Role of vitamin C in prevention of complex regional pain syndrome after distal radius fractures: a meta-analysis

Abstract Background External fixation and dorsal bridge plating are wrist spanning fixation options for distal radius fractures; however, their comparative effectiveness is not well understood. A meta-analysis was conducted to compare the clinical outcomes between these two techniques. Materials and Methods A PubMed database query of all distal radius fracture cases managed with spanning external fixation or dorsal bridge plating was performed. A total of 28 articles met inclusion criteria, yielding 895 patients for data extraction and comparative analysis. Results Dorsal bridge plating demonstrated lower rates of infection (2 vs. 10%, p = 0.05) and complex regional pain syndrome (1 vs. 4%, p = 0.04) but higher rates of hardware failure (4 vs. 1%, p = 0.026). Bridge plating also demonstrated higher rates of excellent/good ratings under the Gartland and Werley outcome score (91 vs. 83%, p = 0.016). There was no significant difference in DASH (Disability of the Arm, Shoulder, and Wrist) scores, radiographic parameters, or unplanned reoperations between the two spanning fixation options. Conclusion Bridge plating and external fixation both appear to be comparable for spanning fixation constructs for distal radius fractures, but with bridge plating having a potentially lower complication profile.

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The impact of mirror therapy on body schema perception in patients with complex regional pain syndrome after distal radius fractures

British Journal of Pain ◽

10.1177/2049463718782544 ◽

2018 ◽

Vol 13 (1) ◽

pp. 35-42 ◽

Cited By ~ 2

Author(s):

Viktor Kotiuk ◽

Olexander Burianov ◽

Olexander Kostrub ◽

Ludmila Khimion ◽

Ivan Zasadnyuk

Keyword(s):

Complex Regional Pain Syndrome ◽

Distal Radius ◽

Body Schema ◽

Pain Syndrome ◽

Distal Radius Fractures ◽

Mirror Therapy ◽

Radius Fractures ◽

The Impact

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Can we reduce the incidence of complex regional pain syndrome type I in distal radius fractures? The Liverpool experience

Hand Therapy ◽

10.1177/1758998316659676 ◽

2016 ◽

Vol 21 (4) ◽

pp. 123-130 ◽

Cited By ~ 11

Author(s):

Sharon Gillespie ◽

Fiona Cowell ◽

Graham Cheung ◽

Daniel Brown

Keyword(s):

Distal Radius Fracture ◽

Complex Regional Pain Syndrome ◽

Distal Radius ◽

Pain Syndrome ◽

Warning Signs ◽

Distal Radius Fractures ◽

Radius Fracture ◽

Type I ◽

Syndrome Type ◽

Radius Fractures

Introduction Complex regional pain syndrome is a multifaceted condition, which is relatively common after distal radius fracture. Method A series of audits and service evaluations were conducted from 2004 to 2013 to investigate the incidence of complex regional pain syndrome type I and any correlation to tight, restrictive, over-flexed casts. Simple subsequent clinical and patient management changes were implemented and impact re-evaluated. Results These audits have contributed to organisational learning and a subsequent reduction in the incidence of complex regional pain syndrome type I in non-operatively managed distal radius fracture from 25%, in keeping with expected incidence in the relevant literature, to a rare event (<1%). Conclusion The authors suggest that careful attention to the prevention of complex regional pain syndrome through staff and patient awareness, vigilance for warning signs and minor modifications to the traditional management of distal radius fractures can significantly reduce the incidence of complex regional pain syndrome type I after distal radius fracture.

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