Because the axillary crutch can cause axillary artery thrombosis and crutch palsy, the elbow crutch is more frequently used. Canadian crutches combine features of both the axilla and elbow crutches. A previous study examined any advantages in terms of energy cost using heart rate. The present study re-evaluates the energy cost by using the measurement of oxygen consumption. The study further suggests that the Canadian crutches have advantages in terms of energy cost.

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Fifty-seven patients have provided 64 dilated pelvicaliceal units for study by diuresis renography and the Whitaker test. Of 45 kidneys showing a type I or type IIIa renographic response (unobstructed), 32 were, according to Whitaker's criteria, obstructed, 8 fell into an equivocal zone and only 5 were unobstructed. Thirty-five of these kidneys--33 of which were associated with moderate or severe loin pain--were operated on for presumed obstruction with generally excellent symptomatic and renographic result. Thus the detection of a type I or type IIIa response in a dilated, painful system cannot be taken to exclude obstruction. Better correlation was obtained between renography and the Whitaker test in patients exhibiting a type IIIb or type II renographic response. Diuresis renography is a sensitive indicator of urodynamic disturbance in the upper urinary tract and an ideal means of evaluating post-operative progress. The Whitaker test provides a reliable means of selecting patients who will benefit from pyeloplasty.

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