Avtor/Urednik		Hernja-Rumpf, Tadeja; Turk, Zmago
Naslov		Obravnava bolnikov s kompleksnim regionalnim bolečinskim sindromom tip 1 po zlomu distalnega dela koželjnice
Prevedeni naslov		Treatment of patients with complex regional pain syndrome after distal radius fracture
Tip		članek
Vir		Rehabilitacija
Vol. in št.		Letnik 10, št. 2
Leto izdaje		2011
Obseg		str. 37-43
Jezik		slo
Abstrakt		Background: Complex regional pain syndrome (CRPS) is a neuropatic pain condition characterized by severe pain and sensory, motoric and autonomic disorders, often associated with tropic changes. The aim of this study was to analyze the CRPS type I incidence in patients after a distal radius fracture, in order to analyze risk factors for its development, and to evaluate rehabilitation effectiveness in terms of reducing pain, improving muscle strength of a fist grip, improving the mobility of the wrist and the use of hand in daily activities. Methods: This retrospective study included 125 patients with fracture of the distal radius who were treated from 2008 to 2010 by the physicians at the Institute of Physical Medicine and Rehabilitation, University Clinical Centre Maribor. The analysis addressed duration of rehabilitation, perceived pain, wrist mobility and muscle strength of a fist grip at the beginning and at the end of rehabilitation. Results: The study included 125 patients; twenty of them (16 %) were clinically identified as CRPS type I. The CRPS proportion among women (19.8 %) was higher than in men (9.1 %), but the association between gender and occurrence of CRPS was not statistically significant (p = 0.135). We also found no association with fracture on the dominant side (p = 1.000). The main symptoms were pain at rest (100 %) and hyperesthesia (100 %). Reduced range of motion (ROM) in the wrist and reduced muscle strength were also observed in all patients. Among signs of sensory disturbance, hyperalgesia was present in 16 patients (80 %), as was discoloration of skin (80 %). Limb edema was also present in 16 patients (80 %). After completing the rehabilitation program, the patients with CRPS demonstrated statistically significant improvements in wrist ROM (p< 0.001) and muscle strength of fist grip (p < 0.001). There was also a statistically significant reduction in pain (p < 0.001) as measured by visual analog scale. (Abs. trunc. at 2000 ch.)
Izvleček		Izhodišča: Kompleksni regionalni bolečinski sindrom (KRBS) je bolečinski sindrom, za katerega so poleg hude bolečine značilne senzorične, motorične in avtonomne motnje, pogosto povezane s trofičnimi spremembami. Zanimala nas je incidenca KRBS pri bolnikih po zlomu distalnega dela koželjnice in dejavniki tveganja za razvoj KRBS ter ocena učinkovitosti rehabilitacije pri zmanjšanju bolečine, izboljšanju mišične moči pri stisku pesti, izboljšanju gibljivosti zapestja in uporabi roke pri dnevnih življenjskih aktivnostih. Metode: Raziskava je bila retrospektivna. Vključili smo bolnike s poškodbo distalnega dela koželjnice, ki so se v obdobju od leta 2008 do 2010 zdravili na Inštitutu za fizikalno in rehabilitacijsko medicino v UKC Maribor. Zanimali so nas starost in spol bolnikov, trajanje rehabilitacije le-teh pri nas, občutek bolečine in gibljivost v zapestju ter mišična moč stiska pesti na začetku in ob zaključku rehabilitacije. Rezultati: V raziskavo je bilo vključenih 125 bolnikov. Dvajset bolnikov je imelo KRBS (16 %). Delež KRBS pri ženskah (19,8 %) je bil opazno višji kot pri moških (9,1 %), a nismo dokazali povezanosti med spolom in nastankom KRBS (p = 0,135). Prav tako nismo ugotovili povezanosti z zlomom na dominantni roki (p = 1,000). Glavna simptoma sta bila bolečina pri bolnikih v mirovanju (100 %) in hiperestezija (100 %). Pri vseh bolnikih je bil zmanjšan obseg gibov v zapestju in groba mišična moč. Od senzoričnih znakov je imelo 16 bolnikov hiperalgezijo (80 %), 16 pa spremenjeno barvo kože. Pri 16 bolnikih je nastal edem (80 %). Pri bolnikih s KRBS je po terapiji prišlo do statistično značilnega povprečnega zmanjšanja bolečine, ocenjene na vidni analogni lestvici (p < 0,001), prav tako se je statistično značilno izboljšala groba mišična moč (p < 0,001) in gibljivost v zapestju (p < 0,001). Zaključki: Ocenjena incidenca KRBS po zlomu distalnega dela koželjnice je bila 16 %. (Izvl. skrajšan na 2000 zn.)
Deskriptorji		RADIUS FRACTURES