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

210 INJURIES OF NERVES.
contraction of flexor muscles ; atrophy of all the hand muscles ;
neuro-tra.umatic arthritis ;
I
loss of sensation; moderate improvement;
discharge. G. L., aged thirty-one, lumberman ;
enlisted,
May, 1861, Company C, 1st Minnesota Infantrj'.
He was healthy to the date of the wound, which was
received July 3, 1863. While advancing at a walk and
capping his gun, a ball entered the right biceps three and
a quarter inches above the level of the internal condyle,
and made its exit three and a quarter inches directly below
the same condyle, wounding the main artery and the ulnar
and median nerves. The hand and, forearm flexed spasmodically,
and the man, tying a handkerchief around the
arm to check the flow of blood, walked to the rear, suffering
with some pain down the front of the arm, but not
in the hand. Motion and feeling were both absent. Three
hours later the artery was tied. A cerate dressing was
applied, and no splint was at any time used. The wound
healed in two months, and at this time sensation and motion
began to improve. He was admitted to Turner's
Lane Hospital, December 24, 1863, when his case was
thus described: the right hand is congested and a little
swollen. In the flexor carpi radialis the loss from atrophy
is one-half. In the other flexors, supinators, and pronators
the loss is one-third. In the thumb muscles proper and
abductor minimi digiti it is one-fourth.
The deep and superficial flexors and the thumb muscles
are slightly contracted. Up to the third month the fingers
were straight, but about that time they began to bend, and
on admission were semi-flexed.
The biceps acts very little; the supinator longus, although
enfeebled, being competent to flex the forearm.
Extension is incomplete from partial contraction of the
biceps, owing to the prolonged flexion of the arm ; pronation
is incomplete, but the supinating power is entire.
The hand can be raised only to the arm-level, when the