Medical and surgical therapy . ; the fingers bend a little at the metacarpo-phalangeal joint, fairly well at the first interphalangealjoint, and not at all at the junction of the second andterminal phalanges. The second phalanx of the thumbis in permanent flexion, and shows the typical deformitydescribed by Jeanne (of Rouen). In spite of the wayin which the heads of the metacarpal bones projectinto the hand, this clawing is very easily overcome:the fork back is less pronounced. Fourth type.—The superficial flexor is very much 114 CLINICAL FORMS OF NERVE LESIONS affected in this type ; the fibr
Medical and surgical therapy . ; the fingers bend a little at the metacarpo-phalangeal joint, fairly well at the first interphalangealjoint, and not at all at the junction of the second andterminal phalanges. The second phalanx of the thumbis in permanent flexion, and shows the typical deformitydescribed by Jeanne (of Rouen). In spite of the wayin which the heads of the metacarpal bones projectinto the hand, this clawing is very easily overcome:the fork back is less pronounced. Fourth type.—The superficial flexor is very much 114 CLINICAL FORMS OF NERVE LESIONS affected in this type ; the fibres of the deep flexorssupplied by the ulnar nerve are not so much involved,and this accounts for the faint attempt at flexion ofthe fourth and fifth fingers and the slight clawing ( and 51). Though paralysed, the interossei react fairly wellto the faradic current. In the early stage there was paresis of the muscles fpK ::;?;?;: J ~4A 1 11 t \l p: -. \ ^1 / \ /. \l V \ \l : \ !!- ??- mi i iii >-„ , •. Fig. 53.—Partial paralysis of medianand ulnar nerves (plexus lesion) (fifthtype). Associated vascular 52.—Partial para-lysis of median andulnar nerves (fifthtype). Associatedvascular lesion. supplied by the musculo-spiral nerve, followed bycomplete riecovery. Fifth type.—hi this type, too,the interossei are deeplyimplicated ; the flexor longus pollicis is normal; theflexors of the fingers partially contract ; the thenarmuscles, which at first were paralysed, are beginning torecover. In the two cases which we illustrate there was anassociated vascular lesion, fairly well compensatedfor in most respects, and irritation of the secretoryfibres which led to excessive sweating in the medianarea (figs. 52-54). LESIONS OF MEDIAN AND ULNAR NERVES 115 Finally, in all these different types the amount ofparalysis of the interossei and flexors should be notedon the one hand; and, on the other, the strength ofthe extensors, associated vascular lesions, anast
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
