Family violence: tools for the orthopaedic surgeon.

Nineteen patients, five years or more following nerve suture, were examined by an exacting two-point discrimination test and by a sensory-nerve-conduction-velocity study. The conduction velocity, which normally correlates well with the diameter of nerve fibers did not correlate with the two-point discrimination test. Patients with very slow conduction times, hence small diameter neurons, often had nearly normal clinical return of sensation. Sutured nerves required greater electrical stimulus compared with control nerves before reaching maximum amplitude on the evoked potential. The clinical results, as measured in the two-point discrimination test, depended on whether the patient was a child or an adult at the time of suture. These findings show that sensory-nerve-conduction velocity cannot be used to quantitate clinical results in studies in experimental animals. They further suggest that the adaptability of the young patient's central nervous system explains, at least in part, their better clinical results.