Investigate the Effect of Psychological Factors in Development of Complex Regional Pain Syndrome Type I in Patients with Fracture of the Distal Radius: A Prospective Study

2018 ◽  
Vol 23 (04) ◽  
pp. 554-561 ◽  
Author(s):  
Maryam Farzad ◽  
Fereydoun Layeghi ◽  
Ali Hosseini ◽  
Al Dianat ◽  
Nadiyeh Ahrari ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Distal Radius Fracture ◽  
Complex Regional Pain Syndrome ◽  
Distal Radius ◽  
Psychological Factors ◽  
Pain Syndrome ◽  
Base Line ◽  
Type I ◽  
Syndrome Type ◽  
One Year

Background: To investigate the role of psychological factors (anxiety and depression) and pain measured on a visual analogue scale (VAS) in the development of complex regional pain syndrome type I (CRPS I) following the distal radius fracture (DRF). Methods: A consecutive sample of patients (N=60) with a distal radius fracture was measured for signs of CRPS by Budapest criteria weekly till 8 weeks and then another follow-up one year after injury to determine the incidence and predictors of developing CRPS I in a prospective cohort study and also to discover whether there is difference between pain, depression, and anxiety level in the patients with and without CRPS I. The most of the patients were treated by Pin stabilization. The Beck depression inventoryshort form (BDI), State-Trait Anxiety Inventory, and Numerical pain rating scale were used to determine the patients’ psychological features and pain intensity at the base line and 8 weeks after the fracture. Results: CRPS I developed in 15 (25%) patients after eight weeks and just last in 10 (16.67%) patients after one year. No difference was found between the two groups (CRPS and non-CRPS group) in terms of state (STAI-I) and trait (STAI-II) anxiety, and BDI score. Pain at the base line was the most important risk factor in developing CRPS (odds ratio [OR] =1.52; 95% CI). Conclusions: After fracturing the distal radius, patients who have high pain intensity have a higher risk of developing CRPS I. To following these patients closely for the development of CRPS I may be advantageous for early preventative and therapeutic interventions.

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

Hand Therapy ◽  
2016 ◽  
Vol 21 (4) ◽  
pp. 123-130 ◽  
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.

scholarly journals Incidence and risk factors of complex regional pain syndrome type I after fracture of the distal radius

2014 ◽  
Vol 57 ◽  
pp. e253
Author(s):  
S. Salah ◽  
A. Jellad ◽  
S. Boudokhane ◽  
S. Mtawa ◽  
H. Migaou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Complex Regional Pain Syndrome ◽  
Distal Radius ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type

scholarly journals Decreasing incidence of complex regional pain syndrome in the Netherlands: a retrospective multicenter study

2021 ◽  
pp. 204946372110419
Author(s):  
Tjitske D Groenveld ◽  
Emily Z Boersma ◽  
Taco J Blokhuis ◽  
Frank W Bloemers ◽  
Jan Paul M Frölke
Keyword(s):  
The Netherlands ◽  
Distal Radius Fracture ◽  
Complex Regional Pain Syndrome ◽  
Distal Radius ◽  
Pain Syndrome ◽  
Annual Incidence ◽  
Radius Fracture ◽  
National Database ◽  
Type I ◽  
Fracture Management

