Document Detail

Correction of severe foot and ankle contracture due to CRPS using external fixation and pain management: report of a pediatric case.
MedLine Citation:
PMID:  18725124     Owner:  NLM     Status:  MEDLINE    
Complex regional pain syndrome-induced dystonia is a severe deformity that can affect the lower extremities and hinder ambulation. Although a number of conservative treatments have been described for this condition, we are not aware of any publications describing the use of surgical intervention for the treatment of this condition. In this report, we describe the case of a pediatric patient with a severe lower extremity deformity in conjunction with chronic pain syndrome. A concerted, interdisciplinary treatment approach was undertaken for the management of this patient, and this included contributions from a foot and ankle surgeon, a pain specialist, an internist, a physical therapist, and a psychiatrist. The primary goal of the treatment strategy was to recreate a plantigrade, weight-bearing lower extremity, while controlling pain. To this end, gradual correction of deformity was achieved using an external fixator and, by 6 months after the surgery, the patient was for the first time in years ambulating on the realigned lower extremity. After 3 years of follow-up, she maintained an activity level that was equal to that which she enjoyed before the injury. Level of Clinical Evidence: 4.
Robert W Mendicino; Chul Kim; Abraham J Kabazie; Alan R Catanzariti
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons     Volume:  47     ISSN:  1542-2224     ISO Abbreviation:  J Foot Ankle Surg     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-08-26     Completed Date:  2008-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9308427     Medline TA:  J Foot Ankle Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  434-40     Citation Subset:  IM    
Department of Foot & Ankle Surgery, The Western Pennsylvania Hospital, Pittsburgh, PA 15224, USA.
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MeSH Terms
Anesthesia, Epidural
Ankle Joint / physiopathology*
Complex Regional Pain Syndromes / physiopathology,  therapy*
Dystonic Disorders / physiopathology,  therapy*
External Fixators
Foot Deformities, Acquired / physiopathology,  therapy*
Joint Deformities, Acquired / physiopathology,  therapy*
Mobility Limitation
Nerve Block
Patient Care Team
Physical Therapy Modalities

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