[Iatrogenic causes of post-traumatic reflex sympathetic dystrophy].

It is suspected that some faults in the course of the treatment of traumas such as: reduction of fractures without sufficient anaesthesia, repeated reductions, tightness of casts, immobilization of fingers, ignoring patients' complaints of the pain and swelling about or painful rehabilitation may have effect on the development of the post-traumatic reflex sympathetic dystrophy. These opinions have not been confirmed by clinical trials. The incidence of above mentioned factors was analysed retrospectively in 165 patients with post-traumatic reflex sympathetic dystrophy within upper extremity and in 86 patients following fracture of distal radius without features of the condition (control group). It was found that the patients with reflex sympathetic dystrophy significantly more frequently complained of pain and swelling in the course of the treatment of trauma in the cast and they were subjected more frequently to painful rehabilitation after removing the cast. These factors appeared to have an effect on developing the reflex sympathetic dystrophy (comparing with the control group). The role of remaining factors that are often considered as significant in the development of reflex sympathetic dystrophy--painful and repeated reductions of fractures as well as immobilization of fingers-was not confirmed.