Sudeck's atrophy in the hand.

Sudeck’s atrophy, or post-traumatic osteodystrophy, is considered by most surgeons in Great Britain to be a relatively rare condition, although in Europe and North America it is claimed by some to be the most common cause of prolonged disability after injury (Jordan 1940, Gurd 1938, Scheibe and Karitzky 1954, Herrmann, Reineke and Caldwell 1942). Only one British contribution appears in the extensive world literature on the subject (Middleton 1937), and Watson-Jones considers it to be a severe form ofdisuse atrophy (Watson-Jones 1952). Much has been written about the treatment of this condition, particularly in relation to surgical attacks on the sympathetic system (BrUcke 1946, Evans 1946, Heyman 1924, Herrmann 1935, Tourney 1948, I(iter 1948), parasympathetic stimulation (Middleton 1937), the application of plaster splints, x-ray therapy (Mumford 1938), physical therapy (Sudeck 1938, Noble and Hauser 1926, Jordan 1940), and more recently on the use ofvasomotor relaxants and cortisone (Dwyer 1952, Rose 1953, Roland 1952, Birkenfeld 1954, Marti 1954). It is the purpose of this paper to show firstly that Sudeck’s syndrome of the acute type is not uncommon in the hand and, secondly, that it responds to conservative treatment if the diagnosis is made within six weeks of the onset of symptoms. No attempt will be made to add yet another theory to explain the etiology, but some observations on the occurrence of thickening of the palmar fascia in association with Sudeck’s syndrome will be recorded.