134 NERVE INJURIES 



disintegration of the nervous matter lays down a line 

 of bait to entice the regenerating fibres along paths 

 of usefulness. 



The phenomena of repair after suture next call 

 for remark. It may be said at once that the sooner 

 the operation is performed the better will be the 

 results. If the muscles have ceased to contract to 

 any form of electrical stimulus, operation is useless. 

 It is very seldom that benefit will be obtained if 

 two years have elapsed since the injury. If asepsis 

 is secured, accurate primary suture seldom if ever 

 fails. 



Sherren gives average time relations as follows : 

 5-25 weeks : Commencing return of protopathic sense. 

 6-12 months : Complete return of protopathic sense. 

 12-18 months : Return of epicritic sense. 

 12-24 months : Motor recovery. 



Taking the ulnar nerve as an example, recovery 

 may be hoped for in twelve months when it has been 

 divided at the "wrist, or in tw f enty-four months when 

 the injury was at the elbow. 



During recovery, a remarkable phenomenon has 

 been described by Trotter, who had nerve sections 

 performed upon himself. Any stimulus over the 

 cutaneous area affected gives rise to a decidedly 

 painful sensation, referred usually to the most distant 

 part of that area. 



Recovery after incomplete division of a nerve is 

 more rapid, usually taking less than six months for 

 sensory restoration ; it is perhaps a year before 

 motor power is normal. Protopathic sense does not 

 return before epicritic, as it does when the nerve is 



