Maier C, Homann H-H, Nicolas V
Abteilung Schmerztherapie, BG Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland.
Schmerz. 2009 Apr;23(2):187-90. doi: 10.1007/s00482-009-0793-6.
The case is described of a 45-year-old man with fixed contracture of the proximal interphalangeal joints (digits III-IV) after a stab wound injury in the forearm with subsequent compartment syndrome and partial ulnar injury. Despite neurographic recovery there was permanent contracture during rehabilitation, which was classified as psychogenic. Differential diagnostic aspects of this assumption will be discussed on the basis of clinical criteria as well as 3-phase skeleton scintigraphy and MRT for differentiation between complex regional pain syndrome (CRPS) type II and other posttraumatic changes. Readers are encouraged to make their own diagnosis on the basis of the clinical findings and to discuss the case online (http://www.blogs.springer.com/derschmerz).
本文描述了一名45岁男性患者，其在前臂刺伤后出现近侧指间关节（第三至四指）固定性挛缩，随后发生骨筋膜室综合征和部分尺神经损伤。尽管神经造影显示恢复，但康复过程中仍存在永久性挛缩，被归类为精神性。将根据临床标准以及三相骨闪烁显像和磁共振成像，讨论这一假设的鉴别诊断方面，以区分II型复杂性区域疼痛综合征（CRPS）和其他创伤后变化。鼓励读者根据临床发现自行诊断，并在网上（http://www.blogs.springer.com/derschmerz）讨论该病例。
