In the rehabilitation of paraplegics reconstructive and corrective operations play a not unimportant part. Their chief value lies in assisting conservative measures as a means of speeding up the social reintegration of these severely disabled people. Furthermore, in certain groups of paraplegics, these operations establish the very basis for a successful rehabilitation. This applies in the first place to that group of spastic and flaccid paraplegics where inadequate early treat ment has led to severe tendon and joint contractures, secondly to that group of paraplegics who develop para-articular ossification of so far unexplained aetiology. The complex problems we meet in the rehabilitation of paraplegics demand exact indications for reconstructive and corrective operations. To fit them suitably into the overall-plan of treatment demands proper knowledge of the neurophysiology of spinal man. In almost twenty years a certain system of reconstructive and corrective operations has been developed at the National Spinal Injuries Centre, Stoke Mandeville. Dr. MICHAELIS, who has acquired considerable experience in the techniques of this operative and post-operative treatment, undertook the commen dable task of presenting these in a monograph. The special value of this publication lies in the description not only of the successes but also of the failures of operative treatment. I hope that this monograph will be a valuable help and guide for all doctors, whose responsible task and goal it is to achieve the social reintegration of the paraplegic.

Introduction: General surgical technique of operations on the limbs of paraplegics

Anaesthesia
a) Details
b) Typical anaesthesia
Neurological terminology
The level of paraplegia
Complete and incomplete paraplegia
Spastic paraplegia
Flaccid paraplegia
Paralysis of autonomic mechanisms
General statistics, Tables 1-7
A. Operations for spasticity and contractures
B. Arthroplasty for extension-ankylosis of the knee joint (Table 21; Figg. 19-21)
C. Operations for para-articular ectopic ossification (Tables 22, 23; Figg. 22-24)
D. Operation for septic arthritis of the hip joint (Tables 24-26; Figg. 25-27)
E. Fractures of the long bones
F. Upper limb
G. Amputation
Literature.