PDF herunterladen
Handchir Mikrochir Plast Chir 2010; 42(1): 30-36
DOI: 10.1055/s-0030-1247569
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Das komplexe regionale Schmerzsyndrom (CRPS I) in der Handchirurgie – schicksalshaft oder vermeidbar? Sichtweise eines Handchirurgen mit jahrzehntelanger Erfahrung mit dem Problem

Complex Regional Pain Syndrome (CRPS I) in Hand Surgery – Misfortune of Fate or Avoidable? The Viewpoint of a Hand Surgeon with Many Years of Experience in this ProblemH.-J. Pollack1
  • 1Klinikum des Landkreises Löbau-Zittau, Klinik für Unfall- und Handchirurgie, Zittau
Weitere Informationen

Publikationsverlauf

eingereicht 23.11.2009

akzeptiert 16.1.2010

Publikationsdatum:
04. März 2010 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Zusammenfassung

Das komplexe regionale Schmerzsyndrom Typ I (CRPS I) ist eine multifaktoriell verursachte Heilverlaufskomplikation, welche den gesamten Körper betrifft und nicht nur einen Teil desselben, wie zum Beispiel die Hand. Basierend auf eigenen Erfahrungen aus 25 Jahren ist es meine Überzeugung, dass diese Komplikation weitestgehend als vermeidbar und weniger als schicksalhaft anzusehen ist. Dabei ist die Zeitspanne zwischen dem Auftreten erster Symptome und dem Therapiebeginn der wichtigste prognostische Faktor.

Abstract

The complex regional pain syndrome type I (CRPS I) is a complication of the healing process of the whole body, not solely a part of it (e. g., the hand), which is caused by a multiplicity of factors. My conviction that the CRPS should less be considered as a misfortune of fate but rather can be avoided in the majority of cases is based on my experience from the last 25 years. The most important prognostic factor is the time period between the first symptoms and the beginning of the therapy.

