CASE REPORT

http://informahealthcare.com/crp

ISSN: 2332-0885 (electronic)

Cas Rep Plast Surg Hand Surg, 2014; Early Online: 1–4
© 2014 The Author(s). Published by Informa Healthcare.

Ken Matsuda1, Mamoru Kikuchi2, Tsuyoshi Murase3, Ko Hosokawa4 & Minoru Shibata1

1Division of Plastic and Reconstructive Surgery, Niigata University Graduate School of Medicine, Niigata, Japan, 2Department of Plastic and Reconstructive Surgery, Saga University Hospital, Saga, Japan, 3Department of

Orthopaedics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan, and 4Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

Abstract

A patient with complex regional pain syndrome type II was successfully treated using free antero­lateral thigh flap transfer with digital nerve coaptation to the cutaneous nerve of the flap. Release of the scarred tissue and soft tissue coverage with targeted sensory nerve coaptation were useful in relieving severe pain.

Introduction

Complex regional pain syndrome (CRPS) is an intractable clinical condition, first reported in the 1800s. It is character­ized by burning pain, hyperalgesia, edema, and sudomotor changes, without or with identifiable associated nerve injury (type I and type II CRPS, respectively) [1]. The pathogenesis of CRPS is unclear but involves both peripheral and central neurologic components, which complicates understanding of the condition. No single treatment has proven completely effective; thus, there are multiple options and approaches for managing CRPS. Surgical intervention is not usually indi­cated for CRPS type I, except in cases of sympathectomy or stimulator implantation [2]; however, surgical approaches may lead to satisfactory outcomes for CRPS type II [3]. We present a case of CRPS type II that was successfully man­aged with free anterolateral thigh flap transfer.

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