The role of sensory peptidergic nerve fibers and neurogenic inflammation in the development of posttraumatic complex regional pain syndrome
OBJECTIVES To study the involvement of sensory peptidergic fibers in the posttraumatic regional pain syndrome (RPS). MATERIAL AND METHODS We examined 57 patients with distal radial bone fractures (27 with noncomplicated fractures and 30 with the development of posttraumatic RPS) using computed thermography and laser Doppler flowmetry (LDF) with wavelet-analysis of skin blood flow oscillations. RESULTS It has been shown that neurogenic inflammation, along with sensory peptidergic fibers activation, is an early component of posttraumatic RPS. Thermographic and LDF criteria for early diagnosis of posttraumatic RPS during the 1st month after the injury are singled out. CONCLUSION The microvascular blood flow oscillatory structures, reflected sensory peptidergic activation and inflammatory sympatholysis are the most effective diagnostic signs (diagnostic effectiveness is 91.2%).