Successful treatment of recurrent reflex sympathetic dystrophy with bilateral lumbar sympathectomies.

The authors report a case of reflex sympathetic dystrophy of the lower right extremity in a 51-year-old white man. The disorder developed 3 months after an ankle fracture, and bilateral lumbar surgical sympathectomies were necessary for successful treatment. Unique to this case is the patient's history of having undergone the same treatment 10 years earlier for the same disorder, which developed after a myocardial infarction and cardiac catheterization of the right femoral artery. Incomplete sympathectomy or regeneration of sympathetic ganglions after the first surgery may explain why the second surgery was necessary in this patient.