Injuries of nerves and their treatment / [James Sherren].

  • Sherren, James, 1872-1945.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Injuries of nerves and their treatment / [James Sherren]. Source: Wellcome Collection.

    23/368 page 11
    POST-ANASSTHETIC PARALYSIS 1] nerves. ‘lhese have already been -referred to in their appropriate sections. The cases in which no manipulative cause can be assigned fall into two groups. The first, which is uncommon, includes the injuries resulting from direct pressure; such are injury to the musculo- spiral, due in most cases to the direct pressure of the edge of the table, or injury to the external popliteal nerve, from the application of a Clover’s crutch or Esmarch’s bandage. In the second geroup are the traction injuries. The brachial plexus of the right side suffers most often, and the muscles supplied by the fifth cervical nerve are usually paralysed alone; if muscles supplied by other nerves suffer as well, those supplied by the fifth are always the most severely affected. This type of injury can only occur when the patient’s arm is abducted from the body or raised above the head; in none of the recorded cases did it follow an operation in which the arms were kept to the side. It most often happens when the right arm has been abducted and externally rotated, and the patient, for the convenience of the surgeon, has been brought to the edge of the table; in this way the weight of the upper limb falls on the brachial plexus and its cords are stretched. In a few cases the paralysis follows elevation of the arms above the head; in these the nerves may be injured as the result of the direct pressure of the
    digitised image 1
    digitised image 2
    digitised image 3