The results of the treatment of post-traumatic reflex sympathetic dystrophy within upper extremity]

Results of a retrospective study of the treatment of 146 patients with post-traumatic reflex sympathetic dystrophy within upper extremity in various stages were presented. Treatment included the following methods: regional intravenous steroid blocks, mannitol, mannitol combined with dexamethasone, physical therapy, calcitonin and surgery. Uniform, clearly defined criteria of diagnosis of the condition and criteria of assessment of the results were used in the study. Final assessment was carried out 6-15 months after ending of the treatment (mean 11 months). Good result (no pain and full finger flexion) was obtained in 94 patients (64%), moderate (pain only after load or loss of flexion less than 3 cm) in 31 (21%) and poor (pain at rest or reduction of flexion more than 3 cm) in 21 (15%). There was found that method of treatment had not significant effect on the result, except surgical treatment after which the worst results were obtained. Significant effect of duration of the disease on the results of the treatment was noted: the earlier treatment the better results. In spite of satisfactory withdrawal of other signs and symptoms, considerable reduction of grip strength after treatment persisted (mean grip strength ratio 28% of the other side) suggesting functional impairment of the hand. The critical approach to evaluation of the results of the treatment of early reflex sympathetic dystrophy was suggested with regard to spontaneous recovery of the condition in many cases.