Early Treatment of Acute Complex Regional Pain Syndrome after Fracture or Injury with Prednisone: Why Is There a Failure to Treat? A Case Series

Figure 2

Case : a 50-year-old diabetic woman fell on ice fracturing her right wrist requiring open reduction internal fixation (ORIF). She developed capsular swelling in the right hand and lack of full flexion and extension at the interphalangeal joints; hand therapy was provided. When assessed 10 months after the accident, there was ongoing loss of range of motion. Shortly after, a motor vehicle accident resulted in a left radial fracture with an ORIF, with capsular restrictions in the wrist and hand, and loss of supination. A bone scan showed activity on the left only. Prednisone was initiated with little change on the old right injury but resolution of pain and loss of range on the new left injury.