Relief from pain in Sudeck's posttraumatic syndrome by fasciotomy. A clinical, radiographic, and scintigraphic study

Abstract

Twenty-three consecutive patients aged 33-80 years with a presumed Sudeck's syndrome of one hand or one foot were seen. A fracture initiated the syndrome in three-quarters of them, and the median duration of suffering was 3.5 months in the hand and 7 months in the foot. Osteoporosis and marked 99mTc-labeled methylene diphosphonate uptake were seen in radiographs and scintigrams respectively. Thirteen of the patients were operatively treated; distal fasciotomy on the volar aspect of the forearm or the ventral aspect of the lower leg gave rapid relief from pain at rest in nine of ten patients thus affected. All the patients became symptom-free, except two who underwent closed treatment. At follow-up 2-8 years later radiographic and scintigraphic findings were usually normal.