The Kootenai herald. [volume] (Kootenai, Idaho) 1891-1904, 1897-02-06
EFFECT OF NERVE G.
GRATING
Power and Feeling Restored to an
Arm PnrnINzed bX Iniurx

anu hceAiHS RESTORED to
Arm Paralyzed by Injury.
Robson has reported the case of a gar
ueher " years of age who sustained a
deep incision on the lower and inner part
OF the right upper arm, with division OF
the brachial artery, by falling on a scythe
says the British Medical Journal. The
artery was hgated by the attending sur-
geon and the two ends of a divided nerve
were sutured. The wound healed slowly
by granulation, but finally closed, leaving
the muscles of the wrist and hand sun
piled by the ulnar and median nerves
paralyzed, while those supplied by the
musculo-spiral nerve retained their motil-
lty Sensibility was lost in the same dis
trlDuton, and also in that of the internal
cutaneoIs nerve.
An operation was subsequently under
taken, an incison being made along the
line of the scar, and prolonged some dis
fance upward and downward and sup
plemented by traverse incision about
an inch above the elbow. The lower end
OF the upper segment of the ulnar nerve.
which was dubious, was found to be con-
hected by hbrous tissue with the upper
END OF the lower segment. A small nerve
was round at che upper part of the wound
which proved to be the internal cuta-
neous. The lower end of the same nerve
was round subsequently and united to the
upper with catgut suture. After consid-
cradle search the Dubious lower end of the
upper segment of the median nerve was
discovered at about the middle Of the I'D
per arm, concealed by the belly of the BIZ
ceps muscle. and the upper end of the low
er segment expanded and sending rami-
ncattons into the scar was found salbse-
quently Just above the bend of the elbow
The tibrous tissue between the ends of
the lunar nerve was cut out and the TWO
healthy portions We're united by grating
strands OF the sciatic nerve of a rabbit
so as to fill up the gap and establish con-
unulty. 1t was not possible 10 bring the
divided ends of the meridian nerve closer
together than 212 inches. In the absence
or more suitable tissue, the spinal cord
OF a rabbit just killed was used as a graft
TO connect the ends of the median nerve
the inserted cord lying loose and quite
free from tension when finally placed in
position. Fine catgut sutures were used
throughout. The edges of the wound
were brought together, the usual dress
ings applied, and the arm was fixed upon
rectangular splint. Union took place
by first intention" with total absence
OF fever and pain.
Eleven days after the operation the IA
llent could feel the scratch of a pin on
the front side of the first section of the
thumb, as well as at the root of the index
hnger. He could tell when the hairs on
the back of the first section of the ring
ana little finger were touched but could
not feel the scratch of pin in that stu
alton. Seven days later sensation had re-
turned over the whole of the palmar sur
race of the thumb and the second sec.
ton of the index finger. After a further
interval of sixteen days sensation seemed
to be creeping slowly along the first fin
ger and to be present over the whole of
the palmar area supplied by the median
nerve, and extending down as far as the
web OF the fingers and a short distance
along the middle finger. The muscles
presented evidences of gradual develop
ment and the general nutrition of the
hand improved. Slight power of grasp
and some power of fiexion of the wrist
returned, with slight power of bending
the thumb and fingers. Sensation was
present all over the thumb and index fin
ger and in the second finger up to the
hrst section on the palmar surface; also
IN the third finger. though less distinct
In the course of several weeks more
sharp shooting pains began to be felt in
the distribution of the ulnar nerve and
the fiexor muscle of the forearm began to
react the galvanism. Improvements thus
continued, when the patient was lost 70
observation, and then was not seen again