PARADOXICAL CLINICAL CONSEQUENCES OF PERIPHERAL-NERVE INJURY - CONDUCTION OF NERVE IMPULSES DOES NOT OCCUR ACROSS THE SITE OF INJURY IMMEDIATELY FOLLOWING NERVE DIVISION AND REPAIR

The occasional apparent clinical phenomenon of the immediate although transient return of peripheral nerve function after nerve division and primary repair has been previously reported. Electrophysiological fin dings from the sciatic nerve of the rabbit have been previously presen ted in support of the concept of the transmission of nerve impulses ac ross a freshly divided and repaired peripheral nerve for a short perio d until the onset of Wallerian degeneration.(1) This paper presents ex perimental evidence to show that these findings were misinterpreted an d that a compound action potential cannot be transmitted across a surg ically repaired division in a peripheral nerve. Observations from prev ious experimental research in neurophysiology are discussed which conf irm these conclusions. The claim that failure to diagnose a peripheral nerve injury at presentation can be explained in some circumstances b y ''jump transmission'' is not based on sound evidence and the concept of ''jump transmission'' cannot be accepted as a defence for clinicia ns who fail to diagnose a peripheral nerve injury.