Surgical experiences in South Africa, 1899-1900 : being mainly a clinical study of the nature and effects of injuries produced by bullets of small calibre / by George Henry Makins.

  • Makins, George Henry, Sir, 1853-
Date:
1901
Catalogue details

Licence: In copyright

Credit: Surgical experiences in South Africa, 1899-1900 : being mainly a clinical study of the nature and effects of injuries produced by bullets of small calibre / by George Henry Makins. Source: Wellcome Collection.

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    below the level of the entry. The humerus escaped injury. Musculo-spiral paralysis was complete; hyperaesthesia in the distribution of the median followed some days later. One month subsequently radial sensation had returned, and a feeling of numbness had taken the place of the median hyperassthesia. The triceps and marginal muscles were much wasted, and only inter- o_sseous extension was possible in the fingers. (125) Brachial nerves.—Wounded at Magersfontein. Entry and exit, in the upper third of the arm internal to the humerus. Complete median paralysis, anaesthesia in the ulnar area, and in the radial supply to the dorsum of the middle and ring fingers. Could flex, extend, and adduct and abduct the wrist; some power of flexion in index finger, in others none. The flexion of the wrist was dependent on the ulnar supply to the muscles of the forearm. No wasting of the interossei, skin normal except for a large trophic blister on the dorsum of the hand. Little improve- ment had taken place in this patient at tlie end of a year. (126) Brachial nerves.—Wounded at Magersfontein. The wound ti-aversed the lower part of the upper third of the arm, fracturing the humerus. Immediate complete loss of power in the arm was experienced, together with loss of all sensation. Three weeks later the humerus was united ; the fracture was evidently the result of passing contact, and not of direct impact. The paralysis was still complete in the distribution of the median, ulnar, and musculo-spiral nerves. There was considerable wasting of the hand and forearm, and a good deal of thickening in the lower third of the arm. Four months after the original injury, the nerves were explored by Mr. Eve, who kindly gives me the following information. All the nerves and vessels of the arm were united into one firm bundle by cicatricial tissue. When dissected clear, the median nerve was found to be thickened and enlarged for about inch of its length ; the ulnar was not completely freed, but was found to be continuous and indurated ; the musculo-spiral was also intact, but at its entrance into the humeral groove a mass of callus was felt. A sclerosed and thickened portion of the median nerve 3^ inches in length was resected, also 1 inch of sclerosed ulnar nerve, and both were sutured. The musculo-spiral nerve was left for future exploration. A small traumatic aneurism w^as found on the brachial artery, and the vessel was ligatured above it. Ten months later no improvement in the median or ulnar nerves. Electrical reaction present in musculo-spiral group of muscles.