Post-traumatic dystrophy of the extremities

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.