Document Detail

Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite.
MedLine Citation:
PMID:  19385450     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. METHODS: This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities. RESULTS: All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene ofdistal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p < 0.05) as compared to conservative management. CONCLUSION: Cervical sympathectomy is a very effective modality of treatment in patients having severe Raynaud's disease of upper limbs secondary to frost bite.
Mohammad Iqbal Khan; Mohammad Tariq; Ahmed Rehman; Afsheeen Zafar; Salman Najam Sheen
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of Ayub Medical College, Abbottabad : JAMC     Volume:  20     ISSN:  1025-9589     ISO Abbreviation:  J Ayub Med Coll Abbottabad     Publication Date:    2008 Apr-Jun
Date Detail:
Created Date:  2009-04-23     Completed Date:  2009-08-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910750     Medline TA:  J Ayub Med Coll Abbottabad     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  21-4     Citation Subset:  IM    
Department of Surgery, Islamic International Medical College, Rawalpindi, Pakistan.
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MeSH Terms
Cervical Plexus / surgery*
Frostbite / complications*
Raynaud Disease / etiology,  surgery*,  therapy
Sympathectomy / methods*
Thoracic Nerves / surgery*
Time Factors
Young Adult

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