Image from page 442 of “Medical and surgical therapy” (1918)

Image from page 442 of “Medical and surgical therapy” (1918)
Hand Wrist Pain
Identifier: medicalsurgicalt02keog
Title: Medical and surgical therapy
Year: 1918 (1910s)
Authors: Keogh, Alfred, Sir, b. 1857
Subjects: Military Medicine Therapeutics Surgery, Operative
Publisher: New York and London : D. Appleton and Company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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Text Appearing Before Image:
e limited ; at thesame time difficulty inflexing the phalanges oneach other is observed.We have just spokenof complete lesions ofthe me(fian or of incom-plete painless lesions.For in causalgic formsof wounds of this nervejoint affections reachquite unexpected pro-portions. We have dis-cussed these conditionsat length elsewhere.^ These manifestations aiBfect the elbow joint (ankylosis in flexion), wTist joint (ankj^losis in flexion), and especially the finger joints. The articulations most affected are the metacarpo-phalangeal and then the interphalangeal. In the attenuated painful forms these last articulations are the only ones involved (figs. 54 and 55). In wounds of the ulnar we must distinguish between complete painless paralyses and incomplete paralyses which are more or less pain-ful. In the former, apart from the retractions found in ulnar claw-hand, joint affections are infrequent, except where the wound has suppurated for a long 1 Clinical Forms of Serve Lesions. Mi^fei^^^^^^

Text Appearing After Image:
iijgl^il^^^^g^^^l^i^ Fig. 55.—An appearance of thehand in the painful form ofwounds of the median nerve.Deformity of the fingers andnails. Ankylosis of the wristin hyperflexion. 394 TREATMENT AND REPAIR OF NERVE LESIONS period, or where the lower end of the humerus hasbeen involved, with injury to the internal condyle. On the contrary, in incomplete lesions of the nervegiving rise to painful symptoms it is not rare to seemultiple articular rigidities arise in spite of earlymobilisation of the limb. These conditions affect the elbow and the wrist, butprincipally the metacarpo-phalangeal and the inter- phalangeal joints. In the course of severe lesionsof the great sciatic and of itsexternal branch of bifurcationthe external popliteal, ankylosisof the knee or ankle is hardlyever seen. It is only the phalangealjoints of the toes which maybe affected by a certain degreeof stiffness. But very marked joint affections are caused by incompletelesions of the trunk of thesciatic, especially th

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