Severe spasmodic contraction of a finger cured by stretching the median nerve / by James Adams.

  • Adams, James.
Date:
[1908]
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Licence: In copyright

Credit: Severe spasmodic contraction of a finger cured by stretching the median nerve / by James Adams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    example of neuromimesis. The tissues and joints of the finger I amputated were all healthy. The cootraction was certainly not organic but was a true spasm and became more violent the more that one attempted to oppose it. I can find no instance of stretching the median nerve having been done in England for contraction of a finger. Callender relates a case of stretching it for neuralgia, and Morton for athetosis, in which both median and ulnar nerves were stretched with success. The nearest case to mine which I have been able to find is that by Professor Nussbaum. He describes operating on a tuberculous girl, six years of age, in which in the course of a resection of the elbow for ankylosis at an inconvenient angle some traction was exercised upon the ulnar nerve and a spasmodic contraction of the fourth and fifth fingers which had hitherto existed was in consequence completely cured. Professor Nussbaum relates at length in the same article a successful result of stretching the ulnar nerve, and the various branches of the brachial plexus in the axilla for extreme spasmodic contraction of the hand, forearm, and upper arm accompanied by anmsthesia of dcrsal aspect of the forearm in a soldier, aged 23 years, the condition being the result of traumatism. In this patient, as in mine, under an anmsthetic all spasmodic action ceased. Had I stretched the nerve when the patient first came under my treatment I have no doubt that I should have saved the middle finger from amputation, as I have now done the ring finger. No doubt the rarity of such a form of spasmodic contraction in a finger partly accounts for the rarity of the operation, but it forcibly illustrates the utility of such a safe and simple surgical procedure where anyone muscle or group of muscles is similarly affected by this form of intractable spasm. Bibliography .—Artaud et Gilson: Revue de Chirurgie, 1882, vol. ii. Blum: Archives Generates de Medecine, 1878, vol. i. Callender: The Lancet, June 26th, 1875, p. 883; Transactions of the Clinical Society, 1874, vol. vii. Ciceri: Gazzetta Medica Italiana Lombardia, 1887, vol. vii. Codman: Boston Medical and Surgical Journal, 1906, vol. civ. Galigtiani: Gazzetta degli Ospedali, 1887. vol viii. Holmes andHulke: System of Surgery, vol. ii. Morton: Journal of Nervous and Mental Diseases, 1882, vol. ix. Nussbaum : Thf. Lancet, 1872, vol. ii., p. 783. Eastbourne.