He sustained an injury to his wrist causing him to have pain during punching. He also had painful full flexion of his wrist and resisted extension.

I have demonstrated the dorsal movement of the ulna with a fixed radius in the video. Although he would maintain some form of wrist stability with taping, he should be seen by a Hand surgeon to correct the instability.

Interesting links:
Radioulnar Joint Instability

Finger (Thumb) Dislocation

Here's a video of a female martial arts exponent who dislocated her left thumb 2 years ago after receiving a kick during competition. I did a test to evaluate the hypermobility of her joint. She is also having some hypermobility of her right thumb but it was less mobile.

Interesting Links:
Dislocation of the Thumb MP Joint

Corneal Laceration

James (not his real name) is a 22 yrs old martial arts sub-elite athlete who sustained a kick to his right eye 6 months ago. He sustained injury to his right cornea laceration due to the contact lens. Although he was seen by an Ophthalmologist and treated for several weeks, he still has blurred vision in his right eye. The corneal injury is visualised as a white patch on the cornea (corneal opacification). It is best seen under slit lamp after fluorescein eye stain. In full thickness corneal laceration, aqueous humour may leak out or there may be bleeding (hyphema) there may be distortion of the shape of the eyeball.

Since he wanted to continue to fight, he has been asked to obtain further treatment with Phototherapeutic keratectomy (PTK) or Corneal Transplant. Failure to do so, he may not be able to clear his Preparticipation examination with 'one good eye'.

Interesting links:
Corneal Laceration
Corneal Abrasion
Corneoscleral Laceration
Sports Pre-participation Examination

Thursday, 17 January 2008


The Proton Malaysia Open Super Series 2008 will be held from the 15th January to 20th January 2008 featuring the top world ranked players (e.g. Lee Chong Wei, Bao Chunlai, Peter Gade and Taufik Hidayat). Once again the prestigious event will be held in the Putra Stadium, Bukit Jalil, Kuala Lumpur. The Malaysian Open offers a total purse of US$250,000. For the first tine, winners of the men's and women's singles will get an equal prize money of USD15,000 while the men's and women's doubles champions will get US$13,800 each.

The qualifying rounds started on the 15th January 2008 and Championship events started a day later. It would be interesting to see who will feature in the Semifinals (19th January 2008) and Finals(20th January 2008).

It was upsetting for the Chinese that women's singles top seed Xie Xingfang pulled out of the competition due to an elbow injury. Anita Kaur shocked 2005 Sea Games champion Adriyanti Firdasari of Indonesia by defeating her 16-21, 25-23, 21-19. There will be more surprises as the championship progresses.

All the best to the players for this tournament!

Important links:
Seeded Entries
Badminton Association of Malaysia Website: News Updates
Match Schedule and Results
BWF Rankings

Tuesday, 15 January 2008

Knee Hyperextension in Ex-Rhythimic Gymnast

Ms Lim is a 35 yrs old ex-rhythmic gymnast who came to see me after a fall on her right knee. It was interesting that she had an extremely flexible left knee with an additional range of 35 degrees in extension. She had been perfectly normal in the left knee and did not suffer from any nagging pain.

She was advised to maintain an active lifestyle to ensure that she looses some weight and also strengthen her back, abdomen, hip and lower limb muscles to prevent injuries.

Blister after unmonitored heat therapy

An adult male patient came yesterday with back pain 2 days after injuring his back carrying a light object at work. He did not complain of any 'shooting pain' (radiating pain) to mentioned that the pain did not subside despite placing a hot water bottle (heat therapy) overnight. He had no pain bending forwards (flexion) but pain getting up from bent position (deflexion).

I examined him and found that he had 4 blisters (fluid filled sac in the skin) on his back (see photo) and spasm of his right erector spinae muscle. He didn't know that some of the pain was due to the blisters!

His muscle strain would recover with a week of physiotherapy and some medication for pain and muscle relaxation. He was not advised any treatment for the blister as it would heal on its own. I advised him to avoid using the hot water bottle directly onto skin or longer than 30 minutes to avoid blisters.

Sunday, 13 January 2008

Right forefoot contusion

Dave played soccer 2 days ago and had slight right forefoot pain during the match but completed the game despite the pain. The pain worsened in the evening and he was given a hot ointment (Methyl Salicylate) by his mother. He faithfully massaged his right foot with the ointment and found that the foot was swollen (the light shade in the picture). He limped into my clinic yesterday and I thought that he had had a fall and or suffered from a stress fracture of one of his metatarsal bones.

He had oedema and tenderness of the softhis 5th metatarsophalangeal joint and both 4th and 5th metatarsal bones.

He was given some RICE treatment, Arnica Comp gel and 5 days of NSAIDS to reduce the swelling and pain. He is expected to get much better and I will review his injury once the swelling subsides over the next 48 hours.

Interesting links:-
Jones Fracture