Dog bite causing ischemia and neurological deficit at the upper extremity: a case report.
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We present a case with median and radial nerve injuries together with brachial artery occlusion after a dog bite that is seen rarely in the literature. A 26 year-old man was admitted to our emergency department with a complaint of dog bite and weakness of fingers at the left upper extremity. There were bite impressions at the left arm. The physical examination of the patient revealed no brachial and radial artery pulse. The neurological examination revealed radial and median nerve deficits. The patient underwent a thromboembolectomy operation following laboratory and radiological evaluations. The nerve injuries were evaluated as partial and medical treatment was administered. (+info)
Is MIPO in humeral shaft fractures really safe? Postoperative ultrasonographic evaluation.
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The influence of contralateral primary afferents on Ia inhibitory interneurones in humans.
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1. Contralateral influences on short latency reciprocal inhibition between wrist extensor and flexor muscles were investigated in twenty-two healthy volunteers. Reciprocal inhibition, probably mediated through the Ia inhibitory interneurone, was measured by conditioning the flexor carpi radialis (FCR) H reflex by weak stimulation of the ipsilateral radial nerve. Maximum reciprocal inhibition occurring at a precise delay between conditioning and conditioned stimulations was taken as the test level of inhibition. 2. Contralateral median or radial nerves were stimulated at short intervals before the onset of reciprocal inhibition. The latter was increased by 8.6% after median nerve stimulation and decreased by 16.5% after radial nerve stimulation. 3. The contribution of sensory fibres in the two nerves to contralateral effects was investigated by stimulating purely sensory branches of the nerves. No clear modification of the contralateral reciprocal inhibition was observed. The effects produced by mixed nerve stimulation are thus likely to have been mediated by Ia fibres. 4. In three hemiplegic patients where reciprocal inhibition was reduced unilaterally, stimulation on the spastic side produced contralateral effects similar to those observed in normal subjects. This result indicates that contralateral effects are not mediated through the Ia inhibitory interneurone ipsilateral to the conditioning stimulus. 5. Since contralateral effects occur after short delays (2 ms, median nerve; 3 ms, radial nerve), we suggest a functional scheme in which the excitability of Ia inhibitory interneurones is modified by contralateral primary afferents via the interneurones activated by group I fibres, probably Ia fibres. The short delays indicate that the interneurone transmitting primary afferent influences to the contralateral side is probably excitatory. (+info)
Regeneration of the radial nerve cord in the sea cucumber Holothuria glaberrima.
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Prolonged conduction block with axonal degeneration. An electrophysiological study.
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Serial electrophysiological studies were performed in a case of 'tourniquet paralysis' of the upper limb after the application of an Esmarch bandage above the elbow. Three months after onset of paralysis, nerve conduction was reduced to a quarter of normal between elbow and and axilla along the few fibres still conducting through the lesion, but was normal distal to the block. Seven months after nerve damage, EMG showed evidence of reinnervation after Wallerian degeneration, and half the nerve fibres had recovered from the conduction block. Thirteen months after nerve injury clinical examination and nerve conduction were normal, but EMG still showed evidence of partial denervation. (+info)
A cadaveric study in the Indian population of the brachialis muscle innervation by the radial nerve.
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Radial nerve innervation to the brachialis muscle has been studied previously by different authors in Caucasian, Chinese, and Thai population. Present study was aimed to describe the radial nerve and musculocutaneous nerve contribution to the brachialis muscle and to elucidate racial differences between Indian and other populations. Hundred-forty superior extremities of 70 embalmed cadavers including 29 female and 41 male cadavers were dissected to study the innervation of brachialis muscle by musculocutaneous nerve and branch from the radial nerve. All the specimens were studied for site of penetration, level of distribution and nature of course and pathway of the branch of the radial nerve to the brachialis muscle. The musculocutaneous nerve innervated the brachialis muscle in 100% specimens, whereas the radial nerve in 72.14% specimens. The radial nerve branch to brachialis pierced the muscle in the lower one third of the humerus in 65.71% specimens; on the other hand in the middle one third in 34.29% specimens. The radial nerve branch to brachialis in 50.71% specimens had relatively straighter course before penetration into the muscle, whereas in 49.29% specimens the nerve had relatively curved course and pathway. Aforementioned results regarding brachialis innervation by radial nerve in Indian population is different from studies reported in other populations. These anatomical facts are important for humeral surgery including both the anterior and posterior approaches especially for orthopedic interventions on the Indian population. (+info)