The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Apr 2008
Age-dependent development of chronic neuropathic pain, allodynia and sensory recovery after upper limb nerve injury in children.
Forty-nine children with distal upper limb nerve injury were studied at a mean follow-up of 2 years 3 months. Patients who were aged 5 years or younger at the time of nerve injury (15/49) had no chronic neuropathic pain symptoms or allodynia. ⋯ Semmes-Weinstein monofilament testing showed a positive correlation between age at injury and abnormal sensory threshold (r = 0.60, P<0.0001). These findings indicate that young children show better sensory recovery and are less likely to develop long-term chronic neuropathic pain syndromes than adults following nerve injury.
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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 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. ⋯ 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.