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J Hand Surg Eur Vol · Apr 2008
Treatment of early complex regional pain syndrome type 1 by a combination of mannitol and dexamethasone.
- A Zyluk and P Puchalski.
- Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland. azyluk@hotmail.com
- J Hand Surg Eur Vol. 2008 Apr 1; 33 (2): 130-6.
AbstractA total of 75 patients, 68 women (91%) and seven men (9%), with a mean age of 58 (range 38-82) years with early Complex Regional Pain Syndrome Type 1 (CRPS Type 1), present for less than 4 months, were given in-patient treatment with 10% mannitol 2 x 250 ml per day and 8 mg dexamethasone per day for 1 week. Measurements assessed included the pain, the range of finger movements, grip strength and our own clinical severity scoring system for CRPS Type 1 (CRPS score). The results were assessed at 1 week and, finally, at a mean of 9 (range 8-12) months. At 1-week assessment, all variables decreased significantly: pain from a mean Visual Analogue Scale (VAS) of 6.7 to 2.3, loss of finger flexion (6-0.3 cm) and the CRPS score (7.6-2.2 points). Total grip strength did not improve. At the final assessment of 70 patients, the VAS score was a mean of 1.8, loss of finger flexion a mean of 0.1 cm, the CRPS score was a mean of 1.6 and grip strength a mean of 34% of the strength of the unaffected hand. All these variables showed statistically significant improvement.
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