If a child has paralytic polio, teach his parents how to prevent contractures as soon as his pain allows[md]they can start only a few days after the acute illness. Preferably four times a day, his joints must be stretched in the direction opposite to that in which a contracture might form[md]for example, stretch an equinus ankle contracture dorsally. Teach them the methods in Fig. 27-2. Fit him with a caliper, as soon as his tender muscles will allow. In the acute stage, leave this on for most of the day and the night. Or, use a plaster gutter splint.
Start to assess the power of his muscles (27-1) as soon as the tenderness allows, usually about three weeks after the start of paralysis. If you assess the degree of recovery each time you see him, you will be able to judge how far he will recover finally. Three months from the onset of paralysis, you will know whether he needs calipers or not.
CONTRACTURES CAN FORM IN A FEW DAYS