Abstract:
PURPOSE:To evaluate the role of sympathetic skin response (SSR) and three-phase bone scintigraphy (TPBS) in the diagnosis of complex regional pain syndrome (CRPS). METHODS:60 patients with CRPS of the hand were recruited. TPBS was performed using a bolus injection of 20 mCi of Tc-99m methylene diphosphonate in an antecubital vein and blood flow (first phase) image, blood pool (second phase) image, and delayed (third phase) image obtained. Patients were considered to have CRPS when the blood pool and blood flow images showed diffuse asymmetric uptake, or when the delayed image indicated increased asymmetric periarticular uptake. SSR was measured simultaneously in the affected and unaffected hands. Standard surface electromyogram disc electrodes were applied to the palm and dorsum of both hands. Electrical stimuli were applied to the skin at the base of little and ring fingers of the unaffected hand. Patients were considered abnormal when response was absent or the peak-to-peak amplitude was <50% of the contralateral hand in at least 2 readings. RESULTS:The delayed phase of TPBS tested positive in all; the first and second phases tested positive in 54 (90%) and 56 (93%) of the patients, respectively. Four of the 6 patients with a negative first phase had had symptoms persisting for more than 6 months, and the other 2 for about 3 to 6 months. No patient presenting within 3 months had a negative scan. SSR was absent in 16 (27%) patients and normal in 44 (73%). 11 (79%) of 14 patients who presented more than 6 months after symptom onset displayed an abnormal SSR, while only 10% of those presenting within 3 to 6 months and 11% of those presenting within 3 months had an abnormal SSR. 12 (75%) of the 16 patients with abnormal SSR had associated decreased sweating, compared with 2 (4.5%) of the 44 patients with a normal SSR. CONCLUSION:TPBS is a very sensitive corroborative test to confirm the clinical suspicion of CRPS during the initial stages, but not in late cases. SSR can be used to document the sympathetic dysfunction in cases having an associated sweating abnormality and may have some diagnostic value in late cases of CRPS, when TPBS is less reliable.
journal_name
J Orthop Surg (Hong Kong)journal_title
Journal of orthopaedic surgery (Hong Kong)authors
Pankaj A,Kotwal PP,Mittal R,Deepak KK,Bal CSdoi
10.1177/230949900601400310subject
Has Abstractpub_date
2006-12-01 00:00:00pages
284-90issue
3eissn
1022-5536issn
2309-4990journal_volume
14pub_type
杂志文章abstract:PURPOSE:To evaluate 12 patients with delayed or nonunion of bones treated with bone marrow injections. METHODS:6 men and 6 women aged 15 to 70 (mean, 45) years underwent bone marrow injections for delayed union (n=2) or atrophic non-union (n=10) of the ulna (n=6), femur (n=3), humerus (n=2), or metacarpal (n=1). Bone ...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901302100116
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:To review the long-term results of 14 cases of histopathologically confirmed schwannoma of the hand and wrist treated with intracapsular tumour removal. METHODS:All operations were performed under loupe magnification and microsurgical dissection, and the tumour was removed after capsular (including endoneurium...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章,评审
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abstract::Isolated pisiform dislocation is rare. We present one such case in a 20-year-old man occurring after a direct injury to the wrist. After an initial delay in diagnosis and unsuccessful closed reduction, he underwent resection of the pisiform. At 12-month follow-up, he had full range of movement of the wrist and no resi...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901001800329
更新日期:2010-12-01 00:00:00
abstract::Concomitant fungal and bacterial atlanto-axial osteomyelitis in immunocompetent individuals is rare. We report one such patient who underwent transoral anterior decompression and posterior occipital cervical fusion, together with antibiotic and antifungal treatment. At 16-month follow-up, the patient had made a full r...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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abstract:PURPOSE:To evaluate the quality of reduction and clinical outcomes by using Percutaneous Distractor and Subtalar Arthroscopy Closed Reduction followed by Internal Fixation (PDSA-CRIF) in the intra-articular calcaneal fracture. METHODS:A consecutive case series of 453 patients with 507 displaced intra-articular calcane...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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更新日期:2021-01-01 00:00:00
abstract:PURPOSE:To assess the effectiveness of a turnbuckle orthosis as a means of improving the range of motion in patients with elbow stiffness. METHODS:17 males and 11 females aged 8 to 68 (mean, 32) years underwent static progressive stretching using a turnbuckle orthosis for elbow stiffness secondary to trauma or surgery...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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abstract:PURPOSES:To examine radiographically the component motion in a bipolar prosthesis and to determine whether the self-centering mechanism really works in vivo. METHODS:38 patients with 41 bipolar hip endoprostheses (30 for coxarthrosis and 11 for osteonecrosis of femoral head) were included in this study. Two radiograph...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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abstract::The author describes a case of a 10-year-old boy with fracture of both forearm bones and a concomitant partial rupture of the ulnar artery. The damage to the ulnar artery was repaired at the time of fasciotomy with a good functional outcome. ...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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更新日期:2000-06-01 00:00:00
abstract:PURPOSE:Sacropelvic fixation continues to present challenges when involved in the adult spinal deformity correction. The S2 alar iliac (S2AI) fixation is commonly used in sacropelvic fixation. Several techniques, including intraoperative navigation and freehand technique, were used for S2AI screws placement. The aim of...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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更新日期:2020-09-01 00:00:00
