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.
(C) 1932 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.