The treatment of paralytic deformities / by Robert W. Lovett.

  • Lovett, Robert W. (Robert Williamson), 1859-1924.
Date:
1910
Catalogue details

Licence: In copyright

Credit: The treatment of paralytic deformities / by Robert W. Lovett. 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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    Influence Toward Normal Growth by Apparatus. That the continued wearing of accurate, properly fitted and effective apparatus can, in a measure, be depended on to influence growth toward the normal would seem to be a statement not requiring extended comment. Such a princi- ple finds its best application in scoliosis, which is not amenable to other treatment, in deformities of the feet in young children, and in older children where operative correction is undesirable. In our consideration of mechanical treatment we must remember that very many cases of infantile paralysis are not to be benefited by operation on account of the extent or character of the paralysis. We must remember, also, that operative measures must, in most instances, be preceded and supplemented by mechanical treat- ment. It is worth our while, therefore, as ortho- pedic surgeons, not to slight the importance of mechanical treatment, but to dwell on the im- portance of such treatment carried out by light, accurate and effective braces. In the American orthopedic surgery of to-day there is too little attention paid to the art of brace fitting, as exemplified in the work of C. Fayette Taylor and Shaffer. 2. OPERATIVE TREATMENT. This consists first (a) in tenotomy, myotomy and fasciotomy of contracted soft parts for the im- provement or removal of fixed deformity. This is followed by fixation in the over-corrected position for two to four weeks at the least, and in many cases for an indefinite time with benefit (see above). The operation is performed either subcutaneously or by the open method. The procedure requires no extended consideration.