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Biomedical subjects

Mohammad M Al-Qattan

Publications and source records attributed to Mohammad M Al-Qattan.

14 recordsLinked to original sources
PubMed2006

Factors in the pathogenesis of Dupuytren's contracture.

This article reviews the basic science elements involved in the pathogenesis of Dupuytren's disease. Dupuytren's contracture is effected by a multitude of complex processes at the cellular level and the exact relative contribution of each is unknown. Various investigators have proposed different theories and documented individual findings regarding the pathophysiology of Dupuytren's contracture. The current report attempts to summarize many of these findings together in a schema of pathogenesis.

Algorithms↗
PubMed2005

The use of adipofascial turnover flaps for coverage of complex dorsal ring finger defects caused by electric burns.

This paper describes a unique occupational electrical injury that results in a complex defect on the dorsal aspect of the ring finger. The injury was seen in seven electricians working while wearing a ring on the ring finger. All patients were treated successfully using random adipofascial turnover flaps. The electric current was found to cause a zone of subcutaneous necrosis adjacent to the skin burn. This zone of subcutaneous necrosis varied in size but never exceeded 5mm and it was easy to recognize the extent of this zone intraoperatively because of the presence of the thrombosed dorsal subcutaneous veins within the necrotic subcutaneous tissue. These observations suggested that adequate debridement and then location of the base of the adipofascial flap proximal to the edge of the debrided area was an appropriate procedure. Other technical considerations were described to ensure a successful outcome. It was concluded that adipofascial turnover flaps were not only reliable in these electrical injuries, but also had several advantages when compared with other flaps commonly used to reconstruct dorsal digital defects.

Accidents, Occupational↗
PubMed2005

Scalp reconstruction with free flaps using the external carotid artery and internal jugular vein as the recipient vessels without the need for interpositional vein grafts or arterio-venous loops.

The technique of lengthening of the pedicles of the rectus abdominus and latissimus dorsi free flaps are described in five patients. Lengthening of these pedicles allowed scalp reconstruction using the external carotid artery and internal jugular vein as the recipient vessels without the need for interpositional vein grafts or arterio-venous loops. Post-operative recovery was uneventful in all cases.

Adult↗
PubMed2005

De-epithelialized cross-finger flaps versus adipofascial turnover flaps for the reconstruction of small complex dorsal digital defects: a comparative analysis.

PURPOSE: To compare the results of 2 reconstructive options (the de-epithelialized cross-finger flap vs the adipofascial turnover flap) for coverage of small complex dorsal digital defects. METHODS: A total of 73 patients with small complex dorsal digital defects were included in the study and were classified into 2 groups: group 1 (n = 31) had reconstruction using the de-epithelialized cross-finger flap and group 2 (n = 42) had reconstruction using the adipofascial turnover flap. The type of complication and patient dissatisfaction with the appearance of the donor site were documented in each study group. RESULTS: All flaps in both groups survived with no infection or hematoma. Specific complications were found in group 1 patients and included flap dehiscence (1 patient), considerable skin graft loss (2 patients), stiffness of the donor finger (5 patients), and inclusion cyst (1 patient). The only specific complication for group 2 patients was the occasional epidermolysis of the skin of the donor site, which was observed in 6 patients. Patient dissatisfaction with the appearance of the donor site was documented in 10 patients in group 1 and none in group 2. The elective flap division in the cross-finger-flap group was considered a disadvantage in children because it required general anesthesia. CONCLUSIONS: The versatility of both flap techniques in digital reconstruction is confirmed; however, considering the type of complication and the need for general anesthesia in children for cross-finger-flap division, the adipofascial flap was determined to be superior in the following specific groups: children, older patients, and patients with osteoarthritis and multiple defects of adjacent border digits.

Adolescent↗
PubMed2005

The middle phalanx in Poland syndrome.

The classic deformity of Poland syndrome consists of the combination of unilateral aplasia of the sternocostal head of the pectoralis major muscle and an ipsilateral hypoplastic hand with simple syndactyly and short fingers. The current study specifically investigates the abnormalities of the middle phalanx in a series of 15 patients with Poland syndrome. The degree of hand hypoplasia and finger brachydactyly was classified into 3 grades: mild (n = 2), moderate (n = 10), and severe (n = 3). The middle phalanges of all fingers in all patients showed abnormalities. The degree of deficiency in the middle phalanx (from mild hypoplasia to aplasia) correlated with the degree of brachydactyly, which in turn correlated with the degree of hand hypoplasia. Several other radiologic features of the hypoplastic middle phalanges were documented, such as the central nidus, the rounded or truncated appearance, and the cone-shaped epiphyses. The embryology of limb development was reviewed and it was proposed that abnormalities of the middle phalanx in Poland syndrome occur as a result of a mild ischemic insult during stage 19 of the embryonic life, leading to an arrest or lack of chondrification of the mesenchymal mass of the phalanx.

