The Korean Journal of Pain
- Volume 2 Issue 2
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- Pages.155-166
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- 1989
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- 2005-9159(pISSN)
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- 2093-0569(eISSN)
A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder
견관절부 외상후 발생된 Shoulder-Hand Syndrome
- Jeon, Jae-Soo (Pain Clinic, Dept. of Anesthesiology, School of Medicine, Soon Chun Hyang University) ;
- Lee, Sung-Keun (Pain Clinic, Dept. of Anesthesiology, School of Medicine, Soon Chun Hyang University) ;
- Song, Hoo-Bin (Pain Clinic, Dept. of Anesthesiology, School of Medicine, Soon Chun Hyang University) ;
- Kim, Sun-Jong (Pain Clinic, Dept. of Anesthesiology, School of Medicine, Soon Chun Hyang University) ;
- Park, Wook (Pain Clinic, Dept. of Anesthesiology, School of Medicine, Soon Chun Hyang University) ;
- Kim, Sung-Yell (Pain Clinic, Dept. of Anesthesiology, School of Medicine, Soon Chun Hyang University)
- 전재수 (순천향대학 병원 마취과학교실 및 통증치료실) ;
- 이성근 (순천향대학 병원 마취과학교실 및 통증치료실) ;
- 송후빈 (순천향대학 병원 마취과학교실 및 통증치료실) ;
- 김선종 (순천향대학 병원 마취과학교실 및 통증치료실) ;
- 박욱 (순천향대학 병원 마취과학교실 및 통증치료실) ;
- 김성열 (순천향대학 병원 마취과학교실 및 통증치료실)
- Published : 1998.11.18
Abstract
Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures
Keywords
- reflex sympathetic dystrophy;
- stellate ganglion block;
- Somatic sensory block;
- posttraumatic osteoporosis;
- salmon calcitonin;
- local anesthetic