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THE EFFECT OF LUMBAR SYMPATHECTOMY UPON THE GROWTH OF LEGS PARALYZED BY ANTERIOR POLIOMYELITIS
R. I. HARRIS; J. L. MCDONALD
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Associate Surgeon, Toronto General Hospital Assistant Surgeon, Hospital for Sick Children
1935 by The Journal of Bone and Joint Surgery.
The Journal of Bone & Joint Surgery.  1936; 18:35-45 
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Abstract

1. Prolonged increase in the blood supply to the lower extremity of a growing child can result in acceleration of the growth of the involved extremity.

2. The increase in blood supply which follows lumbar sympathectomy is capable, also, of inducing acceleration of the rate of growth.

3. The shortness which follows paralysis of the lower extremity from poliomyelitis is due to the loss of accessory factors which normally enhance the basic growth rate of the epiphyseal line. The known factors are the contractions of normal muscles and the maintenance of a normal blood supply.

4. Under appropriate circumstances, lumbar sympathectomy will diminish the shortness due to poliomyelitis.

5. The factors favorable to a good result are:

a. Paralysis limited to one lower extremity.

b. Paralysis moderate in degree.

c. Early operation,—at the age of six years, if possible.

d. Use of ganglionectomy rather than ramisection.

e. Maintenance of the increased vascularity which follows the operation.

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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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