See, Play and Learn No links available. Resources Find an Expert. Other causes of paralysis include Nerve diseases such as amyotrophic lateral sclerosis Autoimmune diseases such as Guillain-Barre syndrome Bell's palsy , which affects muscles in the face Polio used to be a cause of paralysis, but polio no longer occurs in the U. Start Here. Living With. Related Issues. Statistics and Research. There are four types of paralysis — Monoplegia, Hemiplegia, Paraplegia and Quadriplegia.
In childhood, you probably learned that paralysis means the complete inability to move, to sense touch, or to control bodily sensations. As with most things we learn as children, the real meaning of paralysis is actually significantly more nuanced.
Paralysis comes in many forms, and the extent to which a person is immobilized may change over time as physical therapy, changes in health, and sheer luck alter the way the body responds to physical damage. Paralysis is the inability—whether temporary or permanent—to move a part of the body. In almost all cases, paralysis is due to nerve damage, not to an injury to the affected region.
For instance, an injury in the middle or lower regions of the spinal cord is likely to disrupt function below the injury, including the ability to move the feet or feel sensations, even though the actual structures are as healthy as ever. So what happens to the body when it is paralyzed? That depends on the cause of the paralysis, but generally at least one of the following factors is in play:. These injuries can be the product of traumatic accidents, or diseases such as strokes and polio.
Most spinal cord injuries are incomplete , which means that some signals still travel up and down the cord. With an incomplete injury, you may retain some sensation and movement all the time, or the severity of the paralysis may change—sometimes on a highly unpredictable basis.
A complete spinal cord injury , by contrast, completely compressed or severs the nerves in the spinal cord, making it impossible for the signal to travel. Rarely, injuries to the affected area cause paralysis. This is more common among people who have another medical condition, such as diabetes.
For instance, diabetic nerve damage can cause nerves in some area of the body, particularly the feet, to cease functioning. This can result in more laborious movements, a loss or decrease in your ability to walk, and an increased risk in some other health issues, such as cardiovascular episodes. There are many different causes of paralysis—and each one may result in a different kind of paralysis, such as quadriplegia paralysis of arms and legs , paraplegia being paralyzed from the waist down , monoplegia paralysis in one limb , or hemiplegia being paralyzed on one side of the body.
Each of these conditions can cause paralysis—though the chance and severity of the paralysis may vary greatly from one case to the next. In reality, there are many types of paralysis because there are innumerable ways that the body can be injured. There are four main categories of paralysis, however, which have to do with the portion of the body that is affected. Monoplegia is paralysis of a single area of the body, most typically one limb. People with monoplegia typically retain control over the rest of their body, but cannot move or feel sensations in the affected limb.
Though cerebral palsy is the leading cause of monoplegia, a number of other injuries and ailments can lead to this form of partial paralysis, including:. Monoplegia is sometimes a temporary condition, and is especially common in the aftermath of a stroke or brain injury. When the nerves affecting the paralyzed area are not fully severed, it is often possible to regain significant function through physical therapy.
The flow of ions within muscle cells helps produce muscle contractions and movement. Meanwhile, severe head or neck injuries and neuromuscular disorders can lead to permanent paralysis. Damage to the spinal cord is the most common cause of paraplegia. Flaccid paralysis damages the lower motor neurons that stimulate skeletal muscle movement. Over time, the muscles shrink or deteriorate.
Spastic paralysis causes muscle stiffness, involuntary spasms, and muscle weakness. This form of paralysis can result from spinal cord injuries, amyotrophic lateral sclerosis ALS , stroke, or hereditary spastic paraplegia. Symptoms vary, depending on the type and cause of the issue. The most common paralysis symptom is the loss of muscle function in one or more parts of the body. According to the results of the U. Paralysis Prevalence and Health Disparities Survey , the most common causes of paralysis in the United States include:.
Muscle weakness and paralysis result from damage to the nervous system, which any of the health problems above can cause. A healthy nervous system sends information back and forth between the brain and the rest of the body.
