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R. Glen Spurling

. Unless actual anatomical division can be demonstrated, or unless the intrinsic scar is so dense that no motor or sensory impulses can be demonstrated to pass through the scar, only complete neurolysis should be done. Clinical experience and laboratory experiments 15 have shown that regeneration through a crushed segment of nerve is often more nearly complete than can be obtained by end-to-end suture. If a nerve thus treated fails to show evidence of regeneration within 2 months, re-exploration is done, and if there are still no sensory impulses passing through the

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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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Paul Weiss

Fibrillen, besonders im Zahnbein. S.B. Akad. Wiss. Wien , 1906, 115: 281–343. 43. Eden , R. Sind zur Ueberbrückung von Nervendefekten die Verfahren der Tubulisation und der Nerventransplantation zu empfehlen? Zbl. Chir. , 1917 , 44 : 138 – 140 . Eden , R. Sind zur Ueberbrückung von Nervendefekten die Verfahren der Tubulisation und der Nerventransplantation zu empfehlen? Zbl. Chir. , 1917, 44: 138–140. 44. Eden , R. , and Rehn , E. Die autoplastische Fetttransplantation zur Neurolysis und Tendolysis

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I. M. Tarlov and J. A. Epstein

indicated that a free anastomosis develops between the longitudinal and regional blood vessels in approximately 3 weeks. At this time then, or preferably several weeks later, separation of the regional vessels from the graft would probably do no harm and might hasten restoration of function to the innervated part. However, this supposition remains to be tested. Such a neurolysis might be justifiable clinically under conditions where, after months or a year or longer, recovery has either not occurred or has failed to reach a satisfactory level. The extent of functional

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E. S. Gurdjian and H. M. Smathers

Patient Sex Age Year Fracture or Dislocation Primary or Secondary Interval before Surgery Operation Result J.R. M 28 1930 Fractured humerus junction upper and middle thirds Primary 14 weeks Neurolysis and transposition Recovery C.J. M 41 1930 Fractured humerus middle third Secondary 6 weeks Transposition Recovery E.M. M 20 1930 Comminuted supracondylar. Previous open reduction Secondary 7 weeks Neurolysis and transposition Recovery C.S. M 43 1930 Supracondylar Secondary

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James C. White and Hannibal Hamlin

T antalum is a metal that causes practically no irritation on the part of human tissues. 4, 5 It has the added advantages of easy processing into plates, thin sheets, or wire at the factory, and of convenient sterilization, drilling, shaping, or cutting in the operating room. For use in operations on the nerves it is available † in thin sheets (0.001 and 0.002″), in annealed rolls (approximately 0.00075″) of convenient size for wrapping a nerve suture or an area of neurolysis, and in thinner foil (0.00025″). The latter has turned out to be too thin, having

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Emil Seletz

is split along the course of its fibers, all the way to the fascial and tendinous insertion at the iliotibial band over the greater trochanter. Great care is now used to sever the gluteus maximus muscle at its fascial insertion. The entire muscle is now reflected medialwards. For convenience the Stookey incision is divided into three parts. The first (part I, Fig. 26 ) may be used alone to expose the sciatic nerve at the sciatic notch, especially when a neurolysis alone is indicated. The lower third (part III, Fig. 26 ) may be used alone for sciatic nerve

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Treatment of Causalgia

An Analysis of 100 Cases

Theodore B. Rasmussen and Howard Freedman

gradual lessening of the pain. However there was likewise some pain still present at the time of these patients' discharge 6 months after injury. In another 5 patients (3 with pain grade 2 and 2 with pain grade 3) neurolysis or neurorrhaphy within 2 months after injury produced slight or no relief of pain whereas a subsequent attack on the sympathetic nervous system cured the causalgia. In an additional 30 cases various operative procedures were carried out upon the nerves, after treatment directed at the sympathetic nervous system was begun, without altering the course

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Nathan Crosby Norcross and John T. Bakody

features were the presence of the adhesive constricting fibrous bands at the cuff margins, and the progressive strangulating effect of the fibrous capsule about the cuff. Pathological study of this tissue showed it to be composed of mature fibrous tissue without any foreign body giant cells. DISCUSSION Our experience in the use of unannealed tantalum foil as a cuff to protect the site of neurolysis for nerve suture has not been a happy one. We have had occasion to reoperate in some 20 cases in which tantalum foil was left about a nerve for periods varying from 6

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Frank Turnbull

. Fig. 2. Case 3 . D.S., K-49681, age 21, suffered a machinegun wound of right axilla in France on Oct. 15, 1944. At his original operation the brachial vessels required ligation; ulnar nerve was seen to have been transected, median nerve not observed. He returned to Canada and reached Shaughnessy Hospital on Mar. 2, 1945. He had a claw hand with total median and ulnar palsy. Operation . Mar. 6, 1945. Exploration of median and ulnar nerves in axilla. Secondary suture of ulnar not feasible because of long gap. Neurolysis of median nerve was carried out. It was