Email this article Treatment of complex regional pain syndrome after filling a single bone-cyst cavity with beta-tricalcium phosphate granules
- Authors: Aminova L.R.1, Lobashov V.V.1,2, Akhtiamov I.F.1,2
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Affiliations:
- Kazan State Medical University
- City Clinical Hospital No. 7 of Kazan
- Issue: Vol 7, No 4 (2019)
- Pages: 97-104
- Section: Clinical cases
- URL: https://ogarev-online.ru/turner/article/view/11568
- DOI: https://doi.org/10.17816/PTORS7497-104
- ID: 11568
Cite item
Abstract
Backgrоund. Сomplex regional pain syndrome is a condition associated with a multitude of clinical factors. Its characteristic feature is persistent pain caused by injuries and is not anatomically limited to the location of a particular peripheral nerve.
Clinical case. This article describes a case involving the treatment of complex regional pain syndrome in a thirteen-year-old patient, which resulted in a simple bone cyst surgical treatment of the lower-third of the fibula. Diagnostics were based on clinical, laboratorial, histological, radiological, and instrumental methods of research. The treatment methods included medication (nonsteroidal anti-inflammatory drugs, antidepressants, antipsychotics, anticonvulsants, non-opioid analgesics of central action, and bisphosphonates), cold plasma ablation, neurolysis of the sural nerve, prolonged regional anesthesia, tunneling of the bone marrow cavity (filled by substitutional filler), and marginal bone resection.
Discussion. Сomplex regional pain syndrome is a poorly studied condition, which contributes to the complexity of its diagnosis. In this case, the presence of complex regional pain syndrome can be characterized by tissue injury during surgical intervention as well as by intraoperative injury of the nerve fibers. The stages of complex regional pain syndrome detected in studies may not appear in all patients, and in this case, no staging was observed. By eliminating the obliteration of the medullary canal after segmental resection of the sclerosed portion of the bone, it was possible to reduce the severity of pain, which resulted in the subsequent disappearance of the manifestations of complex regional pain syndrome.
Conclusions. This case testifies to the effectiveness of various methods of treating complex regional pain syndrome. The etiology of the specific patient’s pain syndrome should be considered when treating complex regional pain syndrome.
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##article.viewOnOriginalSite##About the authors
Liaisan R. Aminova
Kazan State Medical University
Author for correspondence.
Email: leysan150@gmail.com
ORCID iD: 0000-0001-8701-164X
SPIN-code: 9809-4571
student of Pediatric Faculty
Russian Federation, 49, Butlerov street, Kazan, 420012Vladislav V. Lobashov
Kazan State Medical University; City Clinical Hospital No. 7 of Kazan
Email: lobashoff@ya.ru
ORCID iD: 0000-0002-3467-0358
SPIN-code: 4138-4735
Associate Specialist of Traumatology, Orthopedics and Surgery of Extreme Situations Department; MD, PhD, Orthopedic Surgeon
Russian Federation, 49, Butlerova street, Kazan, 420012; 54, Marshal Chuikov Str., Kazan,, 420103Ildar F. Akhtiamov
Kazan State Medical University; City Clinical Hospital No. 7 of Kazan
Email: yalta60@mail.ru
ORCID iD: 0000-0001-5264-5634
SPIN-code: 6579-8640
Head of the Chair of Traumatology, Orthopedics and Surgery of Extreme Situations Department; MD, PhD, D.Sc., Professor, Orthopedic Surgeon
Russian Federation, 49, Butlerova street, Kazan, 420012; 54, Marshal Chuikov Str., Kazan,, 420103References
- Поздеев А.П., Белоусова Е.А. Солитарные костные кисты у детей // Ортопедия, травматология и восстановительная хирургия детского возраста. – 2017. – Т. 5. – № 2. – C. 65–74. [Pozdeev AP, Belousova EA. Solitary bone cysts in children. Pediatric traumatology, orthopaedics and reconstructive surgery. 2017;5(2):65-74. (In Russ.)]. https://doi.org/10.17816/PTORS5265-74.
- Zhao JG, Wang J, Huang WJ, et al. Interventions for treating simple bone cysts in the long bones of children. Cochrane Database Syst Rev. 2017;2:CD010847. https://doi.org/10.1002/14651858.CD010847.pub3.
- Kadhim M, Thacker M, Kadhim A, Holmes L, Jr. Treatment of unicameral bone cyst: systematic review and meta analysis. J Child Orthop. 2014;8(2):171-191. https://doi.org/10.1007/s11832-014-0566-3.
- Lascombes P, Mamie C. Complex regional pain syndrome type I in children: What is new? Orthop Traumatol Surg Res. 2017;103(1S):S135-S142. https://doi.org/10.1016/j.otsr.2016.04.017.
- Bruehl S. Complex regional pain syndrome. BMJ. 2015;351:h2730. https://doi.org/10.1136/bmj.h2730.
- Harden RN, Oaklander AL, Burton AW, et al. Complex regional pain syndrome: practical diagnostic and treatment guidelines. 4th ed. Pain Med. 2013;14(2):180-229. https://doi.org/10.1111/pme.12033.
- Юркевич В.В., Колесникова И.В., Рудык В.Н. Комплексный регионарный болевой синдром (КРБС) // Вопросы реконструктивной пластической хирургии. – 2006. – № 5. – С. 47–55. [Yurkevich VV, Kolesnikova IV, Rudyk VN. Kompleksnyy regionarnyy bolevoy sindrom (KRBS). Voprosy rekonstruktivnoy plasticheskoy khirurgii. 2006;5(16):47-55. (In Russ.)]
- Shah A, Kirchner JS. Complex regional pain syndrome. Foot Ankle Clin. 2011;16(2):351-366. https://doi.org/10.1016/j.fcl.2011.03.001.
- Корячкин В.А. Комплексный регионарный болевой синдром: пособие для врачей. – СПб.: РНИИТО, 2014. [Koryachkin VA. Kompleksnyy regionarnyy bolevoy sindrom: posobie dlya vrachey. Saint Petersburg: RNIITO; 2014. (In Russ.)]
- Tanaka T, Komaki H, Chazono M, et al. Basic research and clinical application of beta-tricalcium phosphate (beta-TCP). Morphologie. 2017;101(334):164-172. https://doi.org/10.1016/j.morpho.2017.03.002.
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