Joby Jacob George Malal

Bedford Hospital NHS Trust · Trauma and Orthopaedics

Chevron osteotomy, a commonly performed procedure for the treatment of hallux valgus, results in osteonecrosis of the first metatarsal head in 0% to 20% of cases. The aim of this study was to map out the arrangement of the vascular supply to the first metatarsal head and its relationship to the limbs of the chevron osteotomy. Ten cadaveric lower li...

Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent s...

Background: There is a paucity of data available with respect to outcome on long contoured locking plate fixation for proximal humerus fractures with distal fracture extension. Methods: Thirty-four patients with traumatic proximal humerus fractures with distal extension underwent fixation with long contoured locking plates. Twenty-five patients...

Background and hypothesis Reverse shoulder arthroplasty (RSA) is an increasingly popular treatment modality for glenohumeral joint arthritis in association with rotator cuff arthropathy. A prolonged hospital stay following joint arthroplasty risks increased complications for patients plus financial implications for institutions. We hypothesized tha...

Superior labrum anterior and posterior (SLAP) lesion is of fairly recent description and its understanding is rapidly evolving. Its incidence and need for surgical treatment has increased exponentially in line with the increase in shoulder arthroscopies. It is of particular importance in the elite over head athlete and the young. A range of arthros...

Chondroblastomas are benign tumours commonly arising at the epiphysis of long bones such as the femur, tibia and humerus. Literature consists primarily of case reports describing chondroblastomas arising at unusual sites such as the carpus and patella. We report a yet unreported case of a chondroblastoma affecting a thumb sesamoid which was treated...

Aim: Quality improvement project to assess the efficacy, safety and outcomes of performing Reverse Shoulder Replacement (RSR) as a day case procedure. Background: RSRs are increasingly carried out for painful shoulder conditions with rotator cuff deficiency. Reported average length of stay varies from 1 to 2.5 days. As part of a local ‘Transformin...

Abstract Hand preference for perineal hygiene is not a commonly recorded data unlike hand dominance. Ability to reach the perineum is essential for a good functional outcome. There is no evidence in orthopaedic literature regarding its variability. The aim of this study was to examine hand preference for perineal hygiene in a cohort of hospital sta...

The assessment and management of patients with instability of the shoulder joint can be challenging, due to the varying ways patients present, the array of different classification systems, the confusing terminology used and the differing potential management strategies. This review article aims to provide a clear explanation of the common concepts...

Rotator cuff disorders are considered to be among the most common causes of shoulder pain and disability encountered in both primary and secondary care. The general pathology of subacromial impingment generally relates to a chronic repetitive process in which the conjoint tendon of the rotator cuff undergoes repetitive compression and micro trauma...

Professor Grammont revolutionised shoulder surgery with his reverse shoulder arthroplasty design. Patients who had poor results from a conventional shoulder replacement because of cuff deficiency can now be treated effectively. Although designed for cuff tear arthropathy, indications continue to evolve and broaden. The initial results look very pro...

The majority of proximal humerus fractures are sustained via low energy falls in the elderly population. These patients can attain an acceptable level of function via non-operative treatment. There is yet to be a clear consensus on treatment options suitable for those that fall outside of this majority group. Open reduction internal fixation, intra...

A prospective clinical study was undertaken to assess the effectiveness of Nickel-Titanium Memory compression staples for fusion of the intertarsal joints. Ten patients underwent procedures for fusion of various hindfoot and midfoot joints with the memory staples. The patients were evaluated regarding period of immobilization in cast and time to ra...