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Mikaela Rebota (Pamplona), 70, is diagnosed with reflex sympathetic dystrophy or Sudeck’s atrophy after a radius fracture: “I was in terrible pain, but Dr. Piñal’s operation has revived me”.

The patient goes to Dr. Piñal’s clinic 8 months after suffering a radius fracture in the left forearm, reduced with a volar locking plate (VLP). Suffers a picture of pain, burning and significant mobility limitations in arm and hand.

Mikaela is polymedicated with opioid and neuromodulatory drugs, such as morphine and pregabalin, among others, which, according to the patient’s testimony, fail to mitigate a “horrible and permanent pain”.

Dr. Piñal reviews the case and comes to a new diagnosis that links the patient’s situation to a neurostenalgia of the median nerve, for which he designs and performs a new surgery. 24 hours after the intervention the pains cease and the limb function begins to recover. This clinical improvement is even more evident just two weeks after the procedure.

The Spanish surgeon does not consider Sudeck’s atrophy a pathology per se, but rather a diagnostic formula that masks an unidentified origin of the patient’s real problems, which appear after an intervention, a fracture or an infectious process, among other precedent clinical contexts.

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• Dr Piñal：“患有反射性交感神经营养不良症的人必须反对这种诊断，并寻求第二意见”

• Editorial: I have a dream… reflex sympathetic dystrophy (RSD or Complex Regional Pain Syndrome – CRPS1) does not exist