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Amputation for reflex sympathetic dystrophy

P W Dielissen1, A T Claassen, P H Veldman

  • 1Department of Surgery, University Hospital, Nijmegen, The Netherlands.

The Journal of Bone and Joint Surgery. British Volume
|March 1, 1995
PubMed
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Amputation for reflex sympathetic dystrophy (RSD) rarely relieves pain and often leads to recurrence in the stump. While infection and function improved in some cases, prosthesis use was limited due to symptom recurrence.

Area of Science:

  • Pain Management
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome, presents significant challenges in pain management.
  • Amputation is a drastic measure considered for intractable pain, recurrent infections, or functional deficits in RSD patients.

Purpose of the Study:

  • To evaluate the outcomes of amputation in patients with reflex sympathetic dystrophy.
  • To assess the efficacy of amputation in pain relief, infection control, and functional improvement in RSD.
  • To investigate the recurrence rate of RSD following amputation.

Main Methods:

  • Retrospective review of 28 patients with RSD who underwent 34 amputations.
  • Analysis of amputation indications: pain, infection, or functional improvement.

Related Experiment Videos

  • Assessment of post-amputation pain, infection status, residual function, stump recurrence, prosthesis use, and patient satisfaction.

    • Main Results:

    • Only 2 of 34 amputations provided pain relief, which was unpredictable.
    • Infection was cured in 10 of 14 patients, and residual function improved in 9 of 15 patients.
    • RSD recurred in the stump in 28 amputations, particularly when the amputation level was not symptom-free. Prosthesis use was limited due to stump recurrence or hyperpathia.

    Conclusions:

    • Amputation offers limited pain relief for RSD and carries a high risk of stump recurrence.
    • While amputation can resolve infections and improve function in some RSD cases, outcomes are often compromised by symptom recurrence.
    • Despite limited prosthesis use, a majority of patients reported satisfaction with the overall results of amputation for RSD.