Pathophysiologie des Morbus Sudeck : eine experimentelle Studie an Kaninchen und klinische Fallbeispiele

Introduction. Reflex sympathetic dystrophy (RSD) is an unpredictable and difficult to treat syndrome in current hand surgery. It remains a very controversial subject even 100 years after its primary description by P. Sudeck in 1902. Since then, a lot of etiologic hypotheses have been discussed. Some allowed specific therapeutic options: sympathetic blocks, analgesic drugs, specific physiotherapy and neurovascular release with additional upper thoracic sympathectomy (Wilhelm 1987-1998). Material and methods: To assess the influence of limb venous run-off restriction with or without nerve trunc constriction and a trauma on the development of RSD – like scintigraphic changes, 12 female rabbits were operated on and examined by standard 3 stage Technetium scintigraphy and clinical follow – up. Further tools were blood parameter and histology. Forelimbs were not suitable; therefore operations on group 1 with isolated femoral venous outflow restrictions and on group 2 with additional sciatic trunc constrictions were performed and the animals followed for 6 months. Control scintigraphy was performed after 3 and 6 weeks. In 7 out of 12 animals, we applied a standardised distal limb compression without skin damage, either by a metal piston (5 to 10 bar, for 3 seconds) or by a vice (shrinkage from 2 to 0.7 cm). Parallel clinical cases were analysed refer to reasons of RSD, therapy and results. Results: The signs of acute RSD with increased inflow, blood pool and bone uptake could be found in the rabbits 3 and 12 weeks postoperatively. The chronic RSD with hyperperfusion and decreased bone uptake were shown 3 and 9 months after surgery. Conclusions: Although the rabbits did not develop clinical RSD, the scintigraphic findings suggest that this model could be refined for better understanding of the neuro-vascular pathophysiology of RSD. Also the analysis of the clinical cases supported this theory.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2002

Author dc:creator

• Markowicz, Marta

Contributors dc:contributor

• Pallua, Norbert

• info:eu-repo/classification/ddc/610
• Medizin
• Morbus Sudeck
• Sympathische Reflexdystrophie
• Drei-Phasen-Szintigraphie

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-119239%22

OAI identifier oai:identifier

oai:publications.rwth-aachen.de:57174