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71
Causes or Crippling.—Crippling may occur in the following
ways:
1. Congenital defects and birth injuries.
2. Following acute diseases, such as poliomyelitis,
acute inflammation of the bones and joints.
3. Chronic diseases, e.g., tuberculosis, syphilis and
rheumatism.
4. Nutritional diseases: rickets.
5. As a result of accidents.
6. Postural defects.
The defects vary from conditions that are so severe that
they totally incapacitate the child to the milder defects such as
knock knees and flat feet. It must be remembered, however, that
these mild defects may, unless remedied, progress and cause the
patient much distress and in some cases preclude him from entering
certain occupations.
(a) Prevention of Crippling.-The majority of crippling
defects can be prevented and it has been truly stated by that
great pioneer of orthopaedic treatment, Sir Robert Jones, that
"the cripple is made not born." The following is a short summary
of the methods that are employed to prevent crippling.
(i) Ante-natal care and care of the mother at childbirth.
By this care injury to the mother and to the child at birth
may be avoided.
(ii) Care of the Infant.-By stressing the importance of
protective foods such as Milk, Cod Liver Oil, vegetables and
fresh fruit juice it should be possible to prevent rickets and
scurvy. The mother is advised to use pasteurised milk
as in this way the risk of tuberculous infection is reduced.
Rheumatism in its early stages may be detected and at the
infant clinics the mother is advised to seek appropriate
treatment.
(iii) The School Child.-The mother is again told of the
importance of protective foods at medical inspection.
Improvements in lighting of classrooms and in sitting
accommodation for scholars have helped to reduce the minor
degrees of defornrities associated with faulty posture which
unchecked might lead to much discomfort and even incapacity