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November 8, 1919


Author Affiliations

Major, M. C., U. S. Army; Chief of Neurosurgical Service, U. S. Army General Hospital No. 3, Colonia, N. J., and U. S. Army General Hospital No. 41, Fox Hills, Staten Island, N. Y. NEW ORLEANS

JAMA. 1919;73(19):1427-1431. doi:10.1001/jama.1919.02610450023006

Lesions of peripheral nerves have proved to be a rather common complication of gunshot injuries of the extremities. This is especially true of shell wounds, in which the rough, serrated fragments produce extensive laceration of the soft parts and comminution of the bone.

The nerve trauma may result in a complete division of the nerve trunk, or only a portion of its fibers may be injured. It may be crushed against a bone and its fibers interrupted without rupture of the nerve sheath. Frequently it is only bruised, producing swelling and hemorrhage in the nerve substance. In all these conditions, function is usually lost immediately, and if the nerve fibers have been divided, it is not regained until the axis-cylinders have completely regenerated and connected up with the end-plates which subserve the function of motion, sensation, etc. This regeneration of the axis-cylinder consists of a complete outgrowth from the point

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