Quotation from: Manual of SurgeryWritten by: Alexander Miles and Alexis Thomson |
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_Treatment_ is carried out on the lines already laid down for nerve injuries in general. It is impossible to diagnose between complete and incomplete rupture of the nerve cords, until sufficient time has elapsed to allow of the establishment of the reaction of degeneration. If this is present at the end of fourteen days, operation should not be delayed. Access to the cords of the plexus is obtained by a dissection similar to that employed for the subclavian artery, and the nerves are sought for as they emerge from under cover of the scalenus anterior, and are then traced until the seat of injury is found. In the case of the first dorsal nerve, it may be necessary temporarily to resect the clavicle. The usual after-treatment must be persisted in until recovery ensues, and care must be taken that the paralysed muscles do not become over-stretched. The prognosis is less favourable in the supra-clavicular lesions than in those below the clavicle, which nearly always recover without surgical intervention.
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