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The Journal of Bone & Joint Surgery British Volume
Vol. 48-B, Issue 4 | Pages 703 - 728
1 Nov 1966
Griffiths DL















The Journal of Bone & Joint Surgery British Volume
Vol. 39-B, Issue 4 | Pages 613 - 613
1 Nov 1957
Griffiths DL




The Journal of Bone & Joint Surgery British Volume
Vol. 39-B, Issue 3 | Pages 513 - 519
1 Aug 1957
Auckland G Ball J Griffiths DL







The Journal of Bone & Joint Surgery British Volume
Vol. 38-B, Issue 2 | Pages 438 - 439
1 May 1956
Griffiths DL


The Journal of Bone & Joint Surgery British Volume
Vol. 38-B, Issue 1 | Pages 312 - 326
1 Feb 1956
Griffiths DL



The Journal of Bone & Joint Surgery British Volume
Vol. 37-B, Issue 3 | Pages 369 - 370
1 Aug 1955
Griffiths DL












The Journal of Bone & Joint Surgery British Volume
Vol. 34-B, Issue 2 | Pages 167 - 168
1 May 1952
Griffiths DL




The Journal of Bone & Joint Surgery British Volume
Vol. 33-B, Issue 3 | Pages 299 - 300
1 Aug 1951
Griffiths DL


The Journal of Bone & Joint Surgery British Volume
Vol. 33-B, Issue 2 | Pages 297 - 297
1 May 1951
Griffiths DL




The Journal of Bone & Joint Surgery British Volume
Vol. 32-B, Issue 4 | Pages 676 - 693
1 Nov 1950
Griffiths DL



The Journal of Bone & Joint Surgery British Volume
Vol. 32-B, Issue 2 | Pages 274 - 278
1 May 1950
Brockbank W Griffiths DL




The Journal of Bone & Joint Surgery British Volume
Vol. 31-B, Issue 3 | Pages 472 - 475
1 Aug 1949
Brockbank W Griffiths DL


The Journal of Bone & Joint Surgery British Volume
Vol. 31-B, Issue 2 | Pages 313 - 317
1 May 1949
Griffiths DL Brockbank W


The Journal of Bone & Joint Surgery British Volume
Vol. 30-B, Issue 4 | Pages 714 - 722
1 Nov 1948
Brockbank W Griffiths DL


The Journal of Bone & Joint Surgery British Volume
Vol. 30-B, Issue 3 | Pages 556 - 559
1 Aug 1948
Brockbank W Griffiths DL


The Journal of Bone & Joint Surgery British Volume
Vol. 30-B, Issue 2 | Pages 365 - 375
1 May 1948
Brockbank W Griffiths DL


The Journal of Bone & Joint Surgery British Volume
Vol. 30-B, Issue 2 | Pages 280 - 289
1 May 1948
Griffiths DL

Ischaemia threatening an injured limb gives rise to the syndrome of pain, pallor, paralysis, and pulselessness. It is due to arterial injury by laceration, compression, intra-mural rupture or contusion, or to arterial spasm with or without demonstrable local arterial damage. The differentiation of spasm without local injury from organic obstruction is not possible by clinical methods.

The suggested plan of treatment and of management is:

1. General systemic investigation (blood-pressure, blood-count, coagulation time, etc.).

2. Removal of all external pressure.

3. Resuscitation.

4. Direct attempt to relieve the obstruction by operation.

5. Post-operative care.

The operative procedure recommended is:

1. Manipulative reduction of the fracture if possible.

2. Proximal control of the artery.

3. Arteriography.

4. Exposure of the occluded artery (unless contra-indicated by time factors and by the anatomy of the collateral circulation), liberation and mobilisation of the vessel, repair by suture where such is necessary and possible, and arterectomy only forirreparable local damage.

5. The provision of sympathetic block by injection or by sympathectomy.

The important elements of post-operative care are:

1. To maintain the blood-pressure while cooling the limb and heating the patient.