abstract::Intra-osseous lipomas are rare benign tumours. We report one such case in the talus of a 60-year-old man. The patient underwent curettage and bone grafting. At the 22-month follow-up, radiographs of the talus showed dense sclerosis with multiple cortical breaks in the anterior process and no evidence of local recurren...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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更新日期:2012-04-01 00:00:00
abstract:PURPOSE:Sacral insufficiency fractures (SIFs) can cause severe lower back pain and immobility, which have limited therapeutic options. No previous studies have compared clinical outcomes and radiographic findings of sacroplasty with or without balloon assistance for the treatment of SIFs. METHODS:Forty-five patients w...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
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更新日期:2018-05-01 00:00:00
abstract:PURPOSE:To evaluate understanding of the fundamental concepts of informed consent by the public and patients. METHODS:Questionnaires were distributed to any persons (aged more than 16 years) attending the Palmerston North Hospital (excluding in-patients). The first 1000 completed questionnaires were analysed using the...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
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更新日期:2008-08-01 00:00:00
abstract:PURPOSE:To examine whether the activity of peripheral sympathetic nerves in animals with spinal cord injury can be controlled using therapeutic electrical stimulation. METHODS:The spinal cords of 6 Wistar rats were severed at T12/T13 disk level and were given continuous therapeutic electrical stimulation. Microneurogr...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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doi:10.1177/230949900501300211
更新日期:2005-08-01 00:00:00
abstract:PURPOSE:This study assessed the levels of soluble tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and matrix metalloproteinase 1 (MMP-1) in the synovial fluid from osteoarthritic knees to determine their role as well as the relationship between these levels and the severity of osteoarthritis (OA). METHODS...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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更新日期:2018-01-01 00:00:00
abstract:PURPOSE:To compare outcomes of anterior spinal fusion (ASF) versus laminoplasty for cervical spondylotic myelopathy (CSM). METHODS:Records of 26 women and 37 men aged 34 to 83 (mean, 67) years who underwent ASF or laminoplasty for CSM were reviewed. Patient demographics, duration of symptoms, pre- and post-operative J...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900901700303
更新日期:2009-12-01 00:00:00
abstract:PURPOSE:To assess the effectiveness of sympathetic skin response in evaluating peripheral sympathetic nerve activity of patients with spinal cord injury, and to report on the basic properties of sympathetic skin response. METHODS:Sympathetic skin response evoked by electrical stimulation was recorded from the palms an...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900401200108
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Our hypothesis is to utilize a simple suture-guiding device for minimally invasive repair of Achilles tendon without any extra cost with a minimal risk of rerupture. The purpose of this study is to investigate the results of our minimally invasive technique for Achilles tendon repair using a simple ovarian c...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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doi:10.1177/2309499017739484
更新日期:2017-09-01 00:00:00
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journal_title:Journal of orthopaedic surgery (Hong Kong)
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journal_title:Journal of orthopaedic surgery (Hong Kong)
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journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
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更新日期:2008-08-01 00:00:00
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journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章,随机对照试验
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更新日期:2018-05-01 00:00:00
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journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949901101900115
更新日期:2011-04-01 00:00:00
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更新日期:2013-08-01 00:00:00
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journal_title:Journal of orthopaedic surgery (Hong Kong)
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更新日期:2016-08-01 00:00:00
abstract::Neck manipulation is associated with spinal cord injury. However, occurrence of such cases is infrequent. This article presents a 33-year-old gentleman who sustained acute tetraplegia after neck manipulation. The aim of this case report is to create awareness that vigorous neck manipulation could cause injury to the s...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/2309499017690459
更新日期:2017-01-01 00:00:00
abstract::Diabetic muscle infarction of the peroneus brevis is a rare complication of diabetes mellitus. It often presents with an acute leg pain without any obvious signs. Due to poor awareness of this condition, it is often misdiagnosed and results in anxiety of the patient and unnecessary investigations. It is ominous as it ...
journal_title:Journal of orthopaedic surgery (Hong Kong)
pub_type: 杂志文章
doi:10.1177/230949900501300319
更新日期:2005-12-01 00:00:00
abstract:PURPOSE:To evaluate the tibial articular cartilage and histology of the posterior cruciate ligament (PCL) in osteoarthritic knees so as to determine predictors of PCL degeneration. METHODS:23 advanced osteoarthritic knees (mean patient age, 61 years) treated with total knee arthroplasty (TKA) were prospectively studie...
journal_title:Journal of orthopaedic surgery (Hong Kong)
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更新日期:2013-04-01 00:00:00