The type of orthopedic care indicated for those individuals who have recently experienced an attack of poliomyelitis is based on the pathologic processes in both the spinal cord and the skeletal muscles. It is essential to interpret correctly these pathologic processes in terms of the altered anatomy and physiologic function before effective treatment can be instituted. Furthermore, the degree of muscle improvement it is ultimately possible to obtain is determined by the severity and distribution of this pathologic condition.
The first objective in treatment is to preserve all potential neuromuscular units that remain anatomically intact and to maintain the skeleton in proper alinement while the protection of these units is being carried out. It is important to realize that intact anatomic units immediately after the acute disease cannot all function as physiologic units. A paralyzed muscle fiber will not contract until its physiologic processes have been restored, and its physiologic