Signals from the brain travel down the spinal cord and into the peripheral nerves throughout the body. Some other possible causes of nervous system damage and resulting muscle weakness or paralysis include:. Slight recurvatum produces stable knee if triceps surae is active. In bilateral quadriceps paralysis, patient has to crawl. We have operated cases of quardriceps.
We retrospectively reviewed the results of operated cases of quadriceps paralysis. Only could be followedup.
Seventeen patients were lost to followup 66 patients had years followup while 67 patients had years followup and patients had more than 5 years followup. There were female and male patients. In all the patients in whom hamstring to quadriceps transfer was performed, the following prerequisites for successful transfer were considered. First, the power in biceps and semitendinosus must be more than grade 4 or more hip flexor and extensors must be good for clearing the ground without difficulty.
Any flexion deformity of hip or knee valgus or varus was corrected. Knee flexors other than biceps and semitendinosus must be good and gastrocnemius must be active enough to perform knee flexion and prevent recurvatum. Biceps alone should not be transferred as this can lead to lateral displacement of patella. Triceps surae must be normal to prevent genu recurvatum and remain as an active knee flexor after surgery. Therefore, the equinus deformity should not be corrected by tendo achilles lengthening without seeing the result of hamstring transfer.
The entire extremity was prepared and draped after the application of tourniquet and administration of appropriate anesthesia. An incision was made on posterolateral aspect of lower one-third of the thigh and extended distally up to the head of fibula. Biceps femoris tendon was dissected out taking care not to injure the lateral popliteal nerve which lies immediately behind the tendon and winds around the neck of fibula.
Biceps tendon was divided distally along with thin chip of bone at its insertion on the lateral aspect of the head of fibula taking care not to damage the lateral ligaments of knee joint, which wind around the tendon, and muscle bellies are mobilized proximally as the entry of its nerve and blood supply will permit [ Figure 1 ]. A second incision was made on the posteromedial aspect of lower one-third of the thigh to the medial aspect of the tibial condyle.
About four-finger width distance was kept between both the incisions to prevent skin necrosis. Semitendinosus tendon, a cord-like round structure without muscle belly, is found lying behind the sartorius and gracilis muscles.
It was divided from its insertion from tibia and mobilized as proximally as possible with blunt finger dissection. Take as much as length of tendon as possible [ Figure 2 ]. The third incision was made vertically on the patella.
Next two sharp cuts mm apart were placed over periosteum of patella, parallel to each. With the help of sharp osteotome, thick osteoperiosteal flap was raised from one incision to another [ Figure 3 ]. Then, oblique subcutaneous tunnel was made from the first to third incision in such a way that it could accommodate the whole biceps tendon and the tendon can glide freely.
Similar type of tunnel was made between the second and third incision to pass semitendinosus tendon. Now the tendon of biceps was passed through the osteoperiosteal flap, and tendon was sutured near the lower incision on patella and infrapatellar portion of ligamentum patellae. Then, the remaining long portion slit was made in biceps femoris proximal to the previously sutured area for osteoperiosteal flap. It is always advisable to take two sutures with biceps femoris and semitendinosus to keep the direction of the pull on the patella in the midline.
To know about the tension over the patella, the thigh was raised passively to allow knee to go under 30 degrees of flexion and there should not be any giving way of the sutures.
Any restrictions of knee flexion postoperatively was prevented by this precaution. After coagulation of bleeders, the wound was closed over negative suction drain. Postoperatively groin to toe posterior slab was given without any flexion at hip and knee joints. Peroperative photograph showing posteromedial incision with separated semitendinosus tendon.
Schematic diagram showing a Tendon of biceps was passed through the osteoperiosteal flap, b tendon was sutured near the lower incision on patella and infrapatellar portion of ligamentum patellae.
Schematic diagram showing a Semitendinosus tendon after passing from biceps, sutured on its own proximal portion of tendon. The foot end of the bed was raised to prevent edema in the limb. One should not put anything under the leg to elevate, to avoid tension over the hamstring. After suture removal, groin to toe plaster was given for 3—4 weeks.
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