Biomedical subjects

D A Woods

Publications and source records attributed to D A Woods.

At least 19 recordsLinked to original sources

PubMed2006

Septic arthritis of the small joints of the hand.

Twenty-five patients with sepsis of 26 hand joints were treated by urgent debridement, antibiotics and early hand therapy. We reviewed 15 patients (16 joints) in a clinic and three patients by postal questionnaire after a mean follow-up of 54 (range 10-94) months. Of the 26 involved joints, 14 had restricted motion at discharge. Stiffness increased with increase in delay between onset and treatment. At final review, one joint with painful degenerative changes had been fused. Seven patients had regained full movements. The remaining six had some stiffness but, nevertheless, had undergone significant improvement in the ranges of movement. There were two cases with radiological joint degeneration in this group of six patients. Three patients had mild, intermittent pain. No patient had significant disability. While there is significant loss of motion after this joint pathology in the early recovery period, overall motion and function appears to improve over the longer term.

Activities of Daily Living↗

PubMed2005

Recurrent elbow dislocation--an uncommon presentation.

A 58 year old female attended our A&E department following a fall in the garden with swelling and bruising of the right arm and the elbow. Anteroposterior and lateral radiographs were interpreted as showing a normal elbow joint. A diagnosis of soft tissue injury to the elbow was made and the patient was discharged with advice. She returned 2 days later, did not have an x ray, and again given advice. Three weeks later she was referred back to A&E by the general practitioner with persistent swelling of the elbow. Further radiographs showed a posterolateral dislocation of the elbow. The elbow was reduced under sedation but was subsequently dislocated at follow up, and was treated by external fixator and transolecranon pin. The fixator was removed at 4 weeks and the elbow was then stable. This case highlights that recurrent elbow dislocations due to significant ligament injuries can present in joint and subsequently dislocate. A high index of suspicion is necessary and appropriate referral to the specialist must be made to avoid the morbidity associated with recurrent dislocation. It also emphasises the need to always assess the patient on his or her own merits despite previously normal investigations.

Elbow Joint↗

PubMed2004

Driving whilst plastered: is it safe, is it legal? A survey of advice to patients given by orthopaedic surgeons, insurance companies and the police.

Many patients, immobilised in a plaster cast after a fracture of the upper or lower limb, wish to drive. They frequently ask permission to do so from the treating surgeon. Insurance companies are apparently willing to insure these patients to drive if they obtain their doctors permission. The DVLA guidelines are unhelpful in these circumstances. We therefore established current practice within the south west region by canvassing 126 consultant orthopaedic surgeons, 27 insurance companies and the 6 regional police constabularies, sending them specific clinical scenarios and asking how they would advise these patients regarding safety to drive. The results were as follows: sixty-seven (53%) of surgeons responded of which 97% gave specific advice regarding safety to drive. The insurance companies were generally unwilling to respond and a national response was received from the Association of Chief Constables, which specifically stated that safety to drive was for the individual patient to decide and the doctor should not give advice. We consider this to be unsatisfactory for all parties and suggest how this situation could be improved for both the patient and other road users welfare.

Automobile Driving↗

PubMed1999

A safe technique for distal biceps repair using a suture anchor and a limited anterior approach.

We describe a safe and simple method of repairing an acute rupture of the distal biceps tendon using a single limited (3 cm) anterior approach, a suture anchor, and the use of a plastic sheath (arthroscopy cannula or barrel of a 2 ml syringe) to protect the adjacent neural structures and to remove the need for extensive dissection and retraction in order to protect these structures. We have used this technique on three patients to date and all have regained a full range of flexion and extension at the elbow and pronation and supination of the forearm at a minimum of 6 months follow-up. There have been no neurovascular complications.

Adult↗

PubMed1995

A complication of spinal decompression. A case report.

STUDY DESIGN: This case study is designed to report the previously unreported specific complication of acute cauda equina compression after decompression surgery for spinal stenosis. OBJECTIVES: To inform others of the possibility of such a complication; to suggest a possible mechanism for this situation, namely hourglass constriction of the cauda causing ischemia to distal nerve roots; and to suggest a management plan--immediate magnetic resonance imaging to identify the problem and return to the operating room for further decompression--which was successful in this case. SUMMARY OF BACKGROUND DATA: Previous reports of causes of paraparesis or paraplegia after surgery are listed, and previous theories on the etiology of acute cauda compression are discussed. METHODS: The clinical findings of spinal stenosis in a 32-year-old man are presented, and subsequent details of the surgery, complications after surgery, investigation, and future surgery, including magnetic resonance imaging scans before and after surgery, are provided. RESULTS: The result in this case was a patient free of symptoms. CONCLUSIONS: Incomplete decompression in surgery for spinal stenosis can result in acute cauda equina compression. In these circumstances, magnetic resonance imaging can reveal the cause, and in this case, immediate surgery was successful in relieving the symptoms and signs.

Acute Disease↗

PubMed1994

Initial treatment of closed metacarpal fractures. A controlled comparison of compression glove and splintage.

A prospective clinical trial compared two forms of initial management for closed stable fractures of the shaft of the finger metacarpals. Patients were randomized to treatment with a compression glove and early mobilization (21 patients) or to immobilization in a plaster splint (21 patients). The mean loss of total active flexion (MP+PIP+DIP) in the second week after injury was 56 degrees in the glove group and 84 degrees in the splint group (P = 0.0036). In the third week, the mean loss of flexion was 23 degrees and 46 degrees respectively (P = 0.0010). Hand volume and PIP joint circumference were significantly smaller in the glove group in the second week but not in the third and fourth weeks. Within each group, however, there was no correlation between range of motion and swelling, suggesting that these were independent variables in this study. The support of the glove helped to relieve pain. Use of a compression glove avoided the loss of function imposed by splintage and was associated with a greater range of movement during the second and third weeks.

Adolescent↗

PubMed1992

Integrated approach to surfactant environmental safety assessment: fast atom bombardment mass spectrometry and liquid scintillation counting to determine the mechanism and kinetics of surfactant biodegradation.

Fast atom bombardment mass spectrometry and liquid scintillation counting have been used to study the biodegradation of a novel cationic surfactant in live sludge. The rates of primary biodegradation and the extent of complete mineralization were determined. Furthermore, an intermediate degradation product was identified and its rates of formation and subsequent removal have been established. These data find utility in assessing the environmental safety of the surfactant and the accuracy of various environmental fate models.

Biodegradation, Environmental↗

PubMed1991