The normal muscles and their innervation enable one to go about one's work. If there is a disturbance in the innervation of the muscles, accessory muscles must take on the work of those which are handicapped. It is in this type of trouble that the orthopedic surgeon's assistance is required.
A tendency to the development of contractures is due to the loss of muscular balance. Although there may be no demonstrable paralysis, there may be a little weakness, with a tendency for contractures to develop. There is a predilection for involvement of the extensor muscles, with resulting flexion deformities. The state of flexion is the state of relaxation, which gives the patient less pain. When certain muscles are paralyzed and the contractures have developed, the situation is unfavorable for correction because of associated structural changes in the bones and joints.
In the treatment of contractures, Dr. Mommsen is opposed to