E - COMPLICATIONS
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expect an infinitely higher incidence amongst paraplegics. On the other hand, vigorous
passive movements, carried out by physiotherapists in the immediate and early stages
following transverse lesions, especially forceful hip flexion and abduction of the legs
resulting in small haemorrhages and stress to the muscles and connective tissues, were
thought to be aetiological factors in developing this pathological process. In the writer's
view, this could be acceptable at least as an additional factor to account for changes in the
protein-mineral metabolism, set up as a result of the transverse lesion of the cord. In
this connection, it is worthwhile mentioning that chronic trauma to paralysed muscles
such as quadriceps, as a result of pressure due to continuous lying in prone position, may
produce lamellated ossification of the connective tissue between the muscle fibres,
12-8-59
FIG. io3b.
