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复杂性局部疼痛综合征Ⅱ型,局限于食指。将科学证据转化为临床实践的案例报告。

Complex regional pain syndrome type II localized to the index finger. A case report translating scientific evidence into clinical practice.

机构信息

Servicio de Medicina Física y Rehabilitación, Hospital Clínico Herminda Martín, Chillán, Ñuble, Chile.

Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián Concepción, Bíobío, Chile.

出版信息

Physiother Theory Pract. 2024 Nov;40(11):2728-2741. doi: 10.1080/09593985.2023.2276379. Epub 2023 Nov 1.

Abstract

BACKGROUND

Complex regional pain syndrome type II (CRPS-II) is a rare condition associated with peripheral nervous system lesions. Its localized distribution in the fingers is unique, and its treatment is unclear.

CASE DESCRIPTION

A 56-year-old male presented to the emergency department with a saw-cut index finger injury with associated tendon and nerve injuries. After surgery, he was admitted to physical therapy (PT) with persistent pain, joint stiffness, allodynia, and trophic changes compatible with CRPS-II localized in the index finger. The diagnosis was confirmed after applying the Budapest Criteria, and PT was progressive and individualized according to the patient's needs, including graded motor imagery, mobilizations, exercises, and education.

OUTCOMES

After 12 weeks of PT, a clinically significant decrease in pain intensity and improvements in mobility and index finger and upper limb functionality was observed, reducing CRPS symptomatology.

DISCUSSION

This report provides information about a unique case of a localized form of CRPS-II. After reviewing the literature on clinical cases of both CRPS-II and localized forms of CRPS, we highlight that the clinical features of this patient and his positive therapeutic response support the importance of translating the scientific evidence on CRPS into clinical practice.

摘要

背景

复杂性局部疼痛综合征 II 型(CRPS-II)是一种罕见病症,与外周神经系统损伤有关。其在手指的局部分布具有独特性,其治疗方法尚不清楚。

病例描述

一名 56 岁男性因食指被锯伤就诊,伴有肌腱和神经损伤。手术后,他因持续性疼痛、关节僵硬、感觉过敏和营养改变而接受物理治疗(PT),这些改变与局限于食指的 CRPS-II 相符。根据布达佩斯标准进行诊断后,PT 根据患者的需求进行渐进式和个体化治疗,包括分级运动想象、松动、运动和教育。

结果

经过 12 周的 PT 治疗,患者的疼痛强度明显降低,活动度以及食指和上肢功能得到改善,CRPS 症状得到缓解。

讨论

本报告提供了一例局限性 CRPS-II 罕见病例的信息。在回顾了 CRPS-II 和局限性 CRPS 的临床病例文献后,我们强调该患者的临床特征和他的积极治疗反应支持将 CRPS 的科学证据转化为临床实践的重要性。

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