A high incidence of shoulder involvement was seen in severely disabled young people suffering from juvenile chronic polyarthritis who were undergoing surgical procedures on the lower limbs. The progressive nature of the radiological changes is described. Possible lines of surgical management are considered.
A technique of arterial reconstruction suitable for patients with extensive arterial occlusions and for previous failed arterial surgery is described. The "hitch-hike" graft consists of a proximal limb of 6-mm velour Dacron prosthesis and a distal limb of autogenous vein. The intermediate prosthesis-to-vein anastomosis is made into an endarterectomized segment of upper popliteal artery. The results in the first 16 limbs are described. Eleven grafts are functioning from 2 to 14 months after operation and 5 of these have functioned for more than 1 year. The advantages of the technique are: long arterial occlusions may be bridged; autogenous vein is used to cross the knee joint; good measured blood flows may be demonstrated at operation; acceptable patency rates may be obtained up to 1 year.
A high incidence of shoulder involvement was seen in severely disabled young people suffering from juvenile chronic polyarthritis who were undergoing surgical procedures on the lower limbs. The progressive nature of the radiological changes is described. Possible lines of surgical management are considered.
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