A STUDY OF THE OPERATIVE TREATMENT FOR 

 LOSS OF NERVE SUBSTANCE IN PERIPHERAL 

 NERVES. 



G. CARL HUBER, M.D., 

 Assistant Professor of Histology and Embryology in University of Michigan. 



The far-reaching pathological changes which result from loss 

 of continuity in peripheral nerves, and the relative frequency 

 of such injuries, have for many years aroused the attention of 

 physiologists and surgeons. The very voluminous literature 

 bearing on this subject is rich in experimental and clinical 

 observations. 



All the evidence, experimental and clinical, goes to show 

 that the function of a divided nerve (peripheral) can be restored 

 if the severed ends are brought together, and retained in close 

 apposition by means of a suture or otherwise ; that a careful 

 coaptation of the divided ends favors return of function ; and 

 that the results are more hopeful if only a short time intervenes 

 between the injury to the nerve and the application of the 

 suture. The underlying principle in all operations for the 

 repair of a divided nerve is, therefore, to obtain as rapid and as 

 accurate approximation of the divided ends as possible. 



That return of function may take place even though the 

 divided ends are not carefully adjusted and retained in position, 

 has been shown experimentally and clinically. Surgeons regret 

 the fact, that, after dividing and even resecting a nerve, to 

 alleviate neuralgic pains, the pain may return again, in a longer 

 or shorter time. 



Notta, Langenbeck and Hueter, and Weir Mitchell report 

 cases where spontaneous return of function occurred after loss 

 of nerve substance. 



In 1827 Tiedemann cut the nerves in the branchial plexus 

 of a dog, and removed 10-12 centimeters. Complete loss of 

 sensation and motion occurred. Within the next two years 

 these were restored, and in 1829, when the dog was killed, the 

 defect was completely healed. 



