Reflex dystrophy (algoneurodystrophy): results of treatment by corticosteroids.
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Twenty patients with established post-traumatic sympathetic dystrophy were treated with electroacupuncture after physical therapy with or without oral medication had failed to produce satisfactory relief of symptoms. Of these patients 14 (70%) experienced marked and permanent improvement. No complications were encountered. The possible mechanisms involved are discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Among the compression neuropathies associated with the lateral cervical neck region the thoracic outlet syndrome has received special attention during the last decades. In resistant cases, the transaxillary decompression of the neurovascular bundle according to Roos proved to be very successful for us. Since 1982, a total of 185 procedures of this kind were performed with the following results: excellent and good 76%, fair 16%, and not successful 8%.--As the symptoms of Sudeck's dystrophy resemble the clinical findings of a severe thoracic outlet and inlet syndrome, a transaxillary decompression together with sympathectomy was performed in nine resistant dystrophies as well. Thus, in seven patients an excellent result was obtained, and a good and a fair result in one case each. According to our findings, the individual predisposition for Sudeck's dystrophy is based on an impairment of the venous run-off due to a stenosis of the subclavian vein with simultaneous increase of sympathetic activity.
Explore the source record for details and available documents.
BACKGROUND: Thoracoscopic resection of the first through the fourth thoracic sympathetic ganglion for palmary and axillary hyperhidrosis and Raynaud's syndrome is associated with a high initial success rate. However, the reported incidence of compensatory hyperhidrosis of the trunk and legs and Horner's syndrome are high. This study assesses the results of thoracoscopic sympathectomy limited to transection of the interganglionic trunk or resection of one or two thoracic ganglia. METHODS: Twenty-eight thoracoscopic sympathectomies were done for dystrophy of the hand (n = 9), palmar and axillary hyperhidrosis (n = 6), and Raynaud's syndrome (n = 4). The extent of sympathectomy varied from interganglionic division between the second and third ganglion (n = 12), to resection of the third ganglion (n = 12), to resection of the second and third ganglion (n = 4). RESULTS: Sympathectomy resulted initially in relief of symptoms in all cases. Horner's syndrome did not occur. CONCLUSIONS: After a median follow-up of 11 months, two of nine patients with dystrophy judged the result of operation as good. All patients with hyperhidrosis and Raynaud's syndrome judged the result of sympathectomy as good. Compensatory hyperhidrosis was experienced by two patients with dystrophy of the hand who had removal of the second and third sympathetic ganglion.
28 patients with a fracture of the distal end of the radius were treated by a T-plate osteosynthesis through the volar approach. There were 7 unstable distal metaphyseal fractures and 21 dislocated intra-articular fractures. 21 patients were investigated 6 months to 8 years after operation according to the scheme of Sarmiento. 17 patients had a good or excellent result, 4 patients a fair or poor result. 2 patients developed a Sudeck's dystrophy (Algodystrophy), one of them with a radial-ulnar bone bridge. The volar application of the plate is indicated for flexion and extension fractures. In cases with compression of the dorsal cortex a bone graft is indicated to improve a stable osteosynthesis. A conventional tomography on two views helps to diagnose exactly an intra-articular fracture and to decide whether to use a plate or pins and external fixation after open reduction. Remanipulation or an operation 2 weeks after trauma increases the risk of a Sudeck's dystrophy and leads to a poor result.
Many studies and publications have been devoted to Sudeck's syndrome. A much more rare occurrence is described here, namely, after a lesion affecting the lower extremity and knee joint. The case report concerns the typical course of a reflex dystrophy of the knee joint after a mild interior lesion of the knee followed by arthroscopy.
A series of 126 patients who had post-traumatic dystrophy of the hand and foot, with a follow-up of more than five years in most, is described. Nearly all had continuing symptoms and signs. An additional twenty-seven patients, with twenty-eight involved extremities, who were referred from various hospitals in Toronto were treated with one or more intravenous injections of a solution of lidocaine and corticosteroid followed by standard physical therapy. The results were satisfactory or better in twenty-one extremities and poor in seven. Of the twenty-one with a satisfactory result, eleven (six patients with involvement of the hand, bilateral in one, and four patients with involvement of the foot) had an excellent result while the other ten showed substantial improvement. The most important factor in predicting improvement with treatment was a short interval (less than six months) between the onset of dystrophy and the administration of therapy.