Geertzen J H, Dijkstra P U, Groothoff J W, ten Duis H J, Eisma W H
Department of Rehabilitation, University Hospital Groningen, The Netherlands.
Acta Orthop Scand Suppl. 1998 Apr;279:12-8.
The aim of this retrospective and long-term follow-up study was to identify impairments resulting from reflex sympathetic dystrophy (RSD) of the upper extremity and to analyze the relationship between impairment and disability in RSD patients. The study group consisted of a referred sample of 65 RSD patients, with clinical signs in the upper extremity. RSD developed after fractures of the wrist or hand in 29 patients or after a carpal tunnel release in 9 patients. The mean interval between the RSD diagnosis and our evaluation was 5.5 (3-9) years (SD = 0.8). The main outcome measurements were the impairments assessed by standard physical examination. ADL and pain were quantified with a visual analogue scale (VAS). Pain was evaluated immediately before and after the physical examination and the perceived pain was determined in the week before the examination. Significant differences in impairments were found between the affected and the unaffected sides (p < 0.05). According to the AMA-guides, the impairments did not lead to disabilities. Significant correlations were found between VAS-ADL and VAS-pain in the last week prior to evaluation and full fist grip-strength. Pain seems to be the most disabling effect.
这项回顾性长期随访研究的目的是确定上肢反射性交感神经营养不良（RSD）所导致的功能障碍，并分析RSD患者功能障碍与残疾之间的关系。研究组包括65例有上肢临床症状的RSD患者转诊样本。29例患者在手腕或手部骨折后发生RSD，9例患者在腕管松解术后发生RSD。RSD诊断与我们评估之间的平均间隔为5.5（3 - 9）年（标准差 = 0.8）。主要结局指标是通过标准体格检查评估的功能障碍。采用视觉模拟量表（VAS）对日常生活活动能力（ADL）和疼痛进行量化。在体格检查前后即刻评估疼痛，并确定检查前一周的感知疼痛。患侧与未患侧之间在功能障碍方面存在显著差异（p < 0.05）。根据美国医学协会（AMA）指南，这些功能障碍并未导致残疾。在评估前最后一周的VAS - ADL、VAS - 疼痛与全手握力之间发现显著相关性。疼痛似乎是最导致残疾的影响因素。
