BackgroundMarine stings and envenomation are fairly common in Malaysia. Possible contact to various marine life occurs during diving, fishing and food handling. Even though majority of fish stings are benign, there are several venomous species such as puffer fish, scorpion fish, lionfish, stingray and stonefish that require urgent medical treatment. Stonefish is one of the most venomous fish in the world with potential fatal local and systemic toxicity effects to human.Case PresentationWe reported a case of stonefish sting complicated with impending compartment syndrome.ConclusionsMedical staff should be alert about the possibility of this potential emergency in standard management of stonefish stings.

CONCLUSIONMalaysians have a mean femoral head diameter of 44.9 ± 3.2 mm. Among our patients, Chinese patients had a significantly larger femoral head size than Malay and Indian patients. We also found that, in our cohort, men had significantly larger femoral head diameters than women.

This cadaveric study evaluates the margin of safety and technical efficacy of mini open carpal tunnel release performed using Knifelight (Stryker Instruments) through a transverse 1 cm wrist incision. A single investigator released 32 wrists in 17 cadavers. The wrists were then explored to assess the completeness of release and damage to vital structures including the superficial palmar arch, palmar cutaneous branch and recurrent branch of the median nerve. All the releases were complete and no injury to the median nerve and other structures were observed. The mean distance of the recurrent motor branch to the ligamentous divisions was 5.7 +/- 2.4 mm, superficial palmar arch was 8.7 +/- 3.1 mm and palmar cutaneous branch to the ligamentous division was 7.2 +/- 2.4 mm. The mean length of the transverse carpal ligament was 29.3 +/- 3.7 mm. Guyon's canal was preserved in all cases.

Purpose: Endoscopic carpal tunnel release has been shown to be associated with a shorter return to work compared with open carpal tunnel release in the treatment of carpal tunnel syndrome. Unfortunately, it may be associated with a higher risk for median nerve injury when the carpal tunnel is used as a portal for instrumentation. The purpose of this study was to assess safety in using a newly designed retractor through a supraretinacular approach. Methods: We used 8 wrists (4 left and 4 right wrists) from 4 fresh-frozen cadavers for this study. Supraretinacular endoscopic carpal tunnel release using the supraretinacular retractor was performed by a single investigator, followed by exploration of the carpal tunnel and the structures surrounding it. Surgeries were performed using a new surgical instrument consisting of an arch-shaped blade and handle. It includes a retainer adapted to receive a 2.4-or 2.7-mm endoscope and to retain it at the apex of the arch, which can be moved in and out to visualize the entire transverse carpal ligament. The space below the blade is also used as a portal to insert scissors and instrumentation to cut the transverse carpal ligament. Results: All 8 carpal tunnels were completely released with no injury to the median nerve, superficial palmar arch, flexor tendon, or violation into Guyon canal. Mean distance of the flexor retinaculum division to the recurrent motor branch, palmar cutaneous branch, and superficial palmar arch was 6.87 ± 2.80, 7.13 ± 5.33, and 9.13 ± 4.42 mm, respectively. All specimens had an extraligamentous recurrent motor branch. Conclusions: The retractor and described technique were safe and effective in this cadaveric study. Further clinical trials are necessary before it can be adopted as a safe and reliable technique. Type of study/level of evidence: Therapeutic IV.