Complex Regional Pain Syndrome Type I: Incidence and Risk Factors in Patients With Fracture of the Distal Radius
Abstract Objective To examine the incidence and predictors of complex regional pain syndrome type I (CRPS I) after fracture of the distal radius. Design Prospective study. Setting University hospital. Participants A consecutive sample of patients (N=90) with fracture of the distal radius treated by...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2014-03, Vol.95 (3), p.487-492 |
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| description | Abstract Objective To examine the incidence and predictors of complex regional pain syndrome type I (CRPS I) after fracture of the distal radius. Design Prospective study. Setting University hospital. Participants A consecutive sample of patients (N=90) with fracture of the distal radius treated by closed reduction and casting. Interventions Not applicable. Main Outcome Measures Occurrence of CRPS I, occurrence of pain, wrist and hand range of motion, radiographic measures, Patient-Rated Wrist Evaluation, Hospital Anxiety and Depression Scale, and Medical Outcomes Study 36-Item Short-Form Health Survey at baseline and 1, 3, 6, and 9 months follow-up. Results CRPS I occurred in 29 patients (32.2%) with a mean delay ± SD of 21.7±23.7 days from cast removal. Univariate analyses found significant differences between patients with CRPS I and patients without CRPS I at baseline for sex ( P =.021), socioeconomic level ( P =.023), type of trauma ( P =.05), pain at rest and activity ( P =.006 and P |
| doi_str_mv | 10.1016/j.apmr.2013.09.012 |
| format | Article |
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Design Prospective study. Setting University hospital. Participants A consecutive sample of patients (N=90) with fracture of the distal radius treated by closed reduction and casting. Interventions Not applicable. Main Outcome Measures Occurrence of CRPS I, occurrence of pain, wrist and hand range of motion, radiographic measures, Patient-Rated Wrist Evaluation, Hospital Anxiety and Depression Scale, and Medical Outcomes Study 36-Item Short-Form Health Survey at baseline and 1, 3, 6, and 9 months follow-up. Results CRPS I occurred in 29 patients (32.2%) with a mean delay ± SD of 21.7±23.7 days from cast removal. Univariate analyses found significant differences between patients with CRPS I and patients without CRPS I at baseline for sex ( P =.021), socioeconomic level ( P =.023), type of trauma ( P =.05), pain at rest and activity ( P =.006 and P <.001, respectively), wrist dorsiflexion and pronation ( P =.002 and P =.001, respectively), finger flexion ( P =.047), thumb opposition ( P =.002), function of the hand ( P <.001), and physical quality of life (QOL) ( P =.013). Logistic regression showed that risk for CRPS I was higher in cases of women (odds ratio [OR]=5.774; 95% confidence interval [CI], 1.391–23.966), medium and low energy trauma patients (OR=7.718; 95% CI, 1.136–52.44), patients with a Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning score <40 (OR=4.931; 95% CI, 1.428–17.025), and patients with Patient-Rated Wrist Evaluation pain subscale score >16 (OR=12.192; 95% CI, 4.484–43.478). Conclusions CRPS I occurs frequently during the third and fourth week after cast removal, especially in women who report severe pain and impairment of physical QOL. Additional prospective studies are required to verify these findings in comminuted and operated fractures of the distal radius.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2013.09.012</identifier><identifier>PMID: 24080349</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Female ; Health Status ; Hospitals, University ; Humans ; Incidence ; Male ; Middle Aged ; Pain - etiology ; Pain - physiopathology ; Physical Medicine and Rehabilitation ; Quality of Life ; Radiography ; Radius Fractures - complications ; Radius Fractures - diagnostic imaging ; Range of Motion, Articular ; Reflex sympathetic dystrophy ; Reflex Sympathetic Dystrophy - epidemiology ; Reflex Sympathetic Dystrophy - etiology ; Reflex Sympathetic Dystrophy - physiopathology ; Rehabilitation ; Risk Factors ; Sex Factors ; Socioeconomic Factors ; Trauma Severity Indices ; Wrist Joint - diagnostic imaging ; Wrist Joint - physiopathology</subject><ispartof>Archives of physical medicine and rehabilitation, 2014-03, Vol.95 (3), p.487-492</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2014 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-fa06fda67bfc87a612208492cf707c96ad7db57b30d61190b8d36d1117c82b2c3</citedby><cites>FETCH-LOGICAL-c411t-fa06fda67bfc87a612208492cf707c96ad7db57b30d61190b8d36d1117c82b2c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.apmr.2013.09.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24080349$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jellad, Anis, MD</creatorcontrib><creatorcontrib>Salah, Sana, MD</creatorcontrib><creatorcontrib>Ben Salah Frih, Zohra, MD</creatorcontrib><title>Complex Regional Pain Syndrome Type I: Incidence and Risk Factors in Patients With Fracture of the Distal Radius</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Objective To examine the incidence and predictors of complex regional pain syndrome type I (CRPS I) after fracture of the distal radius. Design Prospective study. Setting University hospital. Participants A consecutive sample of patients (N=90) with fracture of the distal radius treated by closed reduction and casting. Interventions Not applicable. Main Outcome Measures Occurrence of CRPS I, occurrence of pain, wrist and hand range of motion, radiographic measures, Patient-Rated Wrist Evaluation, Hospital Anxiety and Depression Scale, and Medical Outcomes Study 36-Item Short-Form Health Survey at baseline and 1, 3, 6, and 9 months follow-up. Results CRPS I occurred in 29 patients (32.2%) with a mean delay ± SD of 21.7±23.7 days from cast removal. Univariate analyses found significant differences between patients with CRPS I and patients without CRPS I at baseline for sex ( P =.021), socioeconomic level ( P =.023), type of trauma ( P =.05), pain at rest and activity ( P =.006 and P <.001, respectively), wrist dorsiflexion and pronation ( P =.