CAN ALGODYSTROPHY BE PREVENTED AFTER HAND SURGERY

Algodystrophy is characterized initially by an increase in arterial fl ow, an increase in blood pool, a decrease in microcirculatory velocity , and a loss of thermoregulatory control. These changes, producing the typical symptomatology, associated diffuse hand pain, diminished hand function, edema, and abnormal color and temperature, are believed now to correspond in most cases to an exaggeration of the normal post-tra umatic inflammatory responses and are not the consequence of sympathet ic damage. Algodystrophy may be prevented in most hand surgery patient s by minimizing the normal postoperative inflammation, by increasing v enous return (especially by avoiding plaster casts and constrictive dr essings), by controlling post-traumatic pain, by promoting early activ e mobilization, and by reassuring the patient. If there is any sign of algodystrophy, three-phase bone scintigraphy should be obtained and t reatment instituted immediately.