[Statistical study of the relationships between the etiology and clinical picture of cerebral palsy]. / Etude statistique des relations existant entre l'étiologie et l'atteinte clinique de l'infirmité motrice cérébrale.

846 children with cerebral palsy were examined and 642 were selected for a statistical study by correspondence analysis. The aim was to identify without any prior assumptions, the relationships between the aetiological factors and the clinical findings. The study was completed by conventional statistical analysis of 584 of the cases. Small birth weight and a history of abnormal pregnancies was associated with a cerebral palsy affecting both legs, and often with a squint. Resuscitation was associated with athetosis and abnormalities of posture and behaviour. If the resuscitation lasted for more than 15 minutes or there were certain problems during delivery, severe abnormalities of both arms and major speech difficulties were observed. Resuscitation for less than 15 minutes or for an unknown time or intractable vomiting during pregnancy was associated with quadraplegia. Hemiplegia was related to post natal events but the aetiology was not always known. Foeto-maternal incompatibility was associated with athetosis, deafness, severe speech problems and ophthalmoplegias.

Functional adaptation of sarcomere number of normal cat muscle.

1. Physiological and histological data were obtained from soleus and tibialis anterior muscles of normal adult cats to study to what extent fibre length and sarcomere number varied between animals and how this was related to the physiological characteristics of the muscles. 2. For a given muscle, the variation in the sarcomere number of individual muscle fibres between animals was found to be about 25%. These difference could partly be explained by comparing the number of sarcomeres and the length of the fibula, which was chosen as an index of the size of the animal. The average sarcomere number in the tibialis anterior muscle was about 60% greater than in the soleus. The variations between animals and between the anterior tibialis and soleus muscles were significantly greater than the variations observed within the same muscle. 3. The sarcomere length is dependent upon the articular angle, that is to say, the length change imposed on the muscle. These length changes are more extensive in the soleus muscle (100%) than in the tibialis anterior muscle (60%). A very significant correlation was found between articular angle and sarcomere length (for soleus r = 0.98, for tibialis anterior r = 0.94). 4. Although fibre length did vary considerably within a given muscle, the sarcomere length showed only minor variations at any given angle. This suggests that sarcomere number is determined in each individual muscle fibre. Such an adaptation implies a concomitant adaptation of the tendinous part of the fibre. This adaptation, resulting in definite sarcomere length at a definite angle, has obvious physiological implications. 5. Conventional length vs. active tension curves were established for the soleus and the tibialis anterior muscles. It is suggested that the difference between the sarcomere number of the two muscles may result in the difference between the shape of curves of these two muscles. 6. Active torque-angle curves were established for the two muscles in situ. The shapes of the curves for soleus and tibialis anterior are similar in spite of the different mechanical conditions of the two muscles. This fact helps to explain why the two muscles, despite their similar articular range, had very different sarcomere number.

[Orthopedic surgery in children with low intelligence quotients]. / Chirurgie orthopédique chez des enfants à quotient intellectuel bas

53 mentally retarded children (IQ lower than 50) sustained orthopaedic procedures for improving locomotion. In this series the authors operated on 26 feet, 6 knees, 22 hips, 8 spines. One only case was operated on the upper limb. Results are carefully analysed. Complete failures were noted in 9 cases. The importance of the postoperative care was emphasized. It seemed more beneficial to operate on several sites in one single stage instead of multiplying surgical operations. Psychological factors in the family and nursing staff must be carefully considered.