The needs and unique problems facing spinal cord injured persons after limb amputation.

Among hundreds of spinal cord injured patients (SCIP) who have been rehabilitated in the Sir Ludwig Guttmann Spinal Cord Injury Unit at the Sheba Medical Centre, Tel Hashomer; we only found six patients who had lost one or more limbs (upper or lower limbs). Although many plastic and orthopaedic surgeons regard paralytic limbs as useless appendages, we cannot agree with this erroneous viewpoint and we find that the clinical and psychological effects of the absence of limb(s) are tremendous. The six case reports are given together with a brief review of the relevant literature.

Normal foot--ground pressure pattern in children.

A modern measuring aid for recording foot--ground pressure (FGP) distribution was used to establish normal patterns in male and female children aged 4 to 6 years. Computer analysis demonstrated the pressure exerted by each part of the foot. Standing at ease, the child with a normal foot exerts most of his ground pressure by the posterior weight-bearing area (WBA). The rest is distributed between the middle and anterior WBAs, with the middle portion exerting no more than 10% of the total foot--ground pressure. The advantage of this measuring system is that once a normal FGP has been established, it can serve as an important diagnostic aid and an accurate guide for deciding on appropriate conservative or surgical treatment of the feet of young children.

Shoulder complications as a cause of delay in rehabilitation of spinal cord injured patients. (Case reports and review of the literature).

We describe ten patients with spinal cord disease or injury who developed upper extremity and shoulder complications during rehabilitation. These shoulder complications caused delay in rehabilitation. We discuss the aetiology, treatment and management of shoulder complications in spinal patients and in patients with other neurological diseases.