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Biomedical subjects

G E Giddins

Publications and source records attributed to G E Giddins.

At least 19 recordsLinked to original sources
PubMed2001

Dynamic external fixation for pilon fractures of the interphalangeal joints.

Eight consecutive pilon fractures of the finger proximal interphalangeal joint and one of the interphalangeal joint of the thumb were treated by closed reduction and application of a new dynamic external fixator. The average range of movement achieved was 12 degrees -88 degrees and there were no serious complications. The technique described offers an effective and simple solution for treatment of pilon fractures of the interphalangeal joint.

Adolescent↗
PubMed2001

Ulnar nerve decompression in the cubital canal using local anaesthesia.

We assessed the outcome of surgical release of the ulnar nerve in the cubital canal under local anaesthetic. Seven of the 20 patients reported complete resolution of their preoperative symptoms. Eleven reported significant improvement immediately following surgery and some continuing improvement thereafter. One patient had no significant benefit, and one had complete resolution, but then his symptoms returned. Sixteen patients stated that they would choose to have the operation performed under local anaesthesia again, but four would have favoured a general anaesthetic. We conclude that decompression of the ulnar nerve under local anaesthetic is a reliable procedure, which is well tolerated by the majority of patients.

Adult↗
PubMed2000

Efficacy of forearm versus upper arm tourniquet for local anaesthetic surgery of the hand.

A prospective study was undertaken to compare the use of forearm and upper arm tourniquets for local anaesthetic procedures on the hand. One hundred consecutive patients with an upper arm tourniquet were compared with a further consecutive 100 patients in whom a forearm tourniquet was used. The tourniquet time was always less than 20 minutes and the scoring of perceived pain was not significantly different in the two groups. Use of a forearm tourniquet was well tolerated and was not associated with an increase in complications.

Adult↗
PubMed1999

Lymphoedema and hand surgery.

We report the case of a woman with a previous history of breast carcinoma, treated with a left radical mastectomy and axillary clearance, who developed lymphoedema in the left arm following a carpal tunnel decompression complicated by a superficial wound infection.

Aged↗
PubMed1999

A reliable technique for radiographic imaging of the pisotriquetral joint.

We report a novel technique for radiographic imaging of the pisotriquetral joint. This technique has proved useful for five consecutive patients presenting with pisotriquetral osteoarthritis. It is consistently reliable in imaging the joint and reduces the number of unsuccessful radiographic attempts.

Humans↗
PubMed1998

The use of facsimiles in acute patient transfers: experience with brachial plexus injuries.

In order to optimize the transfer of patients with acute brachial plexus injuries a facsimile proforma was introduced. The transfer of 20 patients prior to its introduction was compared as a retrospective control group with a prospective analysis of 20 patients transferred after the introduction of the facsimiles. There were many fewer missed injuries, the patients were better investigated and it as easier to decide when to delay patient transfer. Subjectively there was a considerably easier passage of both medical and social information about the patients. The cost of the facsimile and its use is more than compensated by the savings in reduced impatient stay, the reduced need for urgent tests upon receipt of the patient, fewer phone calls and considerably reduced administrative workload.

Brachial Plexus↗
PubMed1998

Late diagnosis and treatment of crush injuries of the fingertip in children.

Crush injuries of the fingertip are common in childhood. In the course of six months seven cases presented to our department, five of which were S III type injuries [Van Beek et al., Hand Clinics 1990; 6(1): 23-35], that is a sterile matrix laceration with a tuft fracture. In all but one case the severity of the injury was not appreciated at initial presentation leading to an average delay in definitive treatment of 6.6 days. Junior doctors need to be aware of the potential severity of these injuries and the difficulty in their diagnosis. Radiographs should routinely be taken and the presence of a fracture should strongly suggest the presence of a nailbed injury. Despite delays in diagnosis definitive treatment can result in good cosmetic and functional results even after a delay of up to two weeks.

Adolescent↗
PubMed1998

Rotational Salter-Harris type 1 fracture of the proximal phalanx.

A purely rotational Salter-Harris type I fracture of the proximal phalanx of the middle finger is described. This injury presents diagnostic problems as the radiographs do not show the displacement. Accurate clinical examination is essential, in particular checking for rotation of the finger.

Adolescent↗
PubMed1997

Expandable rings. A new solution to an old problem.

