Summary
Two cases of Sudeck's atrophy of the foot occurring 16 months and 17 years after infected fractures of the leg were studied radiologically and pathologically. Various cartilaginous changes were observed, the nature and severity of which depended on the joint involved. They included superficial pannus, deep erosion, fibrous ankylosis and, at times, bony ankylosis. These changes are similar to those observed in nine cases studied by Rutishauser et al. Comparison of the pathological changes in human and experimental joint immobilization suggests that these changes are due mainly to decreased mobility of the joints of the foot in Sudeck's atrophy. These observations also suggest that physiotherapeutic mobilization in Sudeck's atrophy is important for the joints as well as for bone. From a more general point of view, they demonstrate that a condition which is nosologically different from the chronic rheumatic diseases can nevertheless cause lesions that are a fundamental part of the pathological changes in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.
Résumé
Présentation anatomo-radiologique de deux cas de dystrophie de Sudeck du pied après fracture infectée de jambe datant de 16 mois et 17 ans. Mise en évidence d'altérations cartilagineuses d'importance variable selon les articulations, avec pannus superficiel, érosion profonde, ankylose fibreuse et parfois osseuse. Ces modifications sont analogues à celles qui ont été observées dans neuf cas comparables étudiés par Rutishauser et coll. En les confrontant aux résultats de l'immobilisation articulaire en pathologie humaine ou expérimentale, on peut admettre qu'elles sont dues principalement à la réduction de mobilité des articulations du pied en cas de dystrophie de Sudeck. Sur le plan pratique ces observations indiquent que l'utilité de la mobilisation physiothérapique dans la dystrophie de Sudeck ne concerne pas seulement l'os proprement dit. Sur un plan plus général elles montrent qu'une condition nosologiquement distincte des rhumatismes chroniques peut créer certaines des lésions élémentaires qui participent aussi à la réalisation des tableaux anatomopathologiques de l'arthrose, de la polyarthrite rhumatoïde, et de la spondylarthrite ankylosante.
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Lagier, R., Van Linthoudt, D. Articular changes due to disuse in Sudeck's atrophy. International Orthopaedics 3, 1–8 (1979). https://doi.org/10.1007/BF00266319
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DOI: https://doi.org/10.1007/BF00266319