Background: Complex regional pain syndrome type I (CRPS) is a symptom-based diagnosis of which the reported incidence varies widely. In daily practice, there appears to be a decrease in incidence of CRPS after a distal radius fracture and in general. Questions/purposes: The aim of this study was to assess the trend in the incidence of CRPS after a distal radius fracture and in general in the Netherlands from 2014 to 2018. Methods: The incidence of CRPS after a distal radius fracture was calculated by dividing the number of confirmed cases of CRPS after distal radius fracture by the total number of patients diagnosed with a distal radius fracture. Medical records of these patients were reviewed. Hospital-based data were used to establish a trend in incidence of CRPS in general. A Dutch national database was used to measure the trend in the incidence of CRPS in the Netherlands by calculating annual incidence rates: the number of new CRPS cases, collected from the national database, divided by the Dutch mid-year population. Results: The incidence of CRPS after distal radius fracture over the whole study period was 0.36%. Hospital data showed an absolute decrease in CRPS cases from 520 in 2014 to 223 in 2018. National data confirmed this with a decrease in annual incidence from 23.2 (95% CI: 22.5–23.9) per 100,000 person years in 2014 to 16.1 (95% CI: 15.5–16.7) per 100,000 person years in 2018. Conclusion: A decreasing trend of CRPS is shown in this study. We hypothesize this to be the result of the changing approach towards CRPS and fracture management, with more focus on prevention and the psychological aspects of disproportionate posttraumatic pain. Level of Evidence: level 3 (retrospective cohort study).

439 DISTAL RADIUS FRACTURES AND COMPLEX REGIONAL PAIN SYNDROME TYPE I

2006 ◽  
Vol 10 (S1) ◽  
pp. S117a-S117
Author(s):  
Ç. Bircan ◽  
S. Gülbahar ◽  
Ö. El ◽  
M. Özkan ◽  
Y. Arslan ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Distal Radius ◽  
Pain Syndrome ◽  
Distal Radius Fractures ◽  
Type I ◽  
Syndrome Type ◽  
Radius Fractures

Pain acceptance-based coping in complex regional pain syndrome Type I: daily relations with pain intensity, activity, and mood

2012 ◽  
Vol 36 (5) ◽  
pp. 531-538 ◽  
Author(s):  
Sungkun Cho ◽  
Lance M. McCracken ◽  
Elaine M. Heiby ◽  
Dong-Eon Moon ◽  
Jang-Han Lee
Keyword(s):  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type ◽  
Pain Acceptance

A randomized controlled trial of amitriptyline versus gabapentin for complex regional pain syndrome type I and neuropathic pain in children

2016 ◽  
Vol 13 (1) ◽  
pp. 156-163 ◽  
Author(s):  
Stephen Brown ◽  
Bradley Johnston ◽  
Khush Amaria ◽  
Jessica Watkins ◽  
Fiona Campbell ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Adverse Events ◽  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type ◽  
Care Providers ◽  
First Line ◽  
Significant Difference

AbstractBackgroundTreatment of neuropathic pain in children is challenging, and requires a multimodal approach of pharmacologic, physical, and psychological therapies; however there is little evidence to guide practice. Amitriptyline and gabapentin are first-line drugs for treating neuropathic pain in adults, yet no studies have examined their efficacy, or compared them directly, to determine which might be better for pain relief and sleep disturbance in children.MethodsAfter informed consent was obtained, 34 patients aged 7–18 years diagnosed with complex regional pain syndrome type I (CRPS I) or a neuropathic pain condition were randomly allocated to receive either amitriptyline or gabapentin. Patients were followed for 6 weeks and assessed for pain intensity, sleep quality and adverse events. We blinded study personnel, including health-care providers, participants, parents, the research coordinator and the data analyst. Patients then completed quantitative sensory testing (QST) and a psychosocial pain assessment with the team psychologist, within 1–3 days of the start of the trial.ResultsAt the end of the 6-week trial, patients on both drugs had important reductions in pain, having surpassed the minimally important difference (MID) of 1. The difference between the groups however was not statistically significant. For the secondary outcomes, we found no statistically significant difference between the two drugs in sleep score or adverse events suggesting that both drugs improve sleep score to a similar degree and are equally safe.ConclusionsAmitriptyline and gabapentin significantly decreased pain intensity scores and improved sleep. There were no significant differences between the two drugs in their effects on pain reduction or sleep disability.ImplicationsAlthough larger, multi-centred trials are needed to confirm our findings, including longterm follow-up, both drugs appear to be safe and effective in treating paediatric patients in the first-line treatment of CRPS I and neuropathic pain over 6-weeks.

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