Harris John, Fallat Lawrence, Schwartz Steven
Department of Podiatric Surgery, Oakwood Healthcare System, Dearborn, MI 48180, USA.
J Foot Ankle Surg. 2004 Sep-Oct;43(5):296-301. doi: 10.1053/j.jfas.2004.07.004.
Complex regional pain syndrome (CRPS) is a multifaceted, progressive, and potentially devastating disorder generally affecting the extremities. In addition, scant information is available regarding the types of patients who develop lower-extremity CRPS. This is a retrospective chart review study of 64 patients who presented to a pain clinic with CRPS of the lower extremity. The study examined 23 variables broadly classified under demographic characteristics, CRPS characteristics, and healthcare utilization. The sample was found to consist of predominantly white, middle-aged women with CRPS I. Subjective complaints consisted of burning, sharp, throbbing, or aching pain with shooting symptoms. Initial presenting clinical findings included allodynia, edema, erythema, and hyperesthesia. The most common precipitating injuries were blunt trauma of the foot with or without fracture or ankle sprain. The most common inciting surgical events were bunionectomy, tarsal tunnel release, and heel-spur surgery. Referral to the pain clinic was delayed more commonly in trauma patients than in postsurgical patients, with a corresponding increase in pain clinic visits for treatment. This study may act as a guide for physicians treating the lower extremity to aid in the recognition of lower extremity complex regional pain syndrome and its characteristics.
复杂性区域疼痛综合征(CRPS)是一种多方面的、进行性的且可能具有毁灭性的疾病,通常影响四肢。此外,关于发生下肢CRPS的患者类型的信息很少。这是一项对64例因下肢CRPS就诊于疼痛诊所的患者进行的回顾性病历审查研究。该研究检查了23个变量,大致分为人口统计学特征、CRPS特征和医疗保健利用情况。研究发现样本主要由患有I型CRPS的白人中年女性组成。主观症状包括伴有放射症状的灼痛、刺痛、搏动性疼痛或酸痛。最初出现的临床症状包括痛觉过敏、水肿、红斑和感觉过敏。最常见的促发损伤是足部钝性创伤,伴或不伴骨折或踝关节扭伤。最常见的引发手术事件是拇外翻切除术、跗管松解术和跟骨骨刺手术。与术后患者相比,创伤患者转诊至疼痛诊所的时间更常延迟,相应地,因治疗而到疼痛诊所就诊的次数增加。这项研究可为治疗下肢疾病的医生提供指导,以帮助识别下肢复杂性区域疼痛综合征及其特征。