Complex Regional Pain Syndrome and Carpal Tunnel Surgery

2017 ◽  
pp. 297-300
Author(s):  
Eduard A. Vaynberg ◽  
Anastasios Sakellariou
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Pain Syndrome ◽  
Carpal Tunnel Surgery

Acute and Nonacute Complications Associated with Interscalene Block and Shoulder Surgery

2001 ◽  
Vol 95 (4) ◽  
pp. 875-880 ◽  
Author(s):  
Alain Borgeat ◽  
Georgios Ekatodramis ◽  
Fabian Kalberer ◽  
Cedric Benz
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Brachial Plexus Block ◽  
Pain Syndrome ◽  
Muscular Weakness ◽  
Interscalene Brachial Plexus Block ◽  
Tunnel Syndrome ◽  
Sulcus Ulnaris ◽  
Plexus Block

Background The incidence, etiology, and evolution of complications after interscalene brachial plexus block (ISB) are not well-known. The authors prospectively monitored 521 patients for complications during the first 9 months after ISB. Methods A total of 521 adults scheduled for elective shoulder surgery performed with an ISB were included in this prospective study. The ISB procedure was standardized for all patients Acute complications were recorded. Patients were observed daily (for 10 days) for paresthesias, dysesthesias, pain not related to surgery, and muscular weakness and were evaluated at 1, 3, 6, and 9 months after surgery. Persistence of paresthesias dysesthesias, pain not related to surgery, or muscular weakness was investigated at 1 or 3 months by means of electroneuromyography. Final evaluation was performed at 9 months. Results A total of 520 patients completed the study; one was excluded after surgical axillary nerve damage. Two hundred thirty-four patients had an interscalene catheter. Acute complications consisted of one pneumothorax (0.2%) and one episode of central nervous system toxicity (incoherent speech; 0.2%). A 10 days, 74 patients (14%) were symptomatic, and none had muscular weakness. At 1 month, 41 patients (7.9%) had symptoms, and none had muscular weakness. Thirty patients under went electroneuromyography; sulcus ulnaris syndrome (n = 8) carpal tunnel syndrome (n = 2), and complex regional pain syndrome (n = 1) were diagnosed. At 3 months 20 patient (3.9%) were symptomatic, and none had muscular weakness All underwent electroneuromyography; carpal tunnel syndrome (n = 2), complex regional pain syndrome (n = 4), plexus neuropathy (n = 1), and plexus damage (n = 1) were diagnosed. At 6 months, 5 patients (0.9%) were symptomatic. At 9 months 1 patient (0.2%) had persistence of dysesthesia. Conclusions Interscalene brachial plexus block performed with a standardized technical approach, material, and drugs is associated with an incidence of short- and severe long-term complications of 0.4%. In case of persistent paresthesia, dysesthesia, or pain not related to surgery after ISB, sulcus ulnaris syndrome, carpal tunnel syndrome, or complex regional pain syndrome should be excluded since specific treatment may be required.

Co-existing carpal tunnel syndrome in complex regional pain syndrome after hand trauma

2009 ◽  
Vol 35 (3) ◽  
pp. 228-231 ◽  
Author(s):  
S. M. Koh ◽  
F. Moate ◽  
D. Grinsell
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Range Of Motion ◽  
Grip Strength ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pain Syndrome ◽  
Hand Surgery ◽  
Pain Scores ◽  
Tunnel Syndrome

This study highlights the benefits of carpal tunnel release (CTR) in four patients presenting with complex regional pain syndrome (CRPS) after hand surgery who also had carpal tunnel syndrome (CTS) diagnosed clinically and by nerve conduction studies. Three of the patients underwent pre- and postoperative volumetric, circumference, grip strength and range of motion measurements. The Disabilities of the Arm, Shoulder and Hand (DASH) functional outcome measure and pain scores were also used. There was almost complete resolution of CRPS symptoms in all four patients, with notable reductions in oedema and improvements in grip strength and range of motion. There were also improvements in DASH outcome scores and pain scores after CTR.

Separating Fact From Fiction: A Nationwide Longitudinal Examination of Complex Regional Pain Syndrome Following Treatment of Dupuytren Contracture

Hand ◽  
2020 ◽  
pp. 155894472096391
Author(s):  
Danielle H. Rochlin ◽  
Clifford C. Sheckter ◽  
Ellen S. Satteson ◽  
Courtney C. Swan ◽  
Paige M. Fox ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Disease Diagnosis ◽  
International Classification Of Disease ◽  
Carpal Tunnel Surgery ◽  
Collagenase Injection ◽  
Dupuytren Contracture ◽  
Risk Reduction Measures ◽  
National Perspective

Background: One of the most feared complications following treatment of Dupuytren contracture is complex regional pain syndrome (CRPS). This study aims to provide a national perspective on the incidence of CRPS following treatment of Dupuytren contracture and identify patient factors to target for risk reduction. Methods: Using the Truven MarketScan databases from 2007 to 2016, individuals aged ≥18 years who developed CRPS within 1 year of treatment of Dupuytren contracture were identified using the International Classification of Disease diagnosis code for CRPS. Predictor variables included: age, sex, employment status, region, type of procedure, and concurrent carpal tunnel surgery. Multivariable logistic regression was used to analyze outcomes. Results: In all, 48 327 patients received treatment for Dupuytren contracture, including collagenase injection (13.6%); percutaneous palmar fasciotomy (10.3%); open palmar fasciotomy (3.9%); palmar fasciectomy with 0 (10.8%), 1 (29.2%), or multiple (19.6%) digit releases; or a combination of these procedures (12.8%). One hundred forty-five patients (0.31%) were diagnosed with CRPS at a mean of 3.4 months (standard deviation, 2.3) following treatment. Significant predictors of CRPS included female sex (odds ratio [OR], 2.02; P < .001), Southern region (OR, 1.80; P = .022), long-term disability status (OR, 4.73; P = .035), palmar fasciectomy with release of 1 (OR, 5.91; P = .003) or >1 digit (OR, 13.32; P < .001), or multiple concurrent procedures for Dupuytren contracture (OR, 8.23; P = .001). Conclusions: Based on national commercial claims data, there is a lower incidence of CRPS following treatment of Dupuytren contracture than previously reported. Risk factors identified should help with preoperative counseling and assist clinicians in targeting risk reduction measures.

Treatment of Hand Allodynia Resulting from Wrist Cutting with Radial and Ulnar Artery Perforator Adipofascial Flaps

2018 ◽  
Vol 23 (01) ◽  
pp. 116-120 ◽  
Author(s):  
Hideto Irifune ◽  
Nobuyuki Takahashi ◽  
Suguru Hirayama ◽  
Eichi Narimatsu ◽  
Toshihiko Yamashita
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Perforator Flap ◽  
Pain Syndrome ◽  
Ulnar Artery ◽  
Flap Coverage ◽  
Tunnel Syndrome ◽  
Artery Perforator ◽  
Pedicle Flaps

In this article, we report two cases in which recurrent adhesive hand neuropathy with allodynia were successfully treated with radial and ulnar artery adipofascial perforator flap coverage. Treatment of recurrent neuropathy, such as recurrent carpal tunnel syndrome and re-adhesion after neurolysis using free and pedicle flaps to cover the nerves, has been reported to show good results. However, for severe painful nerve disorders, such as complex regional pain syndrome, the efficacy of this treatment was unclear. We present two cases diagnosed with recurrent adhesive hand neuropathy with allodynia, resulting from wrist cutting; these cases were treated with neurolysis and flap coverage with good results and no recurrence. This suggests that neurolysis and flap coverage are effective methods for treating complex regional pain syndrome.

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