Medical and surgical therapy . voluntarymovement. This appHes also to the separate extensionof each finger. Prof. Pitres has suggested the twofollowing tests to find out whether recovery frommusculo-spiral paralysis is complete :— Ask the patient to put his arm in the attitude of aman, taking an oath, with wrist and fingers extendedhorizontally, the thumb raised and separated fromthe first finger, and with the tendons of the extensorsand of the long abductor of the thumb marking outthe anatomical snuffbox ; then ask him to supinatehis hand. The second test is simpler still. With the patientsta
Medical and surgical therapy . voluntarymovement. This appHes also to the separate extensionof each finger. Prof. Pitres has suggested the twofollowing tests to find out whether recovery frommusculo-spiral paralysis is complete :— Ask the patient to put his arm in the attitude of aman, taking an oath, with wrist and fingers extendedhorizontally, the thumb raised and separated fromthe first finger, and with the tendons of the extensorsand of the long abductor of the thumb marking outthe anatomical snuffbox ; then ask him to supinatehis hand. The second test is simpler still. With the patientstanding in front of him, the doctor should tell him toplace his little finger on the seam of his trousers with hisfingers well extended, and with the palm of his handturned to the front. His musculo-spiral paralysis iscured if he can do this correctly. The strength of the restored muscles returns verygradually long after complete recovery of voluntarymovement : it can be measured by the dynamometer. THE MUSCULO-SPIRAL NERVE 47. DIAGNOSIS Diagnosis of musculo-spiral paralysis would besimple enough if it could not be simulated by variousconditions due to war injuries. The most curious condition is that lack of power inthe hand described by Henry Meige as congealedhand. The wrist-drop, though suggestive of musculo-spiral paralysis, is neither complete nor limp. Elec-trical reactions arenormal or slightlymodified in this con-dition (fig. 15). More or less markeddrop of the hand canalso be seen followingdirect muscular lesionof the radial muscleswithout paralysis ofthe nerve. Extensiveadhesions may also im-pede the action of theextensor muscles. Finally, some vascular lesions of the tendons orbones of the forearm cause marked ankylosis of thewrist, which simulates musculo-spiral paralysis. In painful lesions of the median nerve (see p. 69)of some months standing, the patient in his desireto relax the nerve-trunk and protect the skin of thepalm of the hand, which becomes very painful
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
