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Biomedical subjects

D R Goodwin

Publications and source records attributed to D R Goodwin.

17 recordsLinked to original sources
PubMed2003

Excision of the trapezium and interposition arthroplasty with gelfoam for the treatment of trapeziometacarpal osteoarthritis.

Excision of the trapezium with Gelfoam interposition was performed in 35 thumbs, 34 of which were evaluated after an average 5 years. Twenty-four patients had unilateral procedures. The follow-up examination included a standardized questionnaire and clinical and radiological examinations. Pain relief was achieved in all cases. The patients considered that 32 of their operated hands had improved function, while two had not improved. All patients were satisfied with the final postoperative result. Adduction of the thumb to the index finger, and opposition to the tip of the little finger was possible in all cases. Weakness, in comparison to the other thumb, of lateral pinch (71%; P=0.0001), tip pinch (74%; P=0.007), and grip strength (85%; P=0.006) were observed. The first web span was preserved in all hands. Calculation of the trapezial space ratio demonstrated only slight, insignificant shortening (7%; P=0.06) of the thumb ray. No significant correlations between the postoperative trapezial space ratio and lateral pinch strength, tip pinch strength, and grip strength were observed. We conclude that excision of the trapezium and Gelfoam interposition has no specific complications and is a reliable surgical treatment for osteoarthritis of the trapeziometacarpal joint.

Aged↗
PubMed2001

Review of the current methods in the diagnosis and treatment of scaphoid fractures.

If neglected or misdiagnosed, non-union of a scaphoid fracture will almost inevitably progress to radiographic and symptomatic osteoarthritis of the wrist with subsequent morbidity and lifelong disability, especially in young males in which the fracture is more common. Fractures of the scaphoid bone are the most common fractures of the carpus and second in occurrence among fractures of the wrist. The diagnosis and treatment are not simple. Familiarity with different imaging methods and treatment options is required. The treatment in most cases is conservative and will lead to uneventful union, but an operation may be needed in certain cases primarily and in the treatment of non-union. The current literature on the diagnosis and treatment of scaphoid fractures is reviewed, and the authors try to make a clear and concise picture of this complex and sometimes controversial field.

Casts, Surgical↗
PubMed1999

The "plastic bag syndrome". Compression of the digital neurovascular bundles by commercial plastic bags.

We report a condition we call the "plastic bag syndrome" in which pressure on the neurovascular bundles causes temporary ischaemia in the distal part of the finger together with a neuropraxia of the digital nerves. Although in most cases the discomfort or numbness is fleeting, requires no medical assistance and is readily forgotten, in some instances the symptoms are such that medical advice is sought. Since the injury can lead to permanent damage and subsequent limitation in the use of the finger, we believe that the public should be advised to take simple precautions to prevent it from happening.

Adult↗
PubMed1996

Patient satisfaction with general anaesthesia. Too difficult to measure?

A questionnaire to evaluate patient satisfaction following general anaesthesia was designed with the aid of focus groups. A subsequent audit identified aspects of care which could be improved on the basis of responses to the satisfaction questionnaire. It is possible to design a discriminating satisfaction questionnaire for general anaesthesia.

Adolescent↗
PubMed1994

Nursing case management activities. How they differ between employment settings.

The diversity of case management approaches raises many questions. Are multiple case managers really required to duplicate each others' services, and if so, to what degree? How does the case manager actually "case manage" a client? How do the activities of the case manager in a direct care environment differ from case managers employed by case management companies or insurance companies? In this article, the author describes differences in case management activities in various employment settings.

Aged↗
PubMed1992

Critical pathways in home healthcare.

Administrators and directors of home health agencies are increasingly accountable for the productive use of resources and quality patient outcomes. However, few reliable ways exist to measure and influence these components. The author proposes the use of the critical pathway typically used in acute care case management as an efficient tool to guide home health nursing practice. The author presents the process for developing a critical pathway for congestive heart failure patients in a home health agency, as well as results of a study determining when nursing interventions were implemented.

Aged↗
PubMed1991

The financial burden of Medicare documentation in home care.

The Health Care Financing Administration 485/486 forms constitute the greatest paperwork burden for most agencies. This article suggests a method for analysis of the amount of resources consumed in the 485/486 process and estimates labor costs incurred to produce these documents.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1989

Treatment of finger-tip injuries with silver sulphadiazine occlusion dressing.

From 1982, patients with finger-tip injuries were treated with sulphadiazine occlusion dressings. The average time taken for the wound to heal, incidence of infection and absence from work were studied. The results of this method gave consistently good results when compared with other techniques which are summarized.

Aging↗
PubMed1987

The disappearing needle.

This is a report of an unusual surgical curiosity involving the median nerve at the wrist. A sewing needle, which penetrated the region of the wrist joint anteriorly, unknown to the patient, also penetrated the median nerve without causing any initial discomfort or neurological deficit. There was no damage to the nerve but locating the "disappearing" needle at operation was difficult.

Child↗
PubMed1985

Pseudogout of the wrist presenting as acute median nerve compression.

Two cases are reported of acute median nerve compression due to calcium pyrophosphate deposition in the wrist, masquerading as a septic condition. There have been recent reports in the literature of the effects of calcium pyrophosphate in joints of the upper limb (Resnick 1983 and Hensley, 1983) These conditions are uncommon and the presentation and initial symptomatology of our case led in the first patient to misdiagnosis and an unnecessary operation, which was avoided in the second case.

Adult↗
PubMed1978

An evaluation of surgical and conservative treatment of fractures of the ankle in 200 patients.

The longterm results of surgical and conservative treatment in two almost identical groups of patients with fractures of the ankle have been analyzed. The results were better after conservative treatment; delayed operation and repeated manipulations were found to be the main reason for the poorer postoperative results, especially in elderly osteoporotic patients. The damage consequent to repeated manipulations, the difficulties resulting from delaying operation, and the advantages of early open reduction are discussed. It may be that under certain conditions of unavoidable delay, a mild residual displacement should be accepted rather than repeated manipulation and delayed open reduction. It is concluded that, when indicated, operations should be performed as early as possible after injury, probably giving the best end results as evidenced by the preliminary findings of a prospective study currently under way.

Adolescent↗