Lymphedema of the hand and forearm following fracture of the distal radius.
Lymphedema of the hand following a fracture of the distal radius is a disabling, but rare complication. Although the pathogenesis of this mechanism is poorly understood, extensive review of the literature suggests that an underlying cause of this lymphedema is psychogenic in nature. After numerous therapeutic modalities including intense physiotherapy, sympathetic nerve blocks and hospitalization, our patient still continued to persist with this debilitating disease. This article presents a case of Colles fracture complicated by nonpitting edema in a 62-year-old woman in whom psychogenic causes were not identified. The surgical procedure in our patient was uncomplicated and thus lymphedema was uncomplicated and thus lymphedema secondary to any vascular injury was ruled out. Questions that need to be addressed are whether the onset of the fracture induced an avascular anastomosis that led to the lymphedema. Our conclusions led us to believe the development of lymphedema of the distal radius following Colles fracture was idiopathic in our patient.
Kasper
David A
DA
Department of Orthopedic Surgery, Veterans Hospital, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6081, USA.
Meller
Menachem M
MM
D005260:Female; D005542:Forearm; D006225:Hand; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D008875:Middle Aged; D011885:Radius Fractures / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*