About post-traumatic neurodystrophic syndrome of the upper limb

According to modern concepts, post-traumatic neurodystrophic syndrome (PTNDS) can be considered as a complex reflex process, the formation of which necessarily involves the central nervous system (certain segments of the brain), the borderline sympathetic nerve trunk and the peripheral nervous system (main nerve trunks of the upper and lower limbs). The main pathomorphological mechanism is the syndrome of regional capillary-trophic insufficiency [1—3, 5]. In accordance with the classification of V.F. Pavlov [4], three phases are distinguished in the clinical picture: the so-called collateral inflammation, dystrophic and atrophic phases. It is known that the first phase is manifested by a significantly pronounced pain syndrome in the area of ​​the damaged segment of the limb, hyperemia of the skin of the hand and forearm, and swelling of this area are determined. The second phase is characterized by a decrease in the intensity of pain, the presence of trophic disorders (the skin acquires a cyanotic-purple hue, shines, is tense, swelling of the limb is pronounced). The third phase is characterized by the absence of pain (or they are expressed to a small extent), the normalization of trophism, the formation of persistent contractures of the joints.