Can algodystrophy be prevented after hand surgery?
Algodystrophy is characterized initially by an increase in arterial flow, an increase in blood pool, a decrease in microcirculatory velocity, and a loss of thermoregulatory control. These changes, producing the typical symptomatology, associated diffuse hand pain, diminished hand function, edema, and abnormal color and temperature, are believed now to correspond in most cases to an exaggeration of the normal post-traumatic inflammatory responses and are not the consequence of sympathetic damage. Algodystrophy may be prevented in most hand surgery patients by minimizing the normal postoperative inflammation, by increasing venous return (especially by avoiding plaster casts and constrictive dressings), by controlling post-traumatic pain, by promoting early active mobilization, and by reassuring the patient. If there is any sign of algodystrophy, three-phase bone scintigraphy should be obtained and treatment instituted immediately.
Schuind
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Department of Orthopaedics and Traumatology, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Belgium.
Burny
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D001132:Arm / Q000601:surgery; D006225:Hand / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D016059:Range of Motion, Articular; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D012307:Risk Factors