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Related Experiment Videos

SHAFT syndrome revisited.

W P Graham1, A W Shearer, D R Mackay

  • 1Section of Plastic & Reconstructive Surgery, Penn State Geisinger Health System, The Milton S. Hershey Medical Center, Hershey, PA 17033-0850, USA.

Annals of Plastic Surgery
|April 23, 1999
PubMed
Summary

Patients with Shaft syndrome present with psychological issues and upper extremity complaints, often involving self-harm or unusual limb positioning. Diagnosis is challenging, requiring high suspicion for effective management.

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Area of Science:

  • Psychiatry
  • Orthopedics
  • Psychosomatic Medicine

Background:

  • The Shaft syndrome, described by Wallace, encompasses patients with significant psychological problems and upper extremity complaints.
  • Patients are categorized into those with factitious injuries and those with anatomically inexplicable limb posturing (clenched fist syndrome).

Purpose of the Study:

  • To review the characteristics and outcomes of patients diagnosed with Shaft syndrome.
  • To highlight diagnostic challenges and the need for heightened clinical suspicion in managing these complex cases.

Main Methods:

  • Retrospective review of patients presenting with Shaft syndrome.
  • Analysis of patient categorization, treatment interventions, and employment outcomes.

Main Results:

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  • Factitious injuries often healed with casting, but 4 patients relapsed.
  • Eight of 14 employed patients returned to work.
  • Psychological counseling was provided, but insight was often limited, hindering progress.
  • Diagnosis proved difficult, with at least 5 patients undergoing unnecessary surgeries.

Conclusions:

  • The Shaft syndrome presents diagnostic difficulties, often requiring a high index of suspicion.
  • Effective management necessitates addressing both psychological and physical complaints.
  • Multidisciplinary approaches may be beneficial for patients with complex psychosomatic presentations.