Factors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture
- Authors
- Roh, Young Hak; Lee, Beom Koo; Noh, Jung Ho; Baek, Jong Ryoon; Oh, Joo Han; Gong, Hyun Sik; Baek, Goo Hyun
- Issue Date
- Dec-2014
- Publisher
- SPRINGER
- Keywords
- Complex regional pain syndrome; Distal radius fracture; Surgical treatment; Risk factors
- Citation
- ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, v.134, no.12, pp.1775 - 1781
- Journal Title
- ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
- Volume
- 134
- Number
- 12
- Start Page
- 1775
- End Page
- 1781
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/12055
- DOI
- 10.1007/s00402-014-2094-5
- ISSN
- 0936-8051
- 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.
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