Abstract
We report a case of severe upper extremity complex regional pain syndrome type 1 (CRPS-1)
and neurogenic edema that ultimately led to a medically necessary below-elbow amputation.
The patient presented with a history of remote bilateral carpal tunnel release complicated
by debilitating and recalcitrant bilateral CRPS-1. Following years of severe neurogenic
edema of the left upper extremity, the patient had full-thickness skin sloughing on
the dorsum of her hand due to massive edema. This subsequently led to maggot infestation
of the soft tissues of the left hand ultimately necessitating amputation. We present
the case as an illustration of an extreme case of neurogenic edema, a potential physical
manifestation of CRPS-1. The case presented discusses upper extremity amputation as
an end treatment option for CRPS-1, though in this case amputation was primarily indicated
secondary to medical necessity.
Keywords
amputation - carpal tunnel syndrome - complex regional pain syndrome - infection -
neurogenic edema
