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

VARIETIES OF MECHANICAL INJURIES OF NERVES. 117
liability to contract like cicatrices elsewhere, and hence
the nerve, however closely confined, may escape altogether
undue pressure.
Among the many animals examined by
Oilier after he
had caused fractures of bones, in one only did he find
a nerve caught in the callus, while every eftbrt to place
nerves so as to engage them in the callus failed altogether.
It seems, then, from experimental data, "that compression
of healthy nerves in callus is not habitual" (Reuillet);
whether it ever happens, this author considers doubtful,
but he is inclined to believe that a nerve injured in any
way, and slowly enlarging from neuritis while incarcerated
in the hardening callus, may sufler severely.
This is a state of things not unlikely to occur; but
there are no recorded cases which I have been able to find
justifying so likely an hypothesis except that reported
by Oilier.*
Case 12.— Aug. Lombard, aged twenty-two years, suffered
a fracture of the humerus at the upper line of the
lower two-fifths of the bone. The fracture was placed in
the earlier of
a starch bandage for forty days, during
which the man had lively lancinating pains at the point
of fracture.
On removal of the apparatus, the extensors were found
to be paralyzed. Four months later, M. Oilier, after
careful examination, concluded that the radial nerve was
suflering primarily from compression by bony fragments,
and secondarily by callus. All other means failing, Oilier
cut down in the line of the nerve, and found it,
as he
says, "swollen like a ganglion, and strangled by a piece
of bone obliquely placed and appearing to belong to the
lower fragment. This point was, in fact, continuous at its
base with the lower end of the bone, which was itself
Keuillet, op cit., p. 49.