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An otherwise healthy and functional 35-year-old man had an undisplaced fracture of the right fifth metacarpal neck after a fall. He presented 21 months later with pain, extensive swelling (Panels A and B), and loss of function in his right hand up to the middle third of his upper arm. On physical examination, there was nonpitting edema, hair loss, allodynia, and vasomotor instability, with increased temperature, sweating, and erythema. These changes had developed since the initial fracture and had progressed slowly. Radiologic studies showed that the fracture had healed (Panel C). Computed tomography of the chest showed axillary lymphadenopathy that . . . [Full Text of this Article] |
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