Episode 62

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Published on:

20th Nov 2023

CRPS Surgery

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss a case of complex regional pain syndrome (CRPS) type two. They explain the difference between CRPS type one and type two, and how a discrete nerve injury can be misdiagnosed as CRPS. They share the story of a patient who developed debilitating nerve pain after bunion surgery and was suffering for six and a half years before being properly diagnosed. The doctors perform a diagnostic block and identify a specific nerve injury. They then perform a surgical procedure to cap the damaged nerve and bury it in muscle to prevent the development of a stump neuroma. The patient experiences significant pain relief and is on the path to recovery.

QUOTES:

"As long as that end nerve is no longer connected to the brain, that's going to wither and shrivel up and go through Wallerian degeneration and go away." -Dr. Damien Dauphinee

“Complex regional pain syndrome. There are two versions. There's a type one, which is nondescript, there's no specific nerve pathway, and there's a type two, which it's more associated with a specific nerve pathway, usually associated with an injury.” -Dr. Raafae Hussain

Top Takeaways:

  • Complex regional pain syndrome (CRPS) can be misdiagnosed if a discrete nerve injury is not identified.
  • Discrete nerve injuries can cause chronic pain and other symptoms similar to CRPS.
  • Surgical intervention, such as capping the damaged nerve and burying it in muscle, can provide significant pain relief for patients with a discrete nerve injury.

What You Will Learn:

  • Differentiating between general CRPS and discrete nerve injury
  • Options for nerve reconstruction or capping
  • Preventing stump neuroma
  • Importance of identifying discrete nerve injuries in CRPS patients 
  • The need for psychiatric care in some cases 
  • The importance of multimodal pain management 
  • CRPS Warriors support group for patients

Resources:

Visit our website: https://thepoddoctors.com/

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About the Podcast

The PODdoctors with Dr. Dauphinee and Dr. Hussain
ThePODdoctors are Dr. Damien Dauphinee, double board certified in Reconstructive Foot and Ankle Surgery and Wound Management and his partner Dr. Raafae Hussain, fellowship trained podiatric surgeon. Each week ThePODdoctors will be discussing aspects of podiatric medicine and surgery to educate our audience on common foot and ankle problems and the latest treatment options available.