The widespread dissemination of the virus of poliomyelitis, when contrasted with the relatively limited incidence of the disease, suggests the existence of a number of contributing causative factors besides the virus. Isolated reports of the effects of either trauma or strain as predisposing factors in the development of acute anterior poliomyelitis are not infrequent. Frey1 reported two cases following fractures in children 3 years old and one in a girl of 14 following the removal of a small chondroma from the left humerus. The disease developed within one month, two and one-half months and one and three-fourths months, respectively. The flaccid paralysis in each case corresponded to the seat of the trauma and to the same spinal cord segment. Zenke2 reported three cases following trauma. The flaccid paralysis in her cases likewise involved muscle groups corresponding to the spinal cord segments originally involved in the trauma. Both authors
TRAUMA AND STRAIN IN RELATION TO POLIOMYELITIS. JAMA. 1941;116(22):2506–2507. doi:10.1001/jama.1941.02820220048012
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