Schlüsselwörter

komplexes regionales Schmerzsyndrom - CRPS I - psychogene Prädisposition

Key words

complex regional pain syndrome - CRPS I - psychogenic predisposition

Literatur

  • 1 Amadio PC, Mackinnon SE, Merrit WH. et al . Reflex Sympathetic Dystrophy Syndrome: consensus report of an Ad Hoc Committee of the American Association for Hand Surgery on the definition of reflex sympathetic dystrophy syndrome.  Plast Reconstr Surg. 1991;  87 371-375
    Google Scholar
  • 2 Arlet J, Maziéres B. Medical treatment of reflex sympathic dystrophy.  Hand Clinics. 1997;  13 ((3)) 477-483
    Google Scholar
  • 3 Atkins RM, Duckworth T, Kanis JA. Algodystrophy following Colles’Fracture.  J Hand Surg. 1989;  14B 161-164
    Google Scholar
  • 4 Bernstein B, Singsen B, Kent F. Reflex Neurovascular Dystrophy in children.  J Pediatr. 1978;  93 211-215
    Google Scholar
  • 5 Blumensaat C. Der heutige Stand der Lehre vom Sudeck-Syndrom.. Hefte zur Unfallheilkunde. Heft 51. Springer Verlag; 1956
    Google Scholar
  • 6 Böhler L. Das Verstecken der Fingernägel nach dem sofortigen Spalten der Gipsverbände als sicherstes Mittel zur Verhütung des Sudeck-Syndroms nach geschlossenen Verletzungen der Arme.  Münch med Wschr. 1959;  101 663-668
    Google Scholar
  • 7 Boyes JH. Trophic and Vascular Conditions. In: Bunnel's Surgery of the Hand ed 5 Philadelphia. JB Lippincott 1978 p. 643-651
    Google Scholar
  • 8 Brömmel B, Fialka V, Eschberger D. et al . Persönlichkeitsmerkmale bei Patienten mit M Sudeck Eine tiefenpsychologische Untersuchung.  Med Psychoanal. 1993;  39 346-355
    Google Scholar
  • 9 Bruehl S, Carlson CR. Predisposing psychological factors in the development of reflex sympathetic dystrophy. A review of the empirical evidence.  Clin J Pain. 1992;  8 287-299
    Google Scholar
  • 10 Chahidi N, Ledoux P. Effect of intraarticular morphine on the incidence of algodystrophy after Colles Fracture.  J Hand Surg. 1996;  21B (S 01) 28
    Google Scholar
  • 11 Chin KR, Lonner JH, Jupiter BS. et al . The clinical and psychological impact of hand and wrist fractures.  J of Hand Surg. 1999;  24A 59-63
    Google Scholar
  • 12 Cohen of Birkenhead . On the motion of blood in veins British Medical Journal Sept. 1971 551-557 (Zit. by Schuind)
  • 13 Cone JCP, Hueston JT. Psychological aspects of hand injury.. In: Tubiana R ed. The Hand Vol. 1 Philadelphia: W.B. Saunders; 1981. pp 704-715
    Google Scholar
  • 14 Cooke ED, Ward C. Vicious circles in reflex sympathetic dystrophy: A hypothesis Discussion paper.  J R Soc Med. 1990;  83 96-99
    Google Scholar
  • 15 DeTakats G. Sympathetic Reflex Dystrophy.  Med Clin North Am. 1965;  49 117-129
    Google Scholar
  • 16 Didierjean A. Psychological aspects of algodystrophy.  Hand Clinics. 1997;  13 363-366
    Google Scholar
  • 17 Doury PCC. Algodystrophy.  Hand Clinics. 1997;  13 ((3)) 327-337
    Google Scholar
  • 18 Doury PCC, Dirheimer Y, Pattin S. Algodystrophy: diagnosis and therapy of a frequent disease of the locomotor apparatus. Berlin, Springer Verlag; 1981
    Google Scholar
  • 19 Ecker A. Norepinephrine in reflex sympathetic dystrophy: An hypothesis.  Clin J of Pain. 1989;  5 313-315
    Google Scholar
  • 20 Egle UT, Nickel R, Schwab R, Hoffmann SO. Die somatoforme Schmerzstörung.  Dt Ärzteblatt. 2000;  97 A-1469-A-1473 (Heft 21)
    Google Scholar
  • 21 Enhos A, Kul F, Arikan G. et al . Our experience with RSD problem.  J of Hand Surg. 1996;  21B ((Suppl. 1)) 44
    Google Scholar
  • 22 Fahrenberg J, Selg H, Hampel R. Das Freiburger Persönlichkeitsinventar (FPI). C. J. Hogrefe; Göttingen;
    Google Scholar
  • 23 Field J, Monk C, Atkins RM. Objektive improvements in algodystrophy following regional intravenous guanethidine.  J Hand Surg. 1993;  18B 339-342
    Google Scholar
  • 24 Field J, Gardner FV. Psychological distress associated with algodystrophy.  J of Hand Surg. 1997;  22B 100-101
    Google Scholar
  • 25 Grundberg AB, Reagan DS. Compression syndromes in reflex sympathetic dystrophy.  J of Hand Surg. 1991;  16A 731-736
    Google Scholar
  • 26 Grunert BK, Devine CA, Sanger JR. et al . Thermal self-regulation for pain control in reflex sympathetic dystrophy syndrome.  J of Hand Surg. 1990;  15A 615-618
