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

VARIETIES OF MECHANICAL INJURIES OF NERVES. 83
the legs,
which involved usually far longer and more serious
ball tracks. Perhaps their frequency may have been
due in part to the greater proportion of all wounds of
the upper limbs. Lesions of the cranial nerves were
rarely seen by us, because these injuries were so often
accompanied by fatal results at an early date, owing to
grave brain or face lesions. One wound of the sympathetic,
the only one on record, and several of the seventh
nerve, with one of the tifth nerve, complete the sum of
our hospital experience in this direction.
In the table of nerve lesions reported by Londe, and
also in
Hamilton's cases, the proportion of injuries of the
upper limbs is far larger than that of the legs;
so that in
civil practice as well as in war the nerves of the arms
to suffer.
especially are most apt
Incised loounds of nerves.— In civil life the most common
examples of nerve wound arise from thrusting a hand
through a glass window-pane, both nerve and vessel being,
generally, severed. I have seen one case of this kind,
in which the ulnar nerve was divided without the artery
beins: cut.
Knife wounds and the like of course exhibit
a variety of incisions of nerves, resulting in greater or
less loss of sensation and of motor power as the division
of the nerve is more or less complete.
Amount of injury.
— The extent of injury to a nerve is of
course of the utmost importance, and is learned only by
the most careful examination of the parts to which the
nerve is finally distributed, in order to ascertain what
movements are lost and what skin surfaces show defects
of sensibility.
I shall have occasion to treat more fully of this subject
in connection with gunshot wounds of nerves ;
but even
here, it will be well to notice certain points which, if neglected,
are apt to lead us astray. Thus in studying loss of
motion, we should remember how closely related are the