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Biomedical subjects

D Wardlaw

Publications and source records attributed to D Wardlaw.

At least 19 recordsLinked to original sources
PubMed1995

A new functional brace for the treatment of Colles' fractures.

A new prefabricated brace for the functional treatment of Colles' fractures has been developed. It is applied at fracture reduction and maintains fracture position by the application of three-point loading. In a prospective randomized clinical trial treating 85 displaced Colles' fractures, with blind independent follow-up, the brace gave better functional results than conventional plaster treatment. The improved function was apparent up to 6 months after injury. Finger function and pinch strength were also better in the brace-treated patients. Anatomical results were similar in the two groups.

Adult↗
PubMed1995

Traumatic dislocation of the lateral sesamoid of the great toe: nonoperative management.

A case of traumatic dislocation of the lateral sesamoid of flexor hallucis brevis tendon associated with metatarsal neck fractures due to a crush injury is reported. This patient was treated nonoperatively by elevation, application of plaster, and then free mobilisation. The patient has now fully recovered and remains completely asymptomatic despite residual sesamoid dislocation 1 year after the injury. The nonoperative management of this injury has not, to our knowledge, been reported previously.

Adult↗
PubMed1994

Developing a valid and reliable measure of health outcome for patients with low back pain.

OBJECTIVE: The authors developed and validated a measure of health outcome for patients with low back pain. RESULTS: A questionnaire was developed incorporating the type of questions asked when taking a clinical history. After testing on a sample of 568 patients, three questions were discarded from the questionnaire. The final questionnaire was found to be reliable and valid in the sense that patients' scores correlated highly with their scores on a general health profile and with GP perceptions of severity. Health status in patients with low back pain was significantly impaired when compared with the general population. CONCLUSION: A clinically based questionnaire, together with a general measure of health, can provide a valid and reliable package for the routine assessment of perceived health in patients with low back pain.

Activities of Daily Living↗
PubMed1992

Glass fibre versus non-glass fibre splinting bandages.

We have assessed the current range of synthetic splinting bandages, comparing glass with non-glass fabrics and plaster-of-Paris. Physical and mechanical tests have been carried out and the opinions of patients, volunteers and orthopaedic staff were recorded. Modern bandages have some better properties than standard plaster bandage but do not conform as well, are more expensive and potentially more hazardous. However, non-glass bandages are lighter, less brittle, more radiolucent and less hazardous than glass fibre bandages and are preferred by both patients and applicators.

Attitude to Health↗
PubMed1991

On immediate functional bracing of Colles' fracture.

A prospective randomized trial was carried out in 60 consecutive patients with Colles' fractures requiring manipulation. They were treated by either a standard Colles' plaster (control group) or in a functional plaster brace applied immediately after reduction of the fracture. The brace extended from the proximal radius and ulna to the level of the radial styloid and allowed a full range of movement at the radiocarpal joint. Both groups comprised 30 patients and were matched for age, sex and dominance of hand. There was no significant difference in initial severity of fracture or the quality of reduction. Radiological results on cast removal (35-42 days) were significantly better in the brace group compared with those treated with a below-elbow cast (P less than 0.05). Wrist function was also significantly better in the brace treated group at 12 weeks after fracture (P less than 0.05). This brace has a number of advantages over standard plaster treatment, but requires a degree of skill and experience in its application. A prefabricated brace has now been developed with a similar 'built in' three-point loading which will be easier for inexperienced staff to apply.

Adult↗
PubMed1991

Intracast pressure measurements in Colles' fractures.

Intracast pressures were recorded in conventional plaster-of-Paris below-elbow casts and compared with a new prefabricated brace for the functional treatment of Colles' fractures. Interface pressures were consistently higher in the brace than in the conventional plaster cast throughout the treatment period, and demonstrated more specific loading to the fracture site.

Adolescent↗
PubMed1991

Radiographic assessment of splinting bandages.

The physical attenuation of X-rays by a variety of splinting bandages was measured and compared with the subjective opinion of nine radiologists. The radiolucency of the bandages and their interference with the interpretation of bony detail on radiographs (using a radiographic knee phantom) was assessed. Plaster-of-Paris (POP) bandages produced the greatest attenuation of X-rays and the greatest interference with interpretation of bony detail. All the polyurethane resin impregnated fabric bandages produced less attenuation than POP, but variations occurred due to the fabric type and knit of the bandage. The lowest attenuation occurred in those bandages using cotton, polyester or polypropylene fabric, and in all but one instance these caused least interference in radiographic interpretation. The exception was the polyester bandage, where the coarse knit of the fabric produced a large difference in X-ray beam absorption between the air spaces and the bandage. The distracting mesh pattern on the radiograph interfered with radiographic visualization. The glass fibre bandages caused intermediate attenuation, being better than POP but not as radiolucent as the non-glass fabrics.

Bandages↗
PubMed1991

Modern splinting bandages.

We have assessed the current range of synthetic splinting bandages, using physical and mechanical tests and the subjective opinions of patients, volunteers and orthopaedic staff. Modern bandages have some better properties than standard plaster bandage but do not conform as well, are more expensive, and potentially more hazardous.

