Medical and surgical therapy . hehand is associated with paresis of the extensors, andthe tendons of the flexor carpi radialis and palmarislongus stand out beneath the skin. This combinationof contracture and paresis of the antagonists some-times gives rise to subluxations. In one of our casesit was fairly easy to apply the palm of the hand tothe anterior surface of the forearm {v. Fig. 7). In conformity with the rule that in reflex paralysisand contractures the symptoms predominate at theextremity of the limb, in the form in question the S YMPTOMA TOLOG Y 523 symptoms were more marked and per
Medical and surgical therapy . hehand is associated with paresis of the extensors, andthe tendons of the flexor carpi radialis and palmarislongus stand out beneath the skin. This combinationof contracture and paresis of the antagonists some-times gives rise to subluxations. In one of our casesit was fairly easy to apply the palm of the hand tothe anterior surface of the forearm {v. Fig. 7). In conformity with the rule that in reflex paralysisand contractures the symptoms predominate at theextremity of the limb, in the form in question the S YMPTOMA TOLOG Y 523 symptoms were more marked and persistent in thehand than in the forearm. Lastly, we may note that these motor disordersoften coexist in varying degrees with the differentforms of contracture of the hand which we are goingto study, especially the so-called accoucheurs hand. Accoucheurs hand.—This form of contracture appearsto be very frequent. It has been seen in every neuro-logical centre following wounds of the forearm, handand fingers (v. PI. V, p. 526 ).. Fig. 7.—Paresis ob the extensors of the hand associated withCONTRACTURE OF THE FLEXORS following perforation of theforearm by a bullet (August 1914). Subluxation of the wrist(April 1916) allowing the palm of the hand to be applied tothe anterior surface of the forearm. In this contracture the hand assumes a conicalshape, and the fingers are arranged like the tiles of aroof, the ridge of the roof being represented by themiddle finger alone or by the middle and ring fingers,which are either placed one above the other or bothlying in the same plane. The index and little fingerswhich lie beneath the rest approach and sometimeseven touch one another at their extremities, thusforming the .sides of an equilateral triangle, the baseof which is represented by the metacarpo-phalangealjoints. All the fingers are slightly flexed at the firstand third phalanx, while the second phalanx is ex-tended, sometimes even to excess, with a tendency Plate IV A. Contracture o
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
