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Article
Factors Influencing the Management of the FlexorTendon Injuries in the Hand

Author: Avadis A. Muradian
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2002 Volume: 8 Issue: 2 Pages: 253
Publisher: Basrah University جامعة البصرة

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Abstract

Thirty-three patients with flexor tendon injuries in 68 fingers were studied. They were 78.8% males 21.2% females. Age was range between 16 - 45 years. Patients were assigned into two zone groups; zone II & V. Twenty six fingers (38.2%) were in zone II, and 42 (61.8%) were in zone V. Primary repair was done in 42.6% and delayed in 57.4%. Both tendons (FDS*& FDP**) were repaired in 43 fingers, isolated FDP were repaired in 25 fingers. Postoperatively, only 31 fingers were managed with early active extension/passive flexion technique. The final results were evaluated by Louisville criteria and were Satisfactory (excellent and good) in 41 fingers (60.4%). The results were correlated to the involved zones, timing of the repair, type of the repair and the post-operative management program. It is concluded from this study that it is preferable to repair both tendons if possible by delayed primary repair with early mobilization when a trained surgeon and surgical resources are available

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Article
LOCAL STEROID INJECTION OR SURGERY IN THE MANAGEMENT OF CARPAL TUNNEL SYNDROME; THE POSSIBLE PREDICTIVE FACTORS FOR THE CHOICE OF TREATMENT

Author: Avadis A Muradian
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 1 Pages: 1-7
Publisher: Basrah University جامعة البصرة

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Abstract

A total of 178 patients with 202 affected hands were studied prospectively for the management of carpal tunnel syndrome (CTS). Eighty six patients (105 hands) were treated with local steroid injection and 92 patients (97 hands) treated by surgical decompression, the follow up period ranged from 1 to 42 months. The period of relief and the risk of symptoms relapse after each management technique was evaluated. Of the total 86 hands (89%) treated surgically were free of symptoms at the follow up period, only 12 hands (11%) treated by local steroid injection were symptom free after more than one year of follow up. The results showed that local steroid injection have long term effect in the hands with mild symptoms, most were free from daily activity related pain and paresthesia with a duration less than 6 months and with mild median nerve compression in electro diagnostic studies. Surgical release provides better long period of recovery with low rate of relapse, in those hands with severe symptoms and nerve compression that lead to continuous night and daily activity complain, regardless of the duration of symptoms.

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Article
ULNAR DIMELIA, A CASE REPORT

Author: AVADIS A MURADIAN
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2007 Volume: 13 Issue: 2 Pages: 73-74
Publisher: Basrah University جامعة البصرة

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Article
A REPORT OF TWO CASES OF SQUAMOUS CELL CARCINOMA OF THE HAND IN PATIENTS WITH EPIDERMOLYSIS BULLOSA DYSTROPHICA

Author: Avadis A Muradian
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2016 Volume: 22 Issue: 2 Pages: 109-113
Publisher: Basrah University جامعة البصرة

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Abstract

Abstract This is a report of two patients (brothers) with unusual generalized skin disorder, a recessive dystrophic epidermolysis bullosa (RDEB) that appeared at childhood, who developed a progressive squamous cell carcinoma (SCC) in their right hands. Later both patients underwent wide local tumor excision, and during the follow-up after surgery, axillary lymph node metastasis observed in the first case, and local recurrence in the second. Therefore early recognition of EBD is important to assist in the diagnosis and treatment of malignant lesions at an early stage in these patients to prevent the subsequent complications.


Article
HAND PROBLEMS IN DIABETIC PATIENTS

Authors: Avadis A Muradian* --- Ali Iskander
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2005 Volume: 11 Issue: 1 Pages: 110-115
Publisher: Basrah University جامعة البصرة

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Abstract

This present study was conducted on 436 diabetic patients, hand disorders were detected in 135 patients (180 hands). The incidence of Dupuytren�s contracture was the highest 34%, carpal tunnel syndrome was diagnosed in 21% of the patients, flexor tenosynovitis in 19%, limited joint mobility in about 15%, hand infections in 10%, tumors in less than 1%, and more than one hand abnormality observed in the same patient in 15% of the diabetics. The results of this article present the prevalence of each hand condition in this common disease in our department.


Article
COMPLICATIONS OF SURGERY FOR CARPAL TUNNEL SYNDROME

Authors: Avadis A Muradian --- Kareem Jasim
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2015 Volume: 21 Issue: 1 Pages: 82-85
Publisher: Basrah University جامعة البصرة

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Abstract

The carpal tunnel release is usually a curative treatment for the carpal tunnel syndrome (CTS), but not without complications, it may ranges from wound infection to nerve laceration. Study population included 150 patients (157 wrists) who had surgery for CTS. Patients were observed for the outcome and associated problems during and after operative procedure. Thirty seven wrists (23%) developed complications, these complications were; intraoperative in 7 wrists, early postoperative (within first 2 weeks) in 10, and late postoperative (after 2 weeks) in 20.This finding indicates that failure or complications following surgical release may occur, and in some situations may relate to the dissection or operating surgeon


