الشفاء الوظيفي وجراحة التخلص من الألم في حالة ضمور سوديك (متلازمة الألم الإقليمية المعقدة أو الحثل الانعكاسي الودي) في الطرف السفلي

21 يوليو, 2021

Marina Bayo_01_20210720

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:

Marina, 12, shows severe pain and significant functional limitations after a right ankle sprain four months ago. After different tests, it’s concluded that she has reflex sympathetic dystrophy or Sudeck’s atrophy in the lower limb, a disease that currently has no treatment.

The functional limitations of the patient force her to move with crutches.

The problem

The patient moves with crutches, goes to rehabilitation and is medicated to treat the symptoms – pain and disability – that we have just described, without another therapeutic horizon before going to Dr Piñal.

The goals

The clinical aims of the case are the elimination of pain and the functional recovery of the affected limb.

The plan

As a first step, Dr Piñal performs with Marina a self-perception test of the limitations caused by her injury, which the patient establishes at 80% in her daily life and especially as an athlete (she practices athletics).

In turn, the Spanish surgeon proposes a diagnostic reevaluation that rules out dystrophy and leads him, initially, to conduct an infiltration with local anesthesia in one of the nerves of the limb, which allows the patient to walk without the help of crutches.

The new diagnosis of the problem must be accurate due to the large number of nerves involved. Once this is achieved, the forecast improves, as we will explain below.

Functional recovery after infiltration.

In a second step, Dr Piñal carries out a resection of the nerve that was causing the pain, which goes to the sinus tarsi (in the antero-external part of the ankle), after which Marina regains the ability to walk normally .

Dr Piñal 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 a trauma, a surgical intervention or an infectious process, among other clinical pictures.

reflex sympathetic dystrophy
Resection suture on the right leg of the patient.
Postoperative status of the patient five days after the intervention performed by Dr Piñal.

The results

Six weeks after the surgery, the patient reduces her perception of disability to zero, and returns to athletics.

Marina back to athletics.

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