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• W2003297549 abstract "1.1. In a group of 1,363 patients with traumatic spinal cord injuries, 156 (11 per cent) sustained fractures of the extremities; no comparable study has been noted in the literature. 2.2. The case material was divided into four groups; Group I contained twenty-eight patients with thirty-four fractures of the upper extremities incurred in the accident which caused the spinal cord injury; Group II contained fifty-two patients with eighty-one fractures of the lower extremities incurred in the accident which caused the spinal cord injury; Group III contained eight patients with eight fractures of the upper extremities incurred after the spinal cord injury; Group IV contained eighty-one patients with 119 fractures incurred after the spinal cord injury. Within this group the most common fracture in forty patients was an impacted supracondylar fracture of the distal femur which was termed “the paraplegic fracture.” 3.3. Groups I and II comprise 44 per cent; Group III, 4 per cent and Group IV, 52 per cent of all patients. 4.4. In Group IV fractures occurred more often with lower than with upper motor neuron lesions and more frequently with complete than incomplete cord or cauda injuries. The significance of these findings is discussed. 5.5. Fractures of the 156 patients occurred most frequently in the age group of twenty-one to forty years. 6.6. Open fractures occurred in 41 per cent in Group I, 18 per cent in Group II, 0 per cent in Group III and 1.7 per cent in Group IV; there were sufficient battle injuries in Groups I and II to explain this distribution of open fractures. 7.7. The magnitude of the trauma was sufficient in Groups I to III to cause the fracture. On the contrary, 44 per cent of the patients in Group IV sustained fractures of the lower extremities with so minimal an amount of trauma, that the fracture was called “pathologic.” 8.8. Renal calculosis among 156 patients with fractures was twice as high (14.1 per cent) as that in 1,485 patients without fractures (6.8 per cent). Stones formed in patients with lower motor neuron lesions more often than in those with upper motor neuron lesions. 9.9. The same fundamental principles of fracture management were applicable in patients with functional extremities and cord damage as in those without cord damage. However, another type of fracture therapy should be applied in patients whose cord injury has rendered their extremities useless so that alignment is only of secondary importance. This therapy consists of “pillow-splints,” sandbag splints and placing on Foster bed in preference to casts which carry the danger of pressure sores or operative procedures which may lead to more complications in the paraplegic than in the neurologically normal individual. 10.10. “Exuberant” callus was most frequently encountered in Group IV, less in Group II and was inversely related to the degree of alignment. 11.11. Nonunion occurred in 16 per cent of the patients in Group I, in 5.7 per cent in Group II, in 12.5 per cent in Group III and in 3.7 per cent in Group IV. The potential role played by the interruption of the sympathetic outflow has been discussed. 12.12. Braces of the lower extremities may be an important factor in preventing these fractures since none of our patients was thus protected at the time of fracture." @default.
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• W2003297549 title "Extremity fractures of patients with spinal cord injuries" @default.
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• W2003297549 doi "https://doi.org/10.1016/0002-9610(62)90256-8" @default.
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