[Clinical estimation of late treatment results in posttraumatic Sudeck's dystrophy treated with mannitol, calcitonin and exercise therapy]

Abstract

The author presents late results of treating 60 patients with posttraumatic Sudeck's dystrophy of upper extremity. The treatment was conducted by 3 methods: 30 patients were receiving mannitol for 1 month, 15 subjects were given calcitonin intramuscularly for 1 month, and programmed rehabilitation according to Mucha's scheme was applied in 15 patients. The results were estimated within the period of 1/2--2 years since the commencement of therapy. The evaluation of the results was accomplished by 3-degree classification namely: good, fair, poor. Main attention was focussed on the rest pain regression and improvement of the hand grasping function. In the total group of 60 patients under treatment, there were 38 persons with good results (62%), in 16 the result was fair (27%) and in 6 persons the outcome was poor (11%). It has been recorded that the treatment during the I stage of disease by all the three methods used was uniformly effective. In the treatment of the II stage the most efficacious was mannitol (statistically significant). Mannitol best influenced the improvement of hand grasping strength after the treatment, as well as regression of DS typical changes in RTG and bone scan. It has been also ascertained that for achievement of good results--regardless of the therapeutic method--the greatest influence was exerted by: the time shorter than 3 months elapsing from the trauma to the onset of the treatment, initial deficit in flexion of the fingers smaller than 3 cm, the presence of typical for DS changes in bone scintigraphy as well as I stage of the disease.