A number of solutions are presented for the problem of over-tight rings particularly in patients with deforming arthropathies of the hand. Rings can be adapted by various methods to allow them to be worn on deformed fingers. An illustrative case is reported.

Equipment Design↗
PubMed1996

"Doctor, when can I drive?': a medical and legal view of the implications of advice on driving after injury or operation.

In view of the increasing medicolegal implications of advice given to patients, in particular the apparent increasing frequency of requests for advice about whether patients are fit to drive, a review was made of the literature, the law and the views of the major motor insurers. A patient should be advised when it is not safe to drive. If he disregards this advice and drives, he would be breaking the law and would not be covered by his insurance. Whilst recovering from an injury or an operation, a patient may not be as physically able as before but he may still be fit enough to drive. When it is considered that the patient's disability is more than about 3 months he should be advised to inform his insurers and to act in accordance with their response. On the other hand, when it is felt that the patient's disability is short-term, he should be advised that he is fit to drive but that he should be careful during the early stages. Provided that the patient feels safe to drive and drives carefully, he should be acting within the law, and should be covered by his existing insurance. In doubt, the patient should contact the Driver, Vehicle and Licensing Centre and his insurers and act accordingly. Doctors should record their advice in the patient's notes and should remember that the patient may be driving vehicles other than a car.

Automobile Driving↗
PubMed1996

Nerve injury following steroid injection for carpal tunnel syndrome. A report of two cases.

Two cases of nerve injury are reported following steroid injection as treatment for carpal tunnel syndrome. One caused an ulnar nerve lesion that recovered well. The other caused a more severe median nerve lesion which responded poorly to conservative treatment. Steroid injection for carpal tunnel syndrome is generally safe but nerve injury may occur and is difficult to treat.

Anti-Inflammatory Agents↗
PubMed1995

A slowly evolving brachial plexus injury following a proximal humeral fracture in a child.

The association of fractures and neurological injuries is well recognized, especially with certain upper limb fractures. Typically, the nerve injury occurs at the time of initial fracture displacement. A case is reported of an unusual combination of fracture and nerve injury in a child, with the extremely rare occurrence of a slowly evolving nerve injury. The potential for delayed nerve injury following a fracture needs to be appreciated to prevent delays in diagnosis and treatment.

Brachial Plexus↗
PubMed1995

Upper arm tourniquet pain in local anaesthetic surgery.

A prospective study was performed on 100 consecutive patients (110 procedures) of the perception of pain from an arm tourniquet during a local anaesthetic procedure. This was assessed subjectively, and objectively using a visual analogue scale. For tourniquet times up to 20 minutes, the tourniquet was well tolerated with only one failure (1% of patients) and all successful patients stated that they would be happy to have a similar procedure again. Unlike previous studies, there appeared to be no correlation between time of tourniquet use and the pain perceived. Rather, there appeared to be an idiosyncratic response to the tourniquet which was borne out by the ten patients who had bilateral procedures at least 6 weeks apart and showed consistently repeatable scores.

Adult↗
PubMed1995

The effect of unilateral intercostal nerve transfer upon lung function.

Intercostal nerve transfer is a well-established technique in the treatment of some severe brachial plexus lesions in adults. There is, however, concern that in the presence of an ipsilateral phrenic nerve palsy it may lead to a significant compromise of respiratory function. 20 patients having intercostal nerve transfers had their lung function assessed pre-operatively and 6 weeks post-operatively. The patients were subsequently questioned about symptoms of respiratory dysfunction. There was no evidence that intercostal nerve transfer leads to a significant reduction in respiratory function in adults. It therefore appears safe to perform intercostal nerve transfers in adults following brachial plexus injuries even in the presence of an ipsilateral phrenic nerve palsy.

Adolescent↗
PubMed1995

Foreign body detected by patients using metal detectors.

A positive response from a metal detector when run over an area of the body is a strong positive indicator of the presence of a metallic object. If there is a possibility of a buried metallic foreign body this positive finding should not be ignored.

Adult↗
PubMed1994

Sellotape ischaemic injury to the fingertip.

A case is reported of significant ischaemic damage to a fingertip from the use of Sellotape. The elasticity of Sellotape has been tested and compared with that of Elastoplast, illustrating the stiffness of Sellotape and thus emphasizing its unsuitability. The general public needs to be aware of the dangers of using non-proprietary dressings and the medical profession must remain vigilant about the elasticity of dressings.

Adolescent↗