Results of the treatment of posttraumatic reflex sympathetic dystrophy of the upper extremity with regional intravenous blocks of methylprednisolone and lidocaine.

The results of the treatment of 36 patients with posttraumatic reflex sympathetic dystrophy of the upper extremity with regional intravenous blocks of methylprednisolone and lidocaine are presented. The extremity is exsanguinated and a tourniquet is applied. A solution of methylprednisolone, lidocaine and heparin is injected. The duration of the block is 20-25 minutes. After the limb is anesthetized the affected joints can be manipulated in a progressive, controlled fashion. With a 1-year follow-up the response to treatment in 25 patients (69%) was considered as good (relief of spontaneous pain, no limitation in finger movement), in 8 as moderate (22%) and in 3 as poor (9%--the symptoms were unaltered or worse). Physiotherapy was applied in all patients (program of finger exercises, whirlpool therapy). Complications in 2 cases were transient superficial thrombophlebitis of the forearm; in 2 other patients the block was interrupted because of severe pain in the limb. We found this method simple, easy to perform, safe and inexpensive; the results are comparable to other established methods of the treatment i.e. sympathetic blocks or calcitonin.