Miller, Donald S.
August 1960
Angiology;Aug1960, Vol. 11 Issue 4, p323
Academic Journal
Young surgeons are sometimes overzealous in treatment. Awareness of the immaturity and fragility of the vessels of the premature infant and of newborns generally is important.6 Careful methods of blood procurement without undue pressure and under scrupulous watchfulness are the sine qua non of treatment of infants who cannot complain and who because of poor nerve patterns have a lower threshold of pain and so do not cry. Sufficient padding of casts, careful examination and differential diagnosis of the older patients, conservatism in treating compression injuries of the extremities, and careful slow extension extension for fixed flexion of joints are merciful precautions within our control which we should exercise. The neurocirculatory phenomena observed in cases of post-traumatic dystrophy or Sudeck's bone atrophy require painstaking ministration. Analgesics, tranquilizers, and, at times, corticosteroids are helpful. For the aged, knowledge of the peripheral blood flow, avoidance of pressure, exercise of gentleness, and deftness in surgical procedures may prevent disastrous end results, for trauma to these patients is the precursor of gangrene and death. Conservatism rather than overzealous treatment is one plea. Another is the plea that the orthopedic surgeon not be so concerned with his specialty that he forgets the interrelationships within the total organism, particularly the neurovascular components. He should equip himself in essential physiology of the blood flow of the extremities and studies of the basic science6 by which he may know how to ascertain the circulatory status as circulatory impairments intervene in diseases of the feet, the hands, the forearms, and the legs.


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