التعافي الوظيفي والتخلص من الألم من خلال الجراحة للمريض المصاب بالحثل الانعكاسي الودي أو حثل سوديك

11 مارس, 2021

Sandra Flores_Sudeck_01_20210302

أدناه يمكنك قراءة الترجمة الإنجليزية لهذا المحتوى المترجم بواسطة مترجم بشري. يمكنك أيضًا عرض الأصل باللغة الإسبانية من خلال النقر على العلم المقابل في الزاوية اليمنى العليا. يتيح لك هذا الرابط الوصول إلى نسخة من الترجمة الآلية من Google للعربية:

Sandra Flores, 31, is diagnosed with complex regional pain syndrome or Sudeck’s atrophy after a previous ligamentoplasty intervention in the right trapeziometacarpal joint (thumb ligament reconstruction). After the procedure, she developed a picture of acute pain and functional difficulties.

The problem

When she goes to Dr. Piñal, the patient presents intense pain, redness and changes in the color of the hand; symptoms that intensify at night. The thumb is locked and any movement is painful. She isn’t capable of flexing her fingers either, which are far from touching her palm when asked to make a fist. Furthermore, she suffers from wrist locking, with a mobility of approximately 40º of flexion-extension, limitations in the elbow and in the internal abduction-rotation of the arm.

The patient is polymedicated with antiepileptic and neuromodulatory drugs such as gabapentin, clonazepam, and pregabalin, in addition to anti-inflammatories, in both cases aimed at raising the pain threshold. Moreover, she has undergone axillary and corticosteroids nerve blocks through infiltration without improvement.

The goals.

The main objectives of Dr. Piñal and his surgical team go through the filiation of the pathology after the diagnosis of Sudeck’s atrophy or complex regional pain syndrome (CRPS 1 and 2) and the subsequent elimination of pain and correction of function problems.

The plan

Dr. Piñal carries out a diagnostic reassessment and a new procedure adapted to his results is designed. The intervention is performed under local anesthesia and minimal sedation. During surgery breaking adhesions in the thumb and making a full fist are achieved.

His work and decades of experience in the analysis of cases of this profile leads Dr Piñal to consider that reflex sympathetic dystrophy does not exist per se, but rather is a category to which the patient is ascribed when diagnostic capabilities are overcome. Thus, from his point of view, most cases of complex regional pain syndrome are due to underlying pathologies of traumatic origin or nerve irritations and injuries.

In the immediate postoperative period, there is already a decrease in pain and functional improvement. Two weeks later, the patient came to the Dr Piñal’s office practically asymptomatic and without pain in the affected hand.

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