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June 1941


Arch Surg. 1941;42(6):1042-1047. doi:10.1001/archsurg.1941.01210120077008

After almost any form of injury to an extremity or to its nerve or blood supply a peculiar type of syndrome may ensue which has been variously designated, depending on the chief clinical manifestations, for instance as Sudeck's atrophy,1 painful osteoporosis,2 traumatic vasospasm3 and reflex dystrophy.4 (Causalgia5 probably belongs to this group. However, marked dilatation rather than spasm seems to be the predominant vasomotor disturbance associated with that condition.) The initial injury may be trivial, such as straining of a ligament or pricking of a finger; or it may be more serious, such as a fracture, a dislocation or a gunshot wound. The syndrome may regress spontaneously, or it may go on to advanced disturbances involving skin, connective tissue, nerves, muscles, joints and bone. Pain, subjective coldness, objective coldness, hyperhidrosis, cyanosis, tense, shiny skin, firm, tender edema, muscular weakness, joint fixation and decalcification of bone