Bandages↗
PubMed1988

Flammability of modern synthetic bandages.

The potential fire hazard associated with polyurethane impregnated fibreglass bandages has been investigated. Tests have been carried out in accordance with the most appropriate British Standard (BS5438:1976). Results of these tests show that polyurethane impregnated fibreglass bandages do not represent a serious risk to a wearer as the rate of heat transfer through the casts is sufficiently rapid to alert the wearer of the proximity of a heat source before the cast ignites.

Bandages↗
PubMed1988

Dust emission during cutting of polyurethane-impregnated bandages.

The airborne dust generated when cutting splinting bandages represents a potential respiratory hazard, particularly to those who regularly remove casts with a power saw. Plaster of Paris (POP) dust is already classified by the Health and Safety Executive as a nuisance dust. This paper reports on a study to determine the nature, size and concentration of dust produced when cutting polyurethane (PU) impregnated bandages using a power saw. It has been shown that, under severe conditions PU bandages produce lower airborne dust concentrations than POP bandage but that all of the bandages tested produced particles small enough to reach the final divisions of the lung. It is therefore recommended that a dust extraction unit be used when cutting all types of bandage.

Air Pollutants, Occupational↗
PubMed1987

Mechanical assessment of polyurethane impregnated fibreglass bandages for splinting.

The introduction of polyurethane (PU) resin impregnated fibreglass bandages is likely to have a significant effect on modern orthopaedic practice. The manufacturers of these products claim many improved properties compared to plaster of Paris bandages, such as , high strength to weight ratio, rapid setting time and high radiolucency. This paper reports on a series of mechanical tests designed to assess the strength, flexibility, working time and wear properties of the current range of fibreglass bandages and to compare them with plaster of Paris bandages. The results have clearly demonstrated that the fibreglass bandages are mechanically superior and offer numerous advantages over plaster of Paris for use as the definitive casting material for both weight-bearing and non-weight-bearing casts.

Bandages↗
PubMed1987

New splinting materials.

Plaster of Paris (P.o.P.) bandage has been the pre-eminent external splinting material for over 150 years and from time to time synthetic alternatives have been tried. So far none has seriously challenged the dominance of P.o.P. as a primary or secondary material in the management of fractures. The recent introduction of Polyurethane coated fibreglass bandage appears to offer a more serious challenge than previous contenders. This technical note reviews bandage type splinting materials and explains some of the properties of the PU materials.

Bandages↗
PubMed1984

The recovery of quadriceps function in patients treated by cast bracing.

The recovery of quadriceps function in patients treated by cast bracing has been assessed in fifty-four patients. The isometric strength and dynamic endurance of the quadriceps muscle were measured at an average of 2 years 8 months after the fracture. The literature is reviewed and a simple method of measurement is described. The results indicate that the recovery of quadriceps function after cast bracing in an unselected group of patients compares favourably with that after open and closed nailing techniques.

Adolescent↗
PubMed1981

Cast bracing of femoral shaft fractures in children: a preliminary report.

This paper reviews the use of cast bracing in fractures of the femoral shaft in children between 1977 at the Royal Aberdeen Children's Hospital. Thirteen children have been treated by cast bracing. All children have achieved a full functional recovery. The average time to cast bracing was 3 weeks, and the average time to discharge was 4 weeks. Thus treated, these children were discharged 4 weeks earlier than those treated by conventional measures. It was found that the technique of cast bracing was applicable to children with no adverse complications.

Braces↗
PubMed1981

A biomechanical study of cast-brace treatment of femoral shaft fractures.

The off-loading characteristics of the cast-braces of 30 patients with fractures of the shaft of the femur have been investigated, during axial loading, using strain-gauge transducers. These were applied at the level of the fracture, where the cast was circumferentially split, and to the hinges of the brace at the knee. They measured the load transferred between the two portions of the thigh cast, and between the thigh cast as a whole and the below-knee cast; by subtraction from the total load on the limb, the skeletal force at the fracture level and at the knee could be calculated. In all patients there was an increase in the fracture load as union progressed which was thought to be due to physiological feedback mechanism from the fracture site. The load carried by the two portions of the thigh cast and by the thigh cast as a whole was proportionately high at first and stabilised at an average of 35 per cent of body weight.

Adolescent↗
PubMed1981

The use of cast-bracing as treatment for fractures of the tibial plateau.

A series of 29 patients with fractures of the tibial plateau were treated by means of a cast-brace. There were seven wedge fractures of the lateral tibial condyle, two dicondylar fractures and 20 compression fractures involving the lateral tibial plateau. The seven patients with wedge fractures were treated by skin or skeletal traction, followed as soon as possible by flexion exercises for the knee. Cast-braces were applied to all fractures as soon as possible after injury, and the patients allowed to bear weight freely. Early restoration of function of the injured limb was thereby achieved. The results of our study over a period of two and a half years indicate that cast-bracing is a very satisfactory method of treating fractures of the tibial plateau. All the fractures united, the movements and control of the knee were excellent, and valgus or varus deformity was unchanged before application and after removal of the brace.

Adolescent↗