    Google Scholar
  • 27 Grunert BK, Matloub HS, Sanger JR. et al . Effects of litigation on maintenance of psychological symptoms after severe hand injury.  J of Hand Surg. 1991;  16A 1031-1034
    Google Scholar
  • 28 Gschwind C, Fricker R, Lacher G. et al . Does peri-operative Guanethidine prevent reflex sympathetic dystrophy?.  J of Hand Surg. 1995;  20B ((6)) 773-775
    Google Scholar
  • 29 Haddox JD, Abram SE. And Hopwood, M.H.: Comparison of psychometric data in RSD and radiculopathy.  Reg Anesth. 1988;  13 27
    Google Scholar
  • 30 Hardy MA, Merritt WH. Psychological evaluation and pain assessment in patients with reflex sympathetic dystrophy.  J Hand Ther. 1988;  3 155-164
    Google Scholar
  • 31 Hendler N. Depression caused by chronic pain.  J Clin Psychiatry. 1984;  45 30-36
    Google Scholar
  • 32 Lankford LL. Reflex sympathetic dystrophy.. In: Omer GE, Spinner M (eds.) Management of peripheral nerve problems. W.B. Saunders, Philadelphia; 1980. pp 216-244
    Google Scholar
  • 33 Lankford LL. Reflex sympathetic dystrophy.. In: Tubiana (ed.) The Hand Vol. V p. 129–175 W.B. Saunders Comp. Philadelphia, London, Toronto, Montreal, Sydney, Tokyo; 1999
    Google Scholar
  • 34 Laulan J, Bismuth JP, Sicre G. et al . The different forms of algodystrophy after fracture of the distal radius: Predictive criteria of the course a 1 year.  J of Hand Surg. 1996;  21B ((Supp. 1)) 28
    Google Scholar
  • 35 Lynch ME. Psychological aspects of reflex sympathetic dystrophy: A review of the adult and paediatric literature.  Pain. 1992;  4 337-347
    Google Scholar
  • 36 Mc Farlane RM, Mc Grouther DA. Complications and their management.. In: Hueston JT, Tubiana R , (Eds) Dupuytren's disease. Edingburgh, Churchill. Livingston; 1985: 377-382
    Google Scholar
  • 37 Miller DS, de Takats G. Posttraumatic dystrophy of the extremities.  Sudeck's atrophy Surg Gynec and Obstet. 1942;  75 558-582
    Google Scholar
  • 38 Moberg E. The Shoulder-Hand-Finger Syndrome.  Acta Chirurgica Scandinavia. 1955;  109 284-292
    Google Scholar
  • 39 Moberg E. The shoulder-hand-finger syndrome as a whole.  Surg Clin North Am. 1960;  40 367-373
    Google Scholar
  • 40 Monsivais JJ, Baker J, Monsivais D. The association of peripheral nerve compression and reflex dystrophy.  J of Hand Surg. 1993;  18B 337-338
    Google Scholar
  • 41 Pak TJ, Martin GM, Magness LJ. et al . Reflex sympathetic dystrophy Review of 140 cases.  Minn Med. 1970;  53 507-512
    Google Scholar
  • 42 Paterson MC, Burke FD. Psychological consequences of upper limb injury.  J of Hand Surg. 1995;  20B 776-781
    Google Scholar
  • 43 Pélissier J, Touchon J, Besset A. et al . La personnalité du sujet atteint d’algodystrophie sympathique réflexe Etude psychométrique par la test MMPI.  Rheumatology XXIII. 1981;  151 151-154
    Google Scholar
  • 44 Placzek JD, Boyer MI, Gelbermann RH. et al . Nerve decompression for Complex Regional Pain Syndrome Typ II following upper Extremity Surgery.  J of Hand Surg. 2005;  30A 69-74
    Google Scholar
  • 45 Pollack H-J, Neumann R, Pollack E. M Sudeck und Psyche.  Beiträge Orthopädie und Traumatologie. 1980;  27 463-468
    Google Scholar
  • 46 Pollack H-J. Is the Complex Regional Pain Syndrome Type I (CRPS I) an avoidable complication in Hand Surgery ?. In: I.B. Matev (Ed.) Complications and Errors in Hand Surgery. Publishing House of the Union of Scientists in Bulgaria, Sofia; 2006
    Google Scholar
  • 47 Poplawski ZJ, Wiley AM, Murray JF. Post-traumatic dystrophy of extremities.  J Bone Joint Surg. 1983;  65 ((Am.)) 642-655
    Google Scholar
  • 48 Pulvertaft RG. Psychological aspects of hand injuries.  Hand. 1975;  7 93-103
    Google Scholar
  • 49 Remé H. Das Sudeck-Syndrom.  Langenbecks Arch klin Chir. 1956;  284 32-39
    Google Scholar
  • 50 Reuler JB, Girard DE, Nardone DA. The chronic pain syndrome. Misconceptions and management.  Ann Intern Med. 1980;  93 588-596
    Google Scholar
  • 51 Schuind F, Burny F. Can Algodystrophy be prevented after hand surgery?.  Hand Clinics. 1997;  13 455-476
    Google Scholar
  • 52 Schwartzmann RJ, Kerrigan J. The movement disorder of reflex sympathetic dystrophy.  Neurology. 1990;  40 57-61
