eMedicine Specialties > Orthopedic Surgery > Trauma

Reflex Sympathetic Dystrophy: Follow-up

Author: Satishchandra Kale, MD, FRCS(Edin), FRCS Ed(UK), Dip Sports Med, Honorary Assistant Professor of Trauma and Orthopedics, University of Bombay; Consultant, Department of Orthopedics, Dr R N Cooper Hospital, Brahmakumaris Global Hospital, India
Contributor Information and Disclosures

Updated: Jul 2, 2008

Follow-up

Deterrence/Prevention:

  • Most cases of reflex sympathetic dystrophy (RSD) in orthopedic practice can be prevented through early detection and early treatment. In most cases, a possible cause can be identified, such as overly tight bandages or plasters, a limb improperly splinted, or neglect of active movement of the part. The treating physician should be aware of and alert for compression syndromes of the underlying nerve or for swelling and pain resulting from a displaced bone fragment. The mainstay of treatment is mobilization of the affected part.

Prognosis:

  • Eighty percent of patients with RSD diagnosed within 1 year of injury improve significantly. However, 50% of patients with untreated symptoms lasting more than 1 year have profound residual impairment.

Patient Education:

  • Emphasize to all patients the importance of early and supervised mobilization of the affected part. Give patients a list of plaster instructions and a list of realistic goals to be achieved within a specified time interval. Any lag in achieving these objectives due to pain, swelling, or other causes should inspire concern leading to early diagnosis and institution of treatment.

Miscellaneous

Medicolegal Pitfalls

  • Prolonged morbidity is observed in approximately 50% of patients with psychiatric diathesis, workers' compensation claims, and lawsuits.
 


More on Reflex Sympathetic Dystrophy

Overview: Reflex Sympathetic Dystrophy
Differential Diagnoses & Workup: Reflex Sympathetic Dystrophy
Treatment & Medication: Reflex Sympathetic Dystrophy
Follow-up: Reflex Sympathetic Dystrophy
Multimedia: Reflex Sympathetic Dystrophy
References
Further Reading
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References

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  18. Clinical Orthopaedics. Reflex sympathetic dystrophy. In: Bailliere's Clinical Orthopaedics. Vol 1. WB Saunders Co;1996.

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Further Reading

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Keywords

reflex sympathetic dystrophy, RSD, algodystrophy, Sudeck atrophy, painful dysfunction syndrome, reflex neurovascular dystrophy, shoulder-hand syndrome, chronic regional pain syndrome, CRPS, causalgia, complex regional pain syndrome, sympathetically mediated pain syndrome, SMP, algodystrophy complex regional pain syndrome, chronic pain syndrome

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Contributor Information and Disclosures

Author

Satishchandra Kale, MD, FRCS(Edin), FRCS Ed(UK), Dip Sports Med, Honorary Assistant Professor of Trauma and Orthopedics, University of Bombay; Consultant, Department of Orthopedics, Dr R N Cooper Hospital, Brahmakumaris Global Hospital, India
Satishchandra Kale, MD, FRCS(Edin), FRCS Ed(UK), Dip Sports Med is a member of the following medical societies: British Orthopaedic Association
Disclosure: Nothing to disclose.

Medical Editor

James F Kellam, MD, Vice-Chair, Department of Orthopedic Surgery, Director of Orthopedic Trauma and Education, Carolinas Medical Center
James F Kellam, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Orthopaedic Trauma Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Samuel Agnew, MD, FACS, Associate Professor, Departments of Orthopedic Surgery and Surgery, Chief of Orthopedic Trauma, University of Florida at Jacksonville; Consulting Surgeon, Department of Orthopedic Surgery, McLeod Regional Medical Center
Samuel Agnew, MD, FACS is a member of the following medical societies: American Association for the Surgery of Trauma, American College of Surgeons, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Mary Ann E Keenan, MD, Professor, Vice Chair for Graduate Medical Education, Department of Orthopedic Surgery, University of Pennsylvania School of Medicine; Chief of Neuro-Orthopedics Program, Department of Orthopedic Surgery, Hospital of the University of Pennsylvania
Mary Ann E Keenan, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, American Society for Surgery of the Hand, and Orthopaedic Rehabilitation Association
Disclosure: Nothing to disclose.

 
 
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