Adolescent↗
PubMed2004

Identification of the phrenic nerve in surgical exploration of the brachial plexus in obstetrical palsy.

This report describes a simple technique for identifying the phrenic nerve at the beginning of exploration of the brachial plexus in obstetrical palsy. Both the phrenic and supraclavicular nerves originate from the C4 root; therefore, retrograde dissection of the supraclavicular nerve will end at the C4 root and identify the phrenic nerve. This technique is very useful to less experienced surgeons but may also be helpful when the experienced surgeon encounters excessive scarring of the anterior scalene muscle. Finally, the dissected supraclavicular nerve may be used as a cable graft in brachial plexus reconstruction.

Birth Injuries↗
PubMed2004

The surgical management of high-grade gynecomastia.

It is now well accepted that low grades of gynecomastia are best treated with liposuction alone. However, the surgical management of the high-grade gynecomastia (Simon's grade III) has remained problematic because both liposuction and conventional subcutaneous mastectomy (without skin excision) have frequently resulted in significant residual skin redundancy, requiring a second operation for skin resection. Our preferred approach to high-grade gynecomastia has been the single-stage subcutaneous mastectomy and circumareolar concentric skin reduction with deepithelialization. However, in the rare case of tubular breast deformity in the male and also in patients with gynecomastia who underwent massive weight loss, simple mastectomy and free nipple graft is performed. Therefore, these 2 groups of patients will be excluded from the current series. Twenty-four consecutive males with high-grade gynecomastia were reviewed. All patients underwent subcutaneous mastectomy with concentric skin resection. There were no major complications such as infection, hematoma, seroma, or nipple-areola complex necrosis. The main disadvantage of the technique was the mild residual skin redundancy, which was noted in all 24 patients. This redundancy, however, was never severe enough to require a secondary procedure, and all patients were satisfied with the final result.

Gynecomastia↗
PubMed2002

An unusual case of preaxial polydactyly of the hands and feet: a case report.

An unusual case of polydactyly of the hands and feet is described. The ulnar 4 digits of both hands and the outer 4 digits of both feet appeared normal, and the extra digits were on the radial side of the hands and on the medial side of the feet. The pattern of polydactyly did not fit any of the well-known deformities associated with radial digital duplication such as thumb polydactyly, mirror hand, or duplicated (multiple) hands. The harmonious deformities of the hands and feet suggest a genetic alteration to the development of all 4 limb buds, but the case did not fit any of the known syndromes that have high-level preaxial digital duplication of the hands and feet.

Fingers↗
PubMed2002

Rotation osteotomy of the humerus for Erb's palsy in children with humeral head deformity.

The most common secondary deformity in older children with Erb's birth palsy is internal rotation contracture of the shoulder. The results of external rotation osteotomy of the humerus in a selected series of children with shoulder internal rotation contracture are reported. Fifteen consecutive patients with a mean age of 6.5 years were included. In all children the internal rotation contracture was associated with loss of the normal sphericity of the humeral head as assessed by preoperative magnetic resonance imaging. The humerus osteotomy was carried out just below the insertion of the deltoid muscle, and fixation was done with stainless steel plate and screws. The results were assessed with a modified Mallet score. Before surgery 12 children had a score of 2 and 3 children had a score of 3. At final follow-up evaluation (range, 1-5 years; average, 3 years), all 15 children had improved shoulder function and obtained a modified Mallet score of 4. An extra bonus of the osteotomy procedure was slight improvement of shoulder abduction and elbow extension. All children could dress, wash, perform self-cleaning, and feed themselves better and no longer needed help with these activities. This osteotomy for selected children is simple and safe and has a high satisfaction rate functionally and aesthetically.

Brachial Plexus Neuropathies↗
PubMed2002

The "beggar's" hand and the "unshakable" hand in children with total obstetric brachial plexus palsy.

A total 12 consecutive children with secondary deformities following total obstetric brachial plexus palsy were included in this retrospective study. In all patients, the main complaints were two socially disabling hand postures: the "beggar's" hand and/or the "unshakable" hand. All children had a supinated forearm with no active pronation and were teased by their friends, who called them "beggars." When the impairment was severe and involved the right hand and wrist, children also complained that they were not able to shake hands. The management approach to these children was described, with the main aim of surgery being the correction of the abnormal posture. Other simultaneous tendon transfers were also performed to improve hand function if there were suitable musculotendinous units. Successful reconstruction was accomplished in all patients. Preoperatively, some children refused to go to school because of teasing, and most did not want to interact socially. After surgery, all children attended school regularly, and parents reported much better social interaction. However, the functional gain was never enough to dramatically improve the daily use of the limb. The contralateral normal limb remained the dominant one for all daily activities, including writing and eating.

Elbow↗