REFLEX SYMPATHETIC DYSTROPHY OF THE UPPER EXTREMITY - A 5.5-YEAR FOLLOW-UP - PART I - IMPAIRMENTS AND PERCEIVED DISABILITY

The aim of this retrospective and long-term follow-up study was to ide ntify impairments resulting from reflex sympathetic dystrophy (RSD) of the upper extremity and to analyze the relationship between impairmen t and disability in RSD patients. The study group consisted of a refer red sample of 65 RSD patients, with clinical signs in the upper extrem ity. RSD developed after fractures of the wrist or hand in 29 patients or after a carpal tunnel release in 9 patients. The mean interval bet ween the RSD diagnosis and our evaluation was 5.5 (3-9) years (SD = 0. 8). The main outcome measurements were the impairments assessed by sta ndard physical examination. ADL and pain were quantified with a visual analogue scale (VAS). Pain was evaluated immediately before and after the physical examination and the perceived pain was determined in the week before the examination. Significant differences in impairments w ere found between the affected and the unaffected sides (p < 0.05). Ac cording to the AMA-guides, the impairments did not lead to disabilitie s. Significant correlations were found between VAS-ADL and VAS-pain in the last week prior to evaluation and full fist grip-strength. Pain s eems to be the most disabling effect.