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).

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.

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.

Fracture of the Wrist and Incidence of the Complex Regional Pain Syndrome Type 1: A Case Series Study

2020 ◽  
Author(s):  
Payam Vezvaei ◽  
Soroosh Alizadeh ◽  
Saeed Reza Mehrpour ◽  
Leila Oryadi-Zanjani
Keyword(s):  
Distal Radius Fracture ◽  
Complex Regional Pain Syndrome ◽  
Distal Radius ◽  
Case Series ◽  
Pain Syndrome ◽  
Radius Fracture ◽  
Case Series Study ◽  
Budapest Criteria ◽  
Series Study

Background: Complex regional pain syndrome (CRPS) is a painful syndrome with signs such as swelling, restriction of motion, and discoloration of the skin and bone. CRPS is divided into two types based on neurological injuries. Type 1 CRPS (CRPS-I), which is more common, has no nerve damage. In this study, we used the Budapest Criteria to investigate the incidence of CRPS. We also evaluated the risk factors for the incidence of CRPS. Methods: This single-center case series study was performed at Shariati Hospital of Tehran University of Medical Sciences, Tehran, Iran, during 2018-2019. We evaluated CRPS-I, two and six weeks after treatment based on Budapest Criteria. The inclusion criteria included distal radius fracture confirmed by clinical and radiographic investigations. The exclusion criteria were patients with fractures in another part of the body, associated nerve damage, vascular injury, and an open fracture. Results: Sixty-two patients with distal radius fracture who underwent casting or surgical treatment enrolled in the study. A total of 9 (14.5%) patients had CRPS-I after distal radius fracture. In 5 (8.1%) patients, CRPS-I occurred within two weeks after fracture. Also, 4 (6.5%) patients had CRPS-I after six weeks from fracture. There was no significant difference between the two sex groups in terms of CRPS (P = 0.345). This complication was significantly higher in the surgical group than in the casting group (P = 0.004). Conclusions: Given the significant incidence of CRPS and its impact on patient's quality of life, further studies are recommended to explore solutions to reduce this complication.

Sign in / Sign up

Export Citation Format

Share Document