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SYMPATHETIC GANGLIONECTOMY AND TRUNK RESECTION IN ARTHRITIS: INDICATIONS AND RESULTS
MELVIN S. HENDERSON; ALFRED W. ADSON
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Section on Orthopaedic Surgery, The Mayo Clinic Section on Neurologic Surgery, The Mayo Clinic
The Journal of Bone & Joint Surgery.  1932; 14:47-56 
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Abstract

It is apparent that there is a group of cases of chronic arthritis in which vasospastic phenomena are seen and are responsible for or aggravate the arthritic symptoms. Sympathetic ganglionectomy and trunk resection offer additional aid in the treatment of these patients, but extreme care should be exercised in the selection of cases. Sympathetic ganglionectomy and trunk resection is indicated for young persons, who have vasomotor phenomena, such as cold, wet, pale, or cyanotic extremities, but whose arteries are patent, elastic, and not occluded. The operation is not indicated in advanced cases, in which there is marked ankylosis; neither is it indicated when the infectious process is still present. The operation affords the greatest amount of relief in the smaller joints of the extremities,—fingers, hands, wrists, toes, feet and ankles. When there is involvement of the larger joints—such as the knees, hips, shoulders, and spinal column—little is accomplished either in checking the disease or in ameliorating the symptoms.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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