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SYMPATHETIC BLOCK IN THE TREATMENT OF LOCAL SHOCK An Experimental Study
James E. M. Thomson; Ferdinand Helwig; Eugene Sire
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LINCOLN, NEBRASKA KANSAS CITY, MISSOURI
1944 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1944; 26:189-196 
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Abstract

1 . From these observations we conclude that novocain block of the sympathetic vasoconstricting mechanism in the severely injured extremities of experimental animals tends to restore the normal circulatory integrity to the extremity.

2. Likewise, it stimulates a more normal interchange of tissue fluids, and excites capillary activity to carry away rapidly the tissue products after trauma. Evidence of this is presented in the composite groups depicting temperature and swelling.

3. Furthermore, the histological sections verify better healing responses in the treated animals. Most of them show excellent organization of the clot by fibroblasts and young proliferating capillaries, with calcification of obviously necrotic muscle in the "treated" injured extremities; while in the untreated sections there is uniformly marked muscle necrosis with autolytic, non-viable, and non-calcified fibers.

These conclusions would seem to indicate that blocking of the vasoconstrictor sympathetic mechanism should be more frequently resorted to as an early therapeutic measure in the treatment of a severely crushed human extremity that shows evidence of "local shock", vasospasm, and similar conditions.

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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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