Medical and surgical therapy . es is preserved. LESIONS OF INJURED NERVES 239 5. Lateral pseudo - neu-roma with or without alateral notch. 6. Partial neuroma (in-tra- or juxta-nervous). 7. Simple nerve indura-tion. 1. Complete Section.—Assoon as the surgeon findsthe nerve-trunk in theoperation wound eitherabove or below the prob-able seat of the lesion,according to the course ofthe projectile, he will see byfollowing it up that in themajority of cases wherecomplete section has oc-curred it plunges sud-denly and at an angleinto the wound (PierreMarie and Foix). An ap-pearance such as this isstr
Medical and surgical therapy . es is preserved. LESIONS OF INJURED NERVES 239 5. Lateral pseudo - neu-roma with or without alateral notch. 6. Partial neuroma (in-tra- or juxta-nervous). 7. Simple nerve indura-tion. 1. Complete Section.—Assoon as the surgeon findsthe nerve-trunk in theoperation wound eitherabove or below the prob-able seat of the lesion,according to the course ofthe projectile, he will see byfollowing it up that in themajority of cases wherecomplete section has oc-curred it plunges sud-denly and at an angleinto the wound (PierreMarie and Foix). An ap-pearance such as this isstrongly in favour of com-plete nerve division. Infact, by following andfreeing the nerve it will befound to be severed, withboth ends separated, swollen,and more or less adherentto the surrounding fibro-sclerotic tissue (fig. 3). Histologically, the upperswelling, or neuroma,when the injury has oc-curred sometime previously,is composed of adult me-dullary sheaths possessingrelatively normal axis-cylin-ders (P. Marie and Foix).. Fig. 4. Complete section. Old-stand-ing upper neuroma. (Mag-nification, 7-5 diameters.) The neuroma is wholly com-posed of myelinated its uppermost part {a)the fibres are parallel, inthe middle part (6) theyspread and diverge, in thelower part (c) they run inall directions. This part is,therefore, not suitable forsuture. (After Pierre Marieand Foix.) 240 TREATMENT AND REPAIR OF NERVE LESIONS
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
