Journal of Foot and Ankle Surgery
Volume 49, Issue 1 , Pages 33-36 , January 2010

Lower Extremity Complex Regional Pain Syndrome: Long-term Outcome after Surgical Treatment of Peripheral Pain Generators

  • Lee Dellon, MD, PhD

      Affiliations

    • Professor of Plastic Surgery and Neurosurgery, Johns Hopkins University, Baltimore, MD
    • Corresponding Author InformationAddress correspondence to: Lee Dellon, MD, PhD, Ste 370, 3333 N. Calvert St, Baltimore, MD 21218.
    • ,
  • Eugenia Andonian

      Affiliations

    • Neurosensory Testing and Clinical Data Co-ordinator, Dellon Institute for Peripheral Nerve Surgery, Baltimore, MD
    • ,
  • Gedge D. Rosson, MD

      Affiliations

    • Assistant Professor of Plastic Surgery, Division of Plastic Surgery, Johns Hopkins University, Baltimore, MD

References 

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  2. Lee KJ, Kirchner JS. Complex regional pain syndrome and chronic management in the lower extremity. Foot Ankle Clin. 2002;7:409–449
  3. Harris J, Fallat LM, Schwartz S. Characteristic trends of lower extremity complex regional pain syndrome. J Foot Ankle Surg. 2004;43:296–301
  4. Poehling GG, Pollock FE, Koman LA. Reflex sympathetic dystrophy of the knee after sensory nerve injury. Arthroscopy. 1988;4:31–35
  5. Mendicino RW, Kim C, Kabzie AC, Catanzariti AR. Correction of severe foot and ankle contracture due to CRPS using external fixation and pain management: report of a pediatric case. J Foot Ankle Surg. 2008;45:434–440
  6. Merksey H, Bogduk N. In Classification of Chronic Pain; Descriptions of Chronic Pain Syndromes and Definition of Terms, ed 2, pp 40–43, International Association for the Study of Pain Press, Seattle, 1994.
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  9. Nelson DV, Stacey BR. Interventional therapies in the management of complex regional pain syndrome. Clin J Pain. 2006;22:438–442
  10. Kumbhat S, Meyer N, Schurr MJ. Complex regional pain syndrome as a complication of a chemical burn to the foot. J Burn Care Rehab. 2004;25:189–191
  11. Trevino SG, Panchbhavi VK, Castro-Aragon O, Rowell M, Jo J. The “kick-off” position: a new sign for early diagnosis of complex regional pain syndrome in the leg. Foot Ankle Int. 2007;28:92–95
  12. Horner G, Dellon AL. Innervation of the human knee joint and implications for surgery. Clin Orthop Rel Res. 1994;301:221–226
  13. Dellon AL, Mont MA, Hungerford DS. Partial denervation for treatment of persistent neuroma pain after total knee arthroplasty. Clin Orthop Rel Res. 1995;316:145–150
  14. Dellon AL, Mont M, Mullik T, Hungerford D. Partial denervation for persistent neuroma pain around the knee. Clin Orthop Rel Res. 1996;329:216–222
  15. Dellon AL, Mont MA. Partial denervation for the treatment of painful neuromas complicating total knee arthroplasty. In Surgery of the Knee, ed 4, pp 1081-1096, edited by JN Insall, WN Scott, Churchill Livingston/Elsevier, Philadelphia, 2005.
  16. Rab M, Ebmer J, Dellon AL. Innervation of the sinus tarsi: implications for treating anterolateral ankle pain. Ann Plast Surg. 2001;47:500–504
  17. Dellon AL. Denervation of the sinus tarsi for chronic post-traumatic lateral ankle pain. Orthopedics. 2002;25:849–851
  18. Dellon AL, Barrett S. Sinus tarsi denervation: clinical results. J Am Podiatr Med Assoc. 2005;95:108–113
  19. Dellon AL, Aszmann OC. Treatment of dorsal foot neuromas by translocation of nerves into anterolateral compartment. Foot Ankle. 1998;19:300–303
  20. Kim J, Dellon AL. Tarsal tunnel incisional pain due to neuroma of the posterior branch of saphenous nerve. J Am Podiatr Med Assoc. 2001;91:109–113
  21. Kim J, Dellon AL. Neuromas of the calcaneal nerves: diagnosis and treatment. Foot Ankle Int. 2001;22:890–894
  22. Dellon AL. Entrapment of the deep peroneal nerve on the dorsum of the foot. Foot Ankle. 1990;11:73–80
  23. Barrett SL, Dellon AL, Rosson GD, Walters L. Superficial peroneal nerve: clinical implications of its anatomic variability. J Foot Ankle Surg. 2006;45:174–176
  24. Mullick T, Dellon AL. Results of treatment of four medial ankle tunnels in tarsal tunnels syndrome. J Reconstr Microsurg. 2008;24:119–126
  25. Ducic I, Maloney CT, Barrett SL, Dellon AL. Perioperative epidural blockade in the management of post-traumatic complex pain syndrome of the lower extremity. Orthopedics. 2003;26:641–644
  26. Mackinnon SE, Dellon AL. Results of treatment of recurrent dorsoradial wrist neuromas. Ann Plast Surg. 1987;19:54–61
  27. Dellon AL, Seif SS. Neuroma of the posterior interosseous nerve simulating a recurrent ganglion: case report and anatomical dissection relating the posterior interosseous nerve to the carpus and etiology of dorsal ganglion pain. J Hand Surg. 1978;3:326–332
  28. Dellon AL, Mackinnon SE, Daneshvar A. Terminal branch of anterior interosseous nerve as source of wrist pain. J Hand Surg Br. 1984;19B:316–322
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  30. Weinstein LP, Berger RA. Analgesic benefit, functional outcome, and patient satisfaction after partial wrist denervation. J Hand Surg Am. 2002;27A:833–839
  31. Barker AR, Rosson GD, Dellon AL. Pressure changes in the medial and lateral plantar, and tarsal tunnels related to ankle position: a cadaver study. Foot Ankle Int. 2007;28:250–254
  32. O'Neill PJ, Parks BF, Walsh R, Simmons LM, Miller SD. Excursion and strain of the superficial peroneal nerve during inversion ankle sprain. J Bone Joint Surg Am. 2007;89A:979–986
  33. Dellon AL. Clinical grading of peripheral nerve problems. Neurosurg Clin North Am. 2001;2:229–240
  34. Ackerman WE, Ahmad M. Recurrent post-operative CRPS I in patients with abnormal preoperative sympathetic function. J Hand Surg Am. 2008;33A:217–222
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  36. Dellon AL, Andronian E, Rosson GD. CRPS of the upper or lower extremity: surgical treatment outcomes. J Brachial Plex Peripher Nerve Inj. 2009;4:1–15
  37. Bruehl S, Harden RN, Galer BS, Saltz S, Backonja M, Stanton-Hicks M. Complex regional pain syndrome: are there distinct subtypes and sequential stages of the syndrome?. Pain. 2002;95:119–124

 Financial Disclosure: None reported.

 Conflict of Interest: A. Lee Dellon, MD, PhD, has a proprietary interest in the Pressure-Specified Sensory Device™ and Sensory Management Services, LLC.

PII: S1067-2516(09)00342-1

doi: 10.1053/j.jfas.2009.08.003

Journal of Foot and Ankle Surgery
Volume 49, Issue 1 , Pages 33-36 , January 2010

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