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

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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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Acknowledgments

We thank S.Y. Lee MD, C.H. Hwang MD and S.H Lee MD, for their role in data management and statistical support. This study was supported by the Korean Human Technology Research Foundation (KOHTERF-2014-01).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, 1198 Kuwol-dong, Namdong-gu, 405-760, Incheon, Korea

    Young Hak Roh, Beom Koo Lee & Jong Ryoon Baek

  2. Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-ro, 200-722, Chuncheon-si, Gangwon-do, Korea

    Jung Ho Noh

  3. Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, Korea

    Joo Han Oh, Hyun Sik Gong & Goo Hyun Baek

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  1. Young Hak Roh
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  2. Beom Koo Lee
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Correspondence to Jung Ho Noh.

Additional information

This work was performed at Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.

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Roh, Y.H., Lee, B.K., Noh, J.H. et al. Factors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture. Arch Orthop Trauma Surg 134, 1775–1781 (2014). https://doi.org/10.1007/s00402-014-2094-5

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  • DOI: https://doi.org/10.1007/s00402-014-2094-5

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