    Google Scholar
  • 53 Sennwald GR. Fasciectomy for treatment of Dupuytren's disease and early complications.  J of Hand Surg. 1990;  15A 755-761
    Google Scholar
  • 54 Sherry DD, Weismann R. Psychological aspects of childhood reflex neurovascular dystrophy.  Pediatrics. 1988;  81 572-578
    Google Scholar
  • 55 Simons P, Smith PC, Lees WR. et al . Venous pumps of the hand.  J Hand Surg. 1996;  21B 595-599
    Google Scholar
  • 56 Singh HP, Davis TRC. The effect of short term dependency and immobility on skin temperature and colour in the hand.  J of Hand Surg. 2006;  31B 611-615
    Google Scholar
  • 57 Soucacos PN, Diznitsas LA, Beris AE. et al . Reflex sympathetic dystrophy of the upper extremity.  Hand Clinics. 1997;  13 ((3)) 339-354
    Google Scholar
  • 58 Stanton RP, Malcolm JR, Wesdock KA. et al . Reflex sympathetic dystrophy in children. An orthopaedic perspective.  Orthopaedics. 1993;  16 773-778
    Google Scholar
  • 59 Subbarao J, Stillwell GK. Reflex sympathetic dystrophy syndrome of the upper extremity. Analysis of total outcome of management of 125 cases.  Arch Phys Med Rehab. 1981;  62 549-554
    Google Scholar
  • 60 Sudeck P. Über die akute entzündliche Knochenatrophie.  Arch klin Chir. 1900;  62 147-156
    Google Scholar
  • 61 Sudeck P. Die sogenannte akute Knochenatrophie als Entzündungsvorgang.  Chirurg. 1942;  15 449-458
    Google Scholar
  • 62 Sudmann E, Sundsfjord JA. Relief from pain in Sudeck's posttraumatic syndrome by fasciotomy.  Arch Orthop Trauma Surg. 1984;  103 185-189
    Google Scholar
  • 63 Tubiana R, Fahrer M, Mc Cullough CJ. Recurrence and other complications in surgery of Dupuytren's contracture.  Clinics in Plastic Surgery. 1981;  8 45-49
    Google Scholar
  • 64 Tubiana R. Complications and Recurrendes after Surgical Treatment of Dupuytren's Disease.. In: Matev IB ,(Ed.) Complications and Errors in Hand Surgery. Publishing House of the Union of Scientists in Bulgaria, Sofia; 2006
    Google Scholar
  • 65 VanHoudenhove B, Neuro-Algodystrophy A. Psychiatrist's view.  Clin Rheum. 1986;  5 399-406
    Google Scholar
  • 66 Veldman PH, Reynen HM, Arntz IE. et al . Signs and symptoms of reflex sympathetic dystrophy: Prospective study of 829 patients.  Lancet. 1993;  342 1012-1016
    Google Scholar
  • 67 Vikol J. L’algodystrophie dans son aspect psychologique.  Médicine et hygiéne. 1986;  44 1237-1244
    Google Scholar
  • 68 Wagner W. Das Sudeck-Syndrom. Maudrich, Wien-Bonn-Bern; 1960
    Google Scholar
  • 69 Waylett J. Behavioral patterns in reflex sympathetic dystrophy.. In: Hunter, Schneider, Mackin, Bell (Eds.) Rehabilitation of the Hand. St. Louis, C.V. Mosby C 1978
    Google Scholar
  • 70 Wilhelm A. Stenosis of the subclavian Vein. An unknown cause of resistant reflex sympathetic dystrophy.  Hand Clinics. 1997;  13 387-411
    Google Scholar
  • 71 Wilson PR. Post-traumatic upper extremity reflex sympathetic dystrophy.  Hand Clinics. 1997;  13 ((3)) 367-372
    Google Scholar
  • 72 Wondrak E. Zur Problematik der Sudeck'schen Dystrophie am Handgelenk.  Zbl Chir. 1981;  106 641-648
    Google Scholar
  • 73 Zachariae L. Incidence and course of posttraumatic dystrophy following operation of Dupuytren's contracture.  Acta Chirurgica Scandinavica. 1964;  Supplementum; 336
    Google Scholar
  • 74 Zemel NP, Balcomb TV, Stark HM. et al . Dupuytren's disease in women: Evaluation of long-term results after operation.  J of Hand Surg. 1987;  12A 1012-1016
    Google Scholar
  • 75 Zucchini M, Alberti G, Moretti MP. Algodystrophy and releated psychological features.  Funct Neurol. 1989;  4 ((2)) 153-156
    Google Scholar
  • 76 Zyluk A. A new clinical severity scoring system for reflex sympathetic dystrophy of the upper limb.  J of Hand Surg. 2003;  28B 238-241
    Google Scholar
  • 77 Zyluk A. Complex regional pain syndrome Type I. Risk factors, prevention and risk of recurrense.  J of Hand Surg. 2004;  29B 334-337
    Google Scholar

Korrespondenzadresse

Dr. Hans-Jürgen Pollack

Klinikum des Landkreises

Löbau-Zittau

Klinik für Unfall- und Handchirurgie

Görlitzer Straße 8

02763 Zittau

eMail: ha-pollack@t-online.de

      >