Six cases of secondary operation for wrist-drop from injury to the musculo-spiral nerve by fracture of the humerus : very little improvement in four, complete restoration of function in two cases / by W.W. Keen.

  • William Williams Keen
Date:
1900
Catalogue details

Licence: In copyright

Credit: Six cases of secondary operation for wrist-drop from injury to the musculo-spiral nerve by fracture of the humerus : very little improvement in four, complete restoration of function in two cases / by W.W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    nerve. Transverse sections of the nerve fully confirm the appear- ance of the longitudinal. As to the exact character of the nerve element present, it is very difficult to say. My own belief is that, first of all, there has been over-development of the fibrous nerve- sheath within which is slowly developing the nerve-fibres, and that should this process continue, function would largely be re-established.” Electrical treatment was begun May 26th, and continued with fair regularity. In September, massage was begun. In the latter part of October, Dr. Sinkler found that the patient began to have slight power to extend the wrist. On December 26th, Dr. Sinkler found the following condi- tions :—“ The patient is able to extend the wrist fully and strongly; there is also full power of extension of all the fingers. He uses his hand for all ordinary purposes, driving frequently a pair of hard-pulling horses. The sensation is fully restored over the area in which it was impaired. With the dynamometer the grip of the right hand is 140 ; left, 65. The extensor muscles of the left forearm still fail to respond to the faradic current, either with slow or rapid interruption. There is an improvement, however, in the reaction to the galvanic current. There is still marked quantitative changes, but the reaction of degeneration is no longer present. The anodal closing contraction is about equal to the cathodal closing contraction.” “On April 9th, 1895, fourteen months after the division of the nerve and eleven months after nerve suture, an examination of the patient shows decided gain in muscular power since the last note The patient can extend the hand and fingers strongly, and says that he feels no sense of weakness in using it. With the dynamometer the right hand registers 130; the left, 84. None of the muscles supplied by the musculo-spiral nerve respond to the faradic current. The reaction of degeneration is no longer present; in fact, there is but slight reaction to the galvanic current with either anodal or cathodal closure. A very strong current causes slight tetanic contraction of the extensor carpi radialis. Sensation in the hand is normal, as is the temperature of the part.”
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