Article
VOLAR PERILUNATE CARPAL FRACTURE DISLOCATION: A CASE REPORT OF UNCOMMON INJURY PATTERN

Authors: Mohammed A Akrawi --- Avadis A Muradian
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2017 Volume: 23 Issue: 1 Pages: 88-92
Publisher: Basrah University جامعة البصرة

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Abstract

VOLAR PERILUNATE CARPAL FRACTURE DISLOCATION: A CASE REPORT OF UNCOMMON INJURY PATTERNMohammed A Akrawi* & Avadis A Muradian@*MB,ChB, FDSOT, Senior Consultant Orthopaedic Surgeon, Newroz Orthopaedic Hospital. @MB,ChB, FICMS, Assist. Prof., Consultant Orthopaedic Surgeon, Erbil, IRAQ.AbstractCarpal fracture dislocations are relatively uncommon category of wrist injuries that often easily unrecognized and can be difficult to treat. We report a case of missed volar perilunar fracture dislocation in a 16 year old boy, and was treated operatively 40 days after injury by open reduction with the repair of ligaments. The outcome was satisfactory despite of the delay in diagnoses and surgery.


Article
REPAIR OF THE FLEXOR TENDON INJURIES OF THE HAND IN CHILDREN: ANALYSIS OF THE REPAIR TECHNIQUES AND TYPE OF IMMOBILIZATION
تصليح اصابات الاوتار القابضة في يد الاطفال: تحليل تقنية التصليح ونوع التثبيت

Author: Avadis A Muradian أ.م.د.افاديس مراديان
Journal: The Medical Journal of Basrah University المجلة الطبية لجامعة البصرة ISSN: 02530759 Year: 2008 Volume: 26 Issue: 1 Pages: 65-67
Publisher: Basrah University جامعة البصرة

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Abstract

ABSTRACTThis is a prospective study of flexor tendon repair in 26 children with 35 involved fingers, their age ranged between1.5 to 15 years (average 7). They were presented for surgery within 3 weeks of the injury. Tendon repair using the 4-strand core suture technique was performed in 65% of the hands and 2-strand in 35%, and postoperatively 73% ofthe patients were immobilized by an above-elbow splint. The average follow up period was 9 months (ranged from 4to 24). Using the Louisville scoring system, satisfactory results was achieved using 4 strand core suture technique andimmobilization by above-elbow splint in 77% of the patients. The postoperative complications consisted of tendonruptures in 15% of the cases mostly in those repaired by 2-strand core sutures with immobilization by below-elbowsplint. So we believe that in children the suture technique and type of immobilization had a great influence on thefinal outcome following flexor tendon injuries.

فرع الجراحة/كلية الطب/جامعة البصرة/العراقدراسة مستقبلية لتصليح اصابات الاوتار القابضة لدى 26 طفلا" مع 35 اصبح متضرر تراوحت اعمارهم مابين 1,5 الى 15 سنة (المعدل 7 سنوات). واجريت لهم العمليات خلال 3 اسابيع من تاريخ الاصابة.وتم تصليح الاوتار بأستمالع طريقة غرزة لب الخيط رقم 4 في 65% من لايدي وأستعمال خيط رقم 2 في 35%. كما ان 73% من المرضى تم تثبيت ايديهم بعد العملية بجبيرة فوق المرفق وكان معدل مدة المتابعة هو تسعة أشهر (بمدى يتراوح بين 4 الى 24 شهرا"). وعند استعمال نظام لوزفيل للحرزَ ، كانت نتيجة طريقة غرزة لب الخيط رقم 4 والتثبيت بواسطة جبيرة فوق المرفق مرضية في 77% من المرضى. وكانت مضاعفات مابعد العملية تمزق الاتار في 15% من الحالات، معظمها عند اولئك الذين تم تصليح أوتارهم بأستعمال غرزة لب الخيط رقم 2 والتثبيت بواسطة جبيرة تحت المرفق. لذا فأننا نعقتد بأن طريقة الغرز ونوع التثبيت في الاطفال له تأثير كبير على النتجة النهائية لإصابات الاتار القابضة. المجلة الطبية لجامعة البصرة ص65-67

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Article
6-MISSILE HAND INJURIES IN BASRAH CITY

Authors: Amin M Hasan --- Ali A Al-Iedan --- Falih W Hashim$ --- Avadis A Muradian
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2008 Volume: 14 Issue: 1 Pages: 23-28
Publisher: Basrah University جامعة البصرة

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Abstract

Missile hand injuries (MHI) have increased in our locality, in this prospective study 130 patients(140 hands) with MHI were included, they were 86% male, and 42% were between 21 to 30years of age. Forty nine percent were injured by bullet and 26% by explosions of differentobjects. Combined tissue injuries were presented in 62% of the patients with associatedfractures in 63%. In 70% of the hands initial surgical wound debridment was performed, 24% ofthe fractures were stabilized by K- wire and with the simple skeletal external fixations in 18%.Serial different types of secondary and definitive surgical treatment were performed in 62% ofthe patients. After the follow up period, most of the patients had multiple complains and only14% had a satisfactory functional hand.The initial, definitive management, the severity and mechanism of the injury that lead tomultiple tissue damage had a great affect on final functional recovery.

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