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Auftreten eines Complex-regional-pain-Syndroms nach intramedullärer Nagelung einer Klavikulaschaftfraktur

Appearance of complex regional pain syndrome after intramedullary nailing of a clavicle fracture

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Zusammenfassung

Nach Osteosynthese einer Klavikulaschaftfraktur mittels elastisch-stabilem intramedullärem Nagel traten zunächst Anzeichen einer verzögerten Frakturheilung auf. Sechs Monate nach dem Eingriff stellte sich die noch deutlich schmerzgeplagte 28-jährige Patientin mit einer rechtsseitig betonten Dystonie der Muskulatur des Schultergürtels und einer begleitenden Allodynie vor. Die Therapieeinleitung des an dieser Lokalisation zuvor nicht beschriebenen „complex regional pain syndrome“ (CRPS/Morbus Sudeck) erfolgte daraufhin durch eine multimodale Schmerztherapie, Physio- und Ergotherapie sowie zusätzliche Gabe von Bisphosphonaten. Die Patientin zeigte sich 14 Monate nach der Operation beschwerdefrei, die Fraktur war zu diesem Zeitpunkt konsolidiert.

Abstract

After operative correction of a clavicle fracture using an elastic stable intramedullary nail the patient presented signs of delayed fracture healing after 2 months. During the sixth postoperative month the 28-year-old obviously pain-ridden female patient showed dystonia of the shoulder girdle and allodynia surrounding the operation field. Upon these findings, we decided – as a result of the complex regional pain syndrome that had not been previously described in this location – to treat the patient by administering bisphosphonates, multimodal analgetic therapy, physiotherapy and occupational therapy. Fourteen months after surgery, the patient showed no remaining symptoms, and the fracture had consolidated at that time.

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  1. Klinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Kerpener Straße 62, 50924, Köln, Deutschland

    G. Stein, E. Skouras, C. Faymonville, U. Thelen & G. Schiffer

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  1. G. Stein
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  2. E. Skouras
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  3. C. Faymonville
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  4. U. Thelen
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  5. G. Schiffer
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Correspondence to G. Stein.

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Stein, G., Skouras, E., Faymonville, C. et al. Auftreten eines Complex-regional-pain-Syndroms nach intramedullärer Nagelung einer Klavikulaschaftfraktur. Unfallchirurg 114, 922–926 (2011). https://doi.org/10.1007/s00113-011-1998-6

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  • DOI: https://doi.org/10.1007/s00113-011-1998-6

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