Complex Regional Pain Syndrome of the Upper Extremity

被引:31
作者
Patterson, Ryan W. [1 ]
Li, Zhongyu [1 ]
Smith, Beth P. [1 ]
Smith, Thomas L. [1 ]
Koman, L. Andrew [1 ]
机构
[1] Wake Forest Univ, Bowman Gray Sch Med, Dept Orthopaed Surg, Winston Salem, NC USA
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2011年 / 36A卷 / 09期
关键词
Chronic pain; complex regional pain syndrome; management; reflex sympathetic dystrophy; upper extremity; REFLEX SYMPATHETIC DYSTROPHY; SPINAL-CORD STIMULATION; SYNDROME TYPE-I; WRIST FRACTURES; COLLES FRACTURE; CLINICAL-TRIAL; VITAMIN-C; ALGODYSTROPHY; FEATURES; THERAPY;
D O I
10.1016/j.jhsa.2011.06.027
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The diagnosis and management of complex regional pain syndrome is often challenging. Early diagnosis and intervention improve outcomes in most patients; however, some patients will progress regardless of intervention. Multidisciplinary management facilitates care in complex cases. The onset of signs and symptoms may be obvious or insidious; temporal delay is a frequent occurrence. Difficulty sleeping, pain unresponsive to narcotics, swelling, stiffness, and hypersensitivity are harbingers of onset. Multimodal treatment with hand therapy, sympatholytic drugs, and stress loading may be augmented with anesthesia blocks. If the dystrophic symptoms are controllable by medications and a nociceptive focus or nerve derangement is correctable, surgery is an appropriate alternative. Chronic sequelae of contracture may also be addressed surgically in patients with controllable sympathetically maintained pain. (J Hand Surg 2011;36A:1553-1562. Copyright (C) 2011 by the American Society for Surgery of the Hand. All rights reserved.)
引用
收藏
页码:1553 / 1562
页数:10
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