LONG-STANDING COMPLEX REGIONAL PAIN SYNDROME-TYPE I: PERSPECTIVES OF PATIENTS NOT AMPUTATED.

Patrick N Domerchie, Pieter U Dijkstra, Jan H B Geertzen
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Abstract

Objective: Complex Regional Pain Syndrome type I (CRPS-I) is an often intractable regional pain syndrome, usually affecting limbs in which amputation may be a final resort. Not all patients are suited for amputation.This retrospective case series with explorative interviews aims to gain insight in the quality of life in those who have been denied an amputation and their functioning with CRPS-I.

Patients and methods: Between 2011 and 2017, 37 patients were denied an amputation. Participants were interviewed regarding quality of life, treatments received since their outpatient clinic visit and their experiences at our outpatient clinic.

Results: A total of 13 patients participated. Most patients reported improvements in pain, mobility and overall situation. All patients received treatments after being denied an amputation, with some reporting good results. Many felt they had no part in decision making. Of the 13 participants 9 still had an amputation wish. Our participants scored worse in numerous aspects of their lives compared with patients with an amputation from a previous CRPS-I study of us.

Conclusion: This study shows that amputation should only be considered after all treatments have been tried and failed, since most participants reported improvements in aspects of their functioning over time.

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长期复杂区域疼痛综合征i型:未截肢患者的观点。
目的:复杂区域疼痛综合征I型(CRPS-I)是一种难治性的区域疼痛综合征,通常影响肢体,截肢可能是最后的手段。并不是所有的病人都适合截肢。这个回顾性的案例系列和探索性访谈旨在深入了解那些被拒绝截肢的人的生活质量和CRPS-I的功能。患者和方法:2011年至2017年,37例患者被拒绝截肢。参与者接受了关于生活质量的访谈,自门诊就诊以来接受的治疗以及他们在门诊的经历。结果:共13例患者参与。大多数患者报告疼痛、活动能力和整体情况有所改善。所有患者在拒绝截肢后都接受了治疗,其中一些报告效果良好。许多人觉得他们没有参与决策。13名参与者中有9人仍有截肢愿望。与先前的CRPS-I研究中截肢的患者相比,我们的参与者在生活的许多方面得分更低。结论:这项研究表明,只有在所有治疗方法都尝试失败后,才应该考虑截肢,因为大多数参与者报告说,随着时间的推移,他们的功能各方面都有所改善。
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