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

"308 INJURIES OP NERVES.
by callus. The extensor tendons were tied fast by adhesions
;
the hand a little swollen. The fingers were rigid,
the thumb level — with the palm and everted, its nail
looking upward,
effects chiefly of the splint.
The
wound of entry was open. Sensation normal : the callus
had destroyed pronation and supination and wrist
movements. The fingers were bound by the fixed extensor
tendons, so that they merely stirred in flexion.
The thumb had all motions save only flexion, which was
feeble. The interosseal motions were not lost, but limited
by the flexing of the digits. Every motion or effort at
motion caused tremor.
The condition of the flexors seemed diflicult to explain.
They were extremely feeble, without their nerves having
suffered by the wound. On faradisation, all the muscles
responded, and, at the third sitting, they acted freely, so
that the muscles could only have been suffering from long
inertia and pressure. A rapid cure resulted. This case
is a fair example of the mischief which too long use of
the splint may occasion. It was sent to us as a case of
neural injury.
Case 53.— Gunshot wound of left 'popliteal space ; injury of
sciatic nerve ; j^alsy of extensors ; loss of sensation ; causalgia ;
(gradual recovery; nutritive phenomena ; prohably cicatrix 'pressure
; recovery. H. M., 26th Pennsylvania Volunteers, shot
May 3, 1863, from without inward, through the left popliteal
space, above the joint, between the tendon of the
biceps and the head of the femur. At its exit the ball
touched the posterior border of the inner hamstring
tendon.
The wound healed in four weeks. When hit he had
great pain down the leg, and at once lost all power and
from local contusion or "shock."
all feeling, probably
Since about June 7th, both feeling and motor power
began to improve. On admission, June 18, 1863, motion