scholarly journals What is the incidence of complex regional pain syndrome (CRPS) Type I within four months of a wrist fracture in the adult population? A systematic review

Hand Therapy ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 45-55
Author(s):  
Catherine Rolls ◽  
Candy McCabe ◽  
Alison Llewellyn ◽  
Gareth T Jones
Keyword(s):  
Systematic Review ◽  
Complex Regional Pain Syndrome ◽  
Diagnostic Criteria ◽  
Adult Population ◽  
Pain Syndrome ◽  
Wrist Fracture ◽  
Type I ◽  
Inclusion Criteria ◽  
Fracture Management ◽  
Incidence Risk

Introduction Complex regional pain syndrome (CRPS) is a severe chronic pain condition, the symptoms of which may develop following trauma to a limb. Despite wrist fracture being a common antecedent, estimates of the incidence of CRPS following this injury vary widely. Our objective was to establish the incidence of CRPS in adults within four months of a wrist fracture, using a systematic review of the literature published since 2010. Methods The databases MEDLINE, PubMed, EMBASE, PsychINFO, CINAHL, BNI and AMED were searched for observational studies reporting the incidence of CRPS following a wrist fracture. Inclusion criteria were the use of a validated diagnostic tool to assess for CRPS within four months of the fracture. Randomised controlled trials and clinical trials were excluded, as were data from patients with evidence of prior neurology. Incidence risk was then extracted or calculated. Included studies were assessed for methodological rigour using the Newcastle–Ottowa Scale for assessment of bias. Results Nine studies met the inclusion criteria. There was a high degree of heterogeneity in study populations including study setting, fracture management and diagnostic criteria. From the three studies with the highest methodological rigour we determined that the incidence risk of CRPS in adults is between 3.7% and 14% using the Budapest criteria, with an observation of lower rates in conservatively managed fractures. Discussion We found evidence that the reported incidence of CRPS is influenced by choice of diagnostic criteria, along with the study location and/or how the fracture is managed.

Skin biomarkers associated with complex regional pain syndrome (CRPS) Type I: a systematic review

2022 ◽  
Author(s):  
Diana Andronic ◽  
Octavian Andronic ◽  
Astrid Juengel ◽  
Martin C. Berli ◽  
Oliver Distler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Type I

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).

scholarly journals Use of Ketamine Infusions for Treatment of Complex Regional Pain Syndrome: A Systematic Review

2021 ◽  
Author(s):  
Anand S. Patil ◽  
Ahish Chitneni ◽  
Suhani Dalal ◽  
Joe Ghorayeb ◽  
Yolanda Pham ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Complex Regional Pain Syndrome ◽  
Large Scale ◽  
Randomized Clinical Trials ◽  
Cochrane Review ◽  
Pain Syndrome ◽  
Inclusion Criteria ◽  
Treatment Resistant ◽  
Ketamine Infusion

AbstractBackgroundThis systematic review aims to review clinical studies on the use of ketamine infusion for patients with treatment-resistant Complex Regional Pain Syndrome (CRPS).MethodsThe following systematic review was registered on PROSPERO (CRD42021228470). Studies for the systematic review were identified through 3 databases; PubMed, CINAHL, and Cochrane Review. Inclusion criteria for studies consisted of randomized clinical trials or cohort studies that conducted trials on the use of ketamine infusion for pain relief in patients with Complex Regional Pain Syndrome (CRPS). Exclusion criteria for studies included any studies that were systematic review, meta-analyses, case reports, literature reviews, or animal studies. In the included studies, the primary outcome of interest was post drug administration pain score.ResultsIn this systematic review, 14 studies met the inclusion criteria and were reviewed. In these studies, the dosage of ketamine infusion used ranged from 0.15 mg/kg to 7mg/kg with primary indication being treatment of Complex Regional Pain Syndrome (CRPS). In 13 of the studies, ketamine infusion resulted in a decrease in pain scores and relief of symptoms.ConclusionsPatients who received Ketamine infusion for treatment-resistant CRPS self-reported adequate pain relief with treatment. This suggests that ketamine infusion may be a useful form of treatment for patients with no significant pain relief with other conservative measures. Future large-scale studies, including randomized double-blind placebo-controlled trials on the use of ketamine infusion for CRPS must be conducted in a large-scale population to further assess the effectiveness of ketamine infusion in these populations.

Diagnostic criteria and follow-up parameters in complex regional pain syndrome type I - a Delphi survey

2008 ◽  
Vol 12 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Florian Brunner ◽  
Stephanie B. Lienhardt ◽  
Rudolf O. Kissling ◽  
Lucas M. Bachmann ◽  
Ulrich Weber
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Diagnostic Criteria ◽  
Pain Syndrome ◽  
Delphi Survey ◽  
Type I ◽  
Syndrome Type

Peripheral Nerve and Brachial Plexus Impairment, AMA Guides, Sixth Edition

2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Complex Regional Pain Syndrome ◽  
Lower Extremities ◽  
Pain Syndrome ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Type I ◽  
Sixth Edition ◽  
Nerve Entrapments

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.

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