Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 1999; 66(1):46-51

[Relations of Aetiopathogenesis and Prevention of Post-traumatic Algoneurodystrophia Part I: Critical Evaluation of Pathogenetic Theories.].

J Skrabal

Ortopedická ambulance, Jablunkov.

The author critisizes current aetiopathogenetic theories of the origin of post-traumatic algoneurodystrophia and on the basis of the available literature and his own experience he formulates his own hypothesis of the theory of the origin of this unpleasant complication. In the sense of psychosomatic perception he summarizes that it is mainly action impulses of negative emotions, especially the feelings of anxiety, but also other stresses in the sociopsychological sense of the word (arising mainly from the concerns about fulfilling oneself) which promote the basic component of chronic pain and together, be it on the prepared or unprepared neurastenic terrain, they develop, based on their sympatothetically mediated potentials of negative emotion, the prerequisites for the onset of post-traumatic algoneurodystrophia. With regard to continuous failure of the treatment of the already developed disease the author proposes as a prevention his own, time-based categorization of post-traumatic patients mainly those with the injury of a sensitive nerve. This categorization is based on tests of pain, vegetative tonus and basal neurotization, the latter in cooperation with a psychiatrist. After certain experience the evaluation of tests was simplified. According to the outcomes he classifies patients into three categories with a different subsequent therapy. He presents algorithm of preventive medical therapy with the proposal of steps to be taken in the period of three weeks following the trauma in all three categories tested. With regard to the fact that after such procedure the incidence of post-traumatic algoneurodystrophia is only minimal and the remaining cases are not complicated we recommend to generalize this therapy. This conclusion is supported both by medical and socioeconomic reasons. Key words: aetiopathogenesis of post-traumatic algoneurodystrophia, prevention of the onset of posttraumatic algoneurodystrophy.

Published: January 1, 1999  Show citation