778 



PARALYSIS OF RADIAL NERVE. 



During the three weeks and three days it was kept, the limb 

 was always flexed and turned slightly inwards, so that the outside 

 toe of the foot became worn. 



Post-mortem examination showed fractured first rib (see Fig. 460) ; 

 the surrounding muscles were not lacerated or ruptured. Only a 

 small provisional callus had formed. The broken and overlapped 

 pieces of bone were freely movable, and not (as might appear from 

 inspection of the figure) rigidly fixed together. 



The reason why fractured first rib and marked radial paralysis 



Fig. 461. — Complete paralysis of the radial nerve. 



are so often associated is to be found in the proximity of the brachial 

 plexus, from which the radial nerve originates, to the site of fracture. 

 Even in incomplete fracture a sufficient effusion of blood may occur 

 to interfere seriously with the nerves of this plexus. 



The symptoms vary according to the degree and extent of the 

 paralysis. When complete, the limb takes a position resembling 

 that in very painful affections of the foot. The shoulder and elbow 

 are extended, while all the other joints are fixed in a position of volar 

 flexion, those of the phalanges often to such a degree that the anterior 

 surface of the wall of the foot maj be almost in contact with the 

 ground (Fig. 461), the limb under such circumstances appearing to 



