The following images represent classic signs and symptoms of Complex Regional Pain Syndrome, also known as CRPS. Historically, this has also been referred to as sympathetic reflex dystrophy or causalgia. I have found that the most sensitive and predictive finding is a dramatic loss in function (strength or motion) of a body part that is…
Steroid Skin Blanching – Franko
The following images demonstrate the temporary depigmentation and atrophy effects of Kenalog injected in the hand and wrist. The follow-up image is 6 months later.
Table Saw Skin Graft – Franko
History: 63 year old gentleman sustained a table saw injury to his right index finger. This included a deep skin injury with full thickness loss but did not seem to involved the tendons, nerves, or vessels. Diagnosis: Right index full thickness loss Treatment: Full thickness skin graft to digit Outcome: Despite early loss of part of the graft, the…
Deep Palm Infection – Franko
History: 71 year old female presented to the hospital about 2 weeks after a fall with increasing pain and swelling in her hand and palm. She had a history of psoriatic arthritis for which she took methotrexate and infliximab. Her presentation was very concerning for a deep infection with a WBC of 41,000, lactate of…
Flexor Tenosynovitis – Franko
History: A 55 year old female with diabetes presented to my office with severe pain and swelling in her middle finger a few days after burning the tip of her finger. This was initially treated with antibiotics for cellulitis however she rapidly progressed to flexor tenosynovitis based on the appearance and was taken to the operating…
Dorsal Wrist Skin Graft – Franko
History: 61 year old female sustained an injury to her right wrist resulting in complete loss of skin over a large area measuring 10 x 6 cm. The existing skin had previously become infected and required debridement. I recommended a skin graft to provide coverage to the area. Diagnosis: Dorsal wrist large skin defect Treatment: Full thickness skin…