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Pressure sores in the sitting paraplegic patient can delay rehabilitation by weeks or months, or can lead to the patient's permanent confinement to bed. This paper describes a method of redistributing the pressure loading on the sitting area so that pressure sores are unlikely to occur. In addition, a clinical approach which increases the patient's awareness of the problem is outlined and case histories and clinical results are described.

An orthosis for a C5 complete tetrapletic providing active extension and pronation of the forearm is presented. It overcomes and prevents the occurrence of the flexed and supinated C5 tetraplegic arms. Technical data and a case report is included.

A total of 515 patients with spinal cord injuries were admitted to the Conradie Hospital's Spinal Cord Injuries Centre during a 3-year period from September 1974 to September 1977. Intermittent catheterization was used for urinary drainage in all patients with incomplete lesions as initially assessed neurologically, and indwelling catheterization in those with complete lesions. Transcutaneous suprapubic Bonnano (stab) continuous catheter drainage was used in a random group of 24 male patients with complete neurological lesions. The majority of the patients were admitted within 24 hours of injury. The follow-up period varied from 1 to 4 years. At 3 months more than 50% of patients had a balanced neurogenic bladder and were catheter-free. At 12 months 19% of patients were still catheter-dependent for reasons explained. Bladder outlet operations were more frequent among patients with thoracic lesions and were indicated 3 times more often in patients with complete neurological lesions. Bladder outlet operations were performed on 8.6% of patients. Only 5 patients (1%) required permanent urinary diversion. A urodynamic work-up is no longer regarded as merely a research tool in the investigation of patients with neurogenic bladder dysfunction. Both urodynamic and videoradiological techniques are a prerequisite to proper management of the neurogenic urinary tract.

A survey of the first 200 cases supplied with a "Paracare" pressure redistribution wheelchair cushion. The rationale of the design and material used is discussed. The method of application and follow-up studies are given and a total evaluation of the results achieved to date are presented.

Patients with spinal cord stabwounds accounted for over one-quarter of the more than 1 600 patients with spinal cord injury admitted to this unit during 13 years. Over half the lesions were of the Brown-Séquard type. Functional recovery was good in nearly two-thirds of patients. The principles of treatment are discussed.

Rehabilitation of the disabled is a dynamic process which should start from the first day post-injury. Total rehabilitation should include, not only attaining maximum function, but also, satisfaction with life in one's own environment. The obstacles created by able-bodied society, are problems that face the disabled person. The right to participate in, and contribute to, all aspects of economic, social and political life is theirs too, as is the right to make decisions about the future. This should not be overlooked, as decision making sows the seeds of motivation. This in turn dictates the measure of success of social reintegration. Assistance is provided in South Africa by various organisations of central government, provincial and local authorities and private welfare organisations. The Cripple Care Association is a private welfare organisation which provides assistance and acts as a link with other relevant organisations. In the Western Cape the number of successfully rehabilitated persons increases and their presence in the community creates an awareness of their needs. This in turn initiates the process of positive change and action.