. A treatise on the nervous diseases of children, for physicians and students. contractures occurearly after the onset of thepalsy, and evidently are de-veloped much more easilythan in the cerebral palsiesof the adult. It is interest-ing in this connection to re-fer to the case of Cotard, inwhich the palsy was due toan intra-uterine lesion, andthe child was born with con-tractured extremities. Thecontractures may vary great-ly in degree and in the num-ber of joints affected. Theflexors and pronators of thearm, the flexors of the legsand of the feet, are most fre-quently affected
. A treatise on the nervous diseases of children, for physicians and students. contractures occurearly after the onset of thepalsy, and evidently are de-veloped much more easilythan in the cerebral palsiesof the adult. It is interest-ing in this connection to re-fer to the case of Cotard, inwhich the palsy was due toan intra-uterine lesion, andthe child was born with con-tractured extremities. Thecontractures may vary great-ly in degree and in the num-ber of joints affected. Theflexors and pronators of thearm, the flexors of the legsand of the feet, are most fre-quently affected. In the casesof diplegia and paraplegiathere is, in addition, a con-tracture of the adductors ofthe thighs, which is respon-sible for the peculiar cross-legged position of the legsand for the cross-legged progression if the child is at all ableto walk. All these contractures give the child a characteris-tic position and gait by which we can recognize the troubleat first sight. Pes equinus or pes equino varus is the mostcommon deformity of the foot. In a few cases an equino. Fig. 108. — Case of Spastic to walk ; cross-legged pro-gression ; rigidity and paralysis of legsand of right upper extremity ; left up-per extremity weak. INFANTILE CEREBRAL PALSIES. 441 valgus is present. If the upper extremity is contracturedthe arm is, as a rule, in close juxtaposition to the trunk,flexed at the elbow, and the hand is generally in a positionof extreme flexion, the fingers often being firmly pressedinto the palm of the hand. (See Fig. 106.) The gait varies much and is dependent both upon the paralysis and thedegree of contracture. Many cases of hemiplegia in children have exactlythe same walk as the adult hemiplegic patients have, but the peculiar cross-legged progression in cases of diplegia and paraplegia is characteristic ofthese infantile palsies, and has no counterpart in the cerebral palsies of theadult. In one case the contractures of the hip and knees were so ex
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