The Stark County Democrat. [volume] (Canton, Ohio) 1833-1912, 1899-09-05
AN ANN AIS NERVES.
THEY HAVE BEEN GRATED TO
MANS.

plantation .O,> of score of Cases No
One Rccovelt Entirely Mus, uIar Power
Improved in { sur Cnscs.
In a certain proportion of cases OF
injuries to nerves the ends cannot be
brought togetner and a portion of
nerve obtained from one Of the lower
animals or from an amputated limb
has been implanted. i'r. K. Peterson
contributed an important article to
transportation of nerves ~ the Amer
lean Journal of the MediC5l Sciences
which contains an original case and
an analysis OF the small n1nber OF
pteviusly recorded cases.
A man, aged "a, was severely iNjured
in the right wrist by circular saw.
The ulnar artery and fievor tendons
were severed. The latter were i'm
mediately sutured. He lost sensibility
in the hand and later there were tro-
phic changes-glossy skin, corrugated
nails and liberation of the skin. ana
marked atropny Of the small muscles.
Five months after the injury the ~
vided ends or the median erve were
exposed. They were found to be
united by connective tissue. The prox-
imal end formed a hard bulb. The
connective tissue and the bulb were
removed, leaving a gap. So much
force was required TO bring together
the cut ends that transportation OF
nerve was decided upon.
Four centimeters of the sciatic nerve
of a young black hound were suture1
between the ends with kangaroo ten
don. A similar operation was per-
formed on the ulnar nerve. On the
following day distinct return Of sensi-
bility in the thumb was found; the
fingers could not be tested without
disturbing the bandage. Two months
after operation the skin had lost its
shiny look and appeared normal and
the muscles, though still atror hide
were regaining power. A month later
sensibility was complete except on the
dorsal surface of the third phalanges
of the second. third and fourth fin
gers. The only anaesthetiC areas on
the palmar aspect were on the second
and third phalanges of the third and
| fourth fingers and on the third
| phalanX of the second finger.
There are twenty recorded cases Of
transportation of nerves. The me-
dian nerve was operated on in seven
cases, the ulnar in three, the median
and ulnar nerves in two. the musculo-
spiral nerve in seven, and the sciatiC
in one. There were eight primary and
twelve secondary operations. The time
from the injury to the operation var
led from forty eight hours to one and
a quarter years. Eight out of the
twelve cases oc secondary operation
showed improvement in sensibility OF
motion, while only four out Of eighl
cases of primary operation improved
The interval between the ends Of the
divided nerves varied from three tC
ten centimetres, but distance did no
seem to affect the result. In nine
cases the transplanted segments were
from the sciatic nerves of dogs, In
three from rabbits, in one from kit.
ten. in one from the spinal cord Of {
rabbit, and in FIVE from recently am
putated limbs. In one case an inch q
the sciatic nerve which had been eX
cised was itself transplanted. In nin'
cases catgut was used to unite the i'm
planted segmcnts to the divided ends
in three silk, aud in one kangaroo ten
don.
No case recovered entirely. Th
nearest approach to complete recover!
took place in the case longes, unde
observation, in which at the end o
six years sersibility had entirely re
turned and the only weak muscle wa
the abductor poilris. In three case
there was practically recovery of sen
sihility and motion and the hand wa
useful. Sensibility completely return
ed in four "ases, .nelrly completely il
three cases, and was improved in fou
cases. Muscular power improved il
four cases. There was improvement II
either motion or sensiDility in tWelv
cases, and no Improvement in eithe
in six cases. The average time IL
which sensibility appeared after tn
operation was about ten days; motion
returned in about two and a hal
months