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

86 INJURIES OF NERVES.
Case 5.*— Division of the ulnar nerve and vessels and of the
median nerve ; ansesthesia of the j^rts supjjlied ; inflammation
of the tips of three fingers, unattended by sensation; diminution
of animal heat in all the ^xirts paralyzed ; increase of heat
during inflammation, hut still not up
—
to the normal standard.
" A healthy girl, aged twenty-two, cut the ulnar side of
her right forearm very deeply on a broken window-pane.
The wound was at the upper part of the lower third, and
passed across the ulnar vessels and nerve deeply into the
mid-structure, probably dividing the median nerve. It
bled very freely indeed. She was taken to the hospital,
where the hemorrhas-e was arrested and the wound dressed.
" She came under my notice three weeks afterwards, the
wound being then just healed. The scar was puckered
in. She stated, as regards pain, that she had had very
little in the wound, but much aching in the palm.
" The hand of the wounded arm looked a little thinner
and a little paler than the other, but there was no other
difierence to the eye. All the fingers were kept bent
slightly in the palm, and she was unable to straighten
them, owing, as she believed, to the effort to extend
dragging on the scar. In the attempt to extend, the scar
was moved. She was able to flex the fingers fairly,
but could not contract her palm or bring the thumb into
The muscular mass
apposition with any of the fingers.
between the thumb and forefinger was thin and flabby.
The beat of the ulnar artery could be detected below the
scar.
" Sensation. — Immediately below the scar she could feel
the prick of a pin, but not acutely ;
an inch or two lower,
she could scarcely feci it. To the radial side, and at all
parts above the scar, she could feel well. At the level of
the wrist, in front, all sensation was lost, excepting over
* Hutchinson, op. cit., p. 314.