A study of six hundred and thirty-five cases of infantile paralysis : with especial reference to treatment : from the Children's Hospital, Boston / Robert W. Lovett and W.P. Lucas.

  • Robert W. Lovett
Date:
1908
Catalogue details

Licence: In copyright

Credit: A study of six hundred and thirty-five cases of infantile paralysis : with especial reference to treatment : from the Children's Hospital, Boston / Robert W. Lovett and W.P. Lucas. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ing of teudoii transfer. The following conclusions have been reached from the study of these cases: The opera- tion m the ankle joint is useful in properly selected cases. It has not been used in the knee. It has been both successful and unsuccessful in the hip, and fairly satisfactory in the shoulder, although here tendon trans- fer is advisable when possible. The use of arthrodesis in the ankle by means of silk has proved satisfactory and is preferable in children to the more destructive operation of removing the joint surface. The cutting away of the joint surface in young children is, at times, followed a few years later by a distortion of the foot into a posi- tion of varus. The latter operation should not be per- foiTued in the ankle on children much under the age of puberty. Nerve Anastomosis.—The question of the value of nerve anastomosis is still suh judice and the operation was performed only once, \vith negative result, in the ^ series reported. About 20 cases have been reported in the literature, which are given in Table 11, which pre- sents the results of available recorded operations per- formed for paralysis of the limbs. The brilliant results reported in Some of the cases would seem to promise a future for the operation. CONCLUSIONS. Infantile paralysis is a less formidable affection than is generally believed, partial paralysis is common, dis- used and stretched muscles appear to be paralyzed, but possess a possibility of function. In addition to me- chanical treatment, an attempt should be made by mas- sage, electricity and especially by muscle training to wake to activity the remaining cells in partly destroyed .groups and thus to secure muscles which perform func- tion. After tendon transfer, the development by muscle training of the transferred tendons is essential to good results, and without this the percentage of failure will be large. ]\rnrll)oro Street.
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