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Claude C. Coleman

particularly difficult insofar as determining the extent or level of the neural damage. A traction lesion is most common in the brachial plexus around the shoulder joint, in the external popliteal, and in the musculospiral from fracture of the humerus with wide dislocation of the fragments. In civilian practice, injury to the brachial plexus from blows or falling on the shoulder is a frequent lesion. These lesions, unfortunately, are generally avulsion of the cords of the plexus from the spinal cord. The lower cords of the plexus often remain intact, enabling the patient to

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W. M. Craig

voluntary power appears at the earliest possible moment. Although splinting plays no part whatever in the regeneration of the peripheral nerve, it is important so far as muscle function and the prevention of deformity are concerned. An overstretched muscle will not regain its contractility even though its nerve supply may be restored completely. According to the reports from Great Britain, six types of splints are required: (1) the abduction splint for brachial plexus injuries; (2) the knuckle duster splint for ulnar paralysis which maintains flexion of the metacarpal

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R. Glen Spurling

( Fig. 1,A – E ). The chief objection to the sling stitch in the past has been the inflammatory reaction occurring around the suture material. With fine tantalum wire this objection has been removed. When the sling stitch is tied, great care must be exercised so that the cuff surfaces of the proximal and distal stumps just touch each other. Too much tension on this stitch causes wrinkling of the tubes—too little leaves an undesirable dead space. Fig. 1-A. Line of incision used for exploration of axillary portion of brachial plexus. Note healed gunshot wound

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Colonel C. G. de Gutiérrez-Mahoney

had long since vanished, I suddenly faradised the brachial plexus, when the patient said at once, ‘My hand is there again. It is bent all up and hurts me.’ It is of course impossible that the motor nerves stimulated should convey any impression centrally, and we must therefore conclude that irritation of sensory trunks may occasion impressions of muscular motion in the sensorium. The phenomena of the phantom vary in nature and in incidence. Weir Mitchell 10 found that 95 per cent of patients experience phantom limb after amputation, Pitres 13 97 per cent

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Edgar F. Fincher, Bronson S. Ray, Harold J. Stewart, Edgar F. Fincher, T. C. Erickson, L. W. Paul, Franc D. Ingraham, Orville T. Bailey, Frank E. Nulsen, James W. Watts, Walter Freeman, C. G. de Gutiérrez-Mahoney, Frank Turnbull, Carl F. List, William J. German, A. Earl Walker, J. Grafton Love, Francis C. Grant, I. M. Tarlov, Thomas I. Hoen and Rupert B. Raney

selected from a series of 40 examples of peripheral nerve injuries. Case 1 . Brachial plexus paralysis; neurolysis; recovery. [Motion pictures.] This is an example of extensive paralysis from extra-neural scar, secondary to blood-vessel injury. Early evacuation of hematoma is recommended in such cases. Case 2 . Median nerve paralysis. Laceration of wrist 4 years previously. Plasma clot suture. Tinel sign 14 days; recovery of sensation 28 days; muscle atrophy and late (3 months) return of motor function, preceded by drop in chronaxie. [Motion pictures.] Case 3

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E. S. Gurdjian and H. M. Smathers

dislocations of the shoulder joint the axillary nerve and the lower portions of the brachial plexus may be involved. There is no evidence that operative treatment of such complications is any more successful than conservative management. 17 TABLE III Interval between injury and surgery Nerve 0–5 weeks 6–10 weeks 11–15 weeks 16–20 weeks 20 weeks and over Radial 7 11 8 2 4 Ulnar 3 1 1 1 3 Median 2 1 Peroneal 1 3 1 1 2 Sciatic 1 TOTAL 11 17

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Richard U. Light and Hazel R. Prentice

hemorrhage alongside one of the cords of the brachial plexus. It is of interest too that the patient did not complain of radiating pain in the distribution of the plexus during the recovery period. In the other case a small but persistent vein, lying adjacent to the internal jugular, was ineffectively controlled by cautery but stopped upon application of a 12×12 mm. stamp of sponge. Carotid Arteriography (1). A small piece of gelatin sponge was used to stop the leakage from the hole left after extraction of the 18 gauge needle through which diodrast was injected into

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Emil Seletz

superficial radial nerves. Fig. 7, Fig. 8 ( left ). Incision for exposure of the radial nerve: (1) in the arm, (2) lateral to the cubital fossa, (3) in the forearm. ( right ). Exploration of the brachial plexus. Transverse axillary incision. The Brachial Plexus. Transverse axillary incision . Exposure of the entire brachial plexus in the axilla can be easily accomplished by a transverse incision following a flexion crease across the entire axilla as shown in Fig. 8 . This is the incision of choice, especially for exposing the radial nerve since it lies

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Treatment of Causalgia

An Analysis of 100 Cases

Theodore B. Rasmussen and Howard Freedman

more of the great nerves 11 Brachial plexus injury 10 Ulnar nerve injury 9 Radial nerve injury 6 Injury to soft tissues only of arm, forearm or hand 4 Fracture of bone or injury to joint 4 Injury to cutaneous nerves of forearm 2 Injury to digital nerves of hand 2 ________ 82 cases TABLE 2 Types of lesions producing causalgia of the lower extremity Sciatic nerve injury 8 cases Tibial nerve injury 2 Peroneal nerve injury 1 Fracture of bone

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Curt P. Richter

taken in July, 1944. The area of high electrical skin resistance included almost all of the area usually supplied by the brachial plexus. Fig. 3. Peripheral nerve chart for the left arm and area of high electrical skin resistance, or denervated area (stippled), produced by evulsion of the spinal cord roots at C-5 and C-6 and compression of roots C-7 and C-8. Fig. 4 shows the chart that is used for the legs. The drawings at the upper left show the front, rear, and side views of the legs, while the drawing at the upper right, of the squatting position