Injuries of nerves and their consequences - Reflex Sympathetic ...

98 INJURIES OF NERVES.
late Prof. Mutter after considerable lapse of time, and in
all the reduction was followed for some weeks b}^ pain,
numbness, and muscular feebleness. What is here exempliiied
in a mild form is more gravely illustrated in two
cases reported by Flaubert.* In one of them a complete
palsy of the arm followed reduction, and, upon examination
post mortem, "the four lower nerves of the axillary plexus
were found to have been torn across." In his tiftli case,
the traction being more moderate, the paralj-sis is conceived
by him to have been due to a simple elongation of
the nerves involved.
Desaultf and other surgeons report histories of palsy instantly
following reduction, or coming on within a few days
afterwards, but none of these equals in interest the case|
of a soldier, whose right arm was reduced on the day
of the displacement with instant production of brachial
paralysis without pain, and yet with permanent reflected
anaesthesia and paralysis of the right neck and with ptosis
and partial loss of sight of the right eye. The forearm
and hand were also insensible.
The risk of nerve injury apparently increases with the
previous duration of the luxation, but even an early reduction
sometimes brings about paralysis. In a case which
is stated to have been caused
Duchenue§ relates, the palsy
by the reducing process; yet, on careful reading, there
seems to be no reason to suppose that it may not have
been produced by the accident, which preceded the reduction
by only two days. "Where the remedial measure is
applied as soon as or earlier than this, it often happens that
* Eep. d'Anat. et de Pbys., 1827. I take tl::s reference from Causard,
having been unable to get the Kepertoire, and 1 am also largely indebted
to his Thesis for statements in regard to this subject.
f ffiuvres com pi., t. i. p. 355.
X Mem. dc la Soc. de Biologic, 1854, p.
§ De I'Electrisation localisee, p. 190, 2d ed.
119, E. Le Bret.