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Based upon a six years' experience the author uphold that continuos extension with an articular suprajacent point of fixation creates a static, reciprocal pressure between the articular surfaces and exposes to articular rigidity. Continuous extension with an articular subjacent point of fixation and gradual flexion of the knee is a preventive method of great clinical value, ensuring consolidation of the fracture focus within a short interval and maintenance of the articular function.

The author maintains that the atrophy of the sural triceps muscle, the retraction of the Achille tendon and the osteoporosis of the calcaneum and of the tarsian bones, occurring after the traumatic sectioning of the Achille tendon, are the results of an inadequate treatment. The cause of these sequellae is the immobilization of the foot in an equinus position, which relaxes the sural triceps and as a result of the lack of mechanical traction factor, leads to local circulatory disturbances followed by a modification in the structure of the bone and of the muscle. On the basis of this pathophysiological concept the author has excluded post-operative immobilization in the equinus position, and in fact any type of immobilization, recommending in contrast a mobilization of the foot from the very first days after the suture of the tendon. The clinical results obtained confirm the value of the hypothesis.

The position in which the articulation is immobilized is in fact the pattern in which capsular fibrosis and of the connective tissue is settled. It will also determine the degree of remanent articular mobility. The author does not recommend immobilization in the so-called "functional" position since this does not prevent the developement of articular rigidity and is even responsible for their developement. In view of maintaining the articular function when the articulation itself is involved or when it is immobilized due to lesions in its vicinity, immobilization should be made in a position allowing for maximal elongation of the connective fibers in the area which depends from the vascular and nervous viewpoint from the traumatic lesion, or that which is involved by surgery, that is in positions which are quite different from those used at present.

The author maintains that the osteoma of the brachial muscle as well as post-traumatic periarticular calcifications, occur in the muscle mass or in the tendon that prolongs it, or in the articular capsule, as a result of surgical treament and post-operative immobilization, and only exceptionally following orthopaedic treatment of traumatic lesions. Articular mobilization in the first week after osteosynthesis, or in the frame of conservative treatment, is not followed by osteoma of the brachial muscle or by calcifications surrounding the articulation, a fact that suggest that the presently applied therapeutic methods, which recommend strict and prolonged articular immobilization should be avoided. The development of ossification can be explained by post-traumatic changes in the muscular microcirculation, rendered more severe by surgical treatment and maintained by muscular inactivity. Early articular mobilization is the most efficient method of prophylaxis of these complications, which are determined not by the traumatic lesions themselves but by the present therapeutic methods applied.