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Reconstruction

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Surgical Disorders of the Peripheral Nerves

Abstract

We are indebted to Peter Smith (2006), librarian to the Royal National Orthopaedic Hospital, for advising us about the life and work of Stromeyer who by subcutaneous tenotomy cured William Little of his equinovarus deformity (Fig. 13.1). Little was the founder of the Orthopaedic Institution of London which became, later, the Royal National Orthopaedic Hospital. Stromeyer acquired great experience in control of infection, in war injuries, and also in the treatment of injuries inflicted during the construction of the canal between the Danube and the Rhine. It is to Jones (1916, 1921) that credit is due for establishing hospitals dedicated to rehabilitation; to him also goes the accolade for defining the most important principles that should be followed in reconstruction. The joints must be congruent and supple, the transferred muscle must be strong enough; the course of the transferred muscle and tendons should be direct, and the transplant should be attached with slight tension. The work of Jones and his colleagues at the great Alder Hay Military Hospital was reviewed by McMurray (1919). McMurray’s essay describes techniques still in use in anterior transfer of the hamstring muscles, the use of extensor carpi radialis longus in high median palsy and in his account of transfers for radial palsy he emphasises restoration of gliding planes and of avoidance of splinting in extreme positions. McMurray condemns trapezius transfer in the flail shoulder recommending arthrodesis instead. The failure of nerve grafting and of entubation in repair of the radial nerve is described.

Rolfe Birch M. Chir, FRCP&S (Glas), FRCS (Edin), FRCS (Eng) by election Professor in Neurological Orthopaedic Surgery, University College, London

Visiting Professor, Department of Academic Neurology, Imperial College, London

Honorary Orthopaedic Consultant, Hospital for Sick Children Great Ormond Street, London

The National Hospital for Nervous Diseases, Queen Square, London

Raigmore Hospital, Inverness

Honorary Orthopaedic Surgeon to the Royal Navy

Consultant in Charge, War Nerve Injuries Clinic at the Defence Medical Rehabilitation Centre, Headley Court, Leatherhead, Surrey

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  1. University College, London, UK

    Rolfe Birch M. Chir, FRCP&S (Glas), FRCS (Edin), FRCS (Eng) by election (Professor in Neurological Orthopaedic Surgery)

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Birch, R. (2010). Reconstruction. In: Surgical Disorders of the Peripheral Nerves. Springer, London. https://doi.org/10.1007/978-1-84882-108-8_13

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  • DOI: https://doi.org/10.1007/978-1-84882-108-8_13

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-107-1

  • Online ISBN: 978-1-84882-108-8

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