Factors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture

Young Hak Roh, Beom Koo Lee, Jung Ho Noh, Jong Ryoon Baek, Joo Han Oh, Hyun Sik Gong, Goo Hyun Baek

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Purpose: Wrist fracture is considered a typical initiating trauma for complex regional pain syndrome type I (CRPS I). However, few studies have comprehensively evaluated factors associated with the occurrence of CRPS I after the surgical treatment of a distal radius fracture (DRF). This study evaluates the factors influencing the occurrence of CRPS I after the surgical treatment of a DRF.

Methods: A total of 477 patients with a DRF who had been treated surgically were enrolled in this prospective observational study. Patients were followed for 6 months after surgery, and CRPS I was diagnosed using the Budapest diagnostic criteria for research. The factors assessed for the development of CPRS I were age, gender, the body mass index, the type of fracture, the energy of trauma, the number of trial reductions, the type of surgery, and the duration of immobilization. A multivariate logistic regression analysis was conducted to identify independent predictors of the occurrence of CRPS I.

Results: Among the 477 patients, 42 (8.8 %) satisfied the Budapest criteria for CRPS I within 6 months of surgery. Female patients developed CRPS I more frequently, and the patients who developed CRPS I were older and more likely to sustain a high energy injury or have a comminuted fracture. According to the multivariate analysis, female patients and those with a high energy trauma or severe fracture type were significantly more likely to develop CRPS I (p = 0.02, 0.01, and 0.01, respectively).

Conclusions: High energy injuries, severe fractures, and the female gender contribute to the development of CRPS I after the surgical treatment of DRF. The results have important implications for physicians who wish to identify patients at high risk for CRPS I after operative fixation for DRF and instigate treatment accordingly.

Original languageEnglish
Pages (from-to)1775-1781
Number of pages7
JournalArchives of Orthopaedic and Trauma Surgery
DOIs
StatePublished - 2014

Keywords

  • Complex regional pain syndrome
  • Distal radius fracture
  • Risk factors
  • Surgical treatment

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