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Related Experiment Videos

Reflex sympathetic dystrophy

W W Dzwierzynski1, J R Sanger

  • 1Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin Clinic, Froedtert Hospital, Milwaukee 53226.

Hand Clinics
|February 1, 1994
PubMed
Summary
This summary is machine-generated.

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Early diagnosis and prompt treatment of Reflex Sympathetic Dystrophy (RSD) are crucial for hand surgeons. A multimodal approach combining diagnostic blocks, physical therapy, and psychological support improves patient outcomes.

Area of Science:

  • Hand Surgery
  • Pain Management
  • Neurology

Background:

  • Reflex Sympathetic Dystrophy (RSD) requires early clinical awareness for effective management by hand surgeons.
  • RSD diagnosis is primarily clinical, supported by objective measures like digital temperature, bone scans, and radiographs.
  • Identifying and addressing underlying causes of RSD is vital for successful treatment.

Purpose of the Study:

  • To outline an effective diagnostic and therapeutic protocol for Reflex Sympathetic Dystrophy (RSD).
  • To emphasize the importance of a multidisciplinary approach in managing RSD.
  • To detail the role of stellate ganglion blocks and other interventions in RSD treatment.

Main Methods:

  • Clinical diagnosis supplemented by digital temperature, three-phase bone scan, and hand radiographs.

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  • Initial treatment involves a trial of 2-3 diagnostic and therapeutic stellate ganglion blocks.
  • Post-block management includes active range-of-motion exercises, a stress loading program, and biweekly sympathetic blocks.
  • Alternative treatments like bretylium intravenous regional blocks and long-acting stellate ganglion blocks are considered.
  • Referral to a hand psychologist for counseling, psychotherapy, relaxation therapy, and biofeedback is integral.

    • Main Results:

    • Successful stellate ganglion blocks are indicated by Horner's sign and extremity temperature changes.
    • Biweekly sympathetic blocks aim for pain relief until the patient achieves normal function.
    • A multitherapy approach is employed to break the pain cycle and restore function.

    Conclusions:

    • Prompt diagnosis and a comprehensive, multitherapy treatment strategy are essential for optimal outcomes in Reflex Sympathetic Dystrophy (RSD).
    • The integration of anesthetic blocks, physical therapy, and psychological support is key to successful RSD management.
    • Hand surgeons must maintain a high index of suspicion and awareness for RSD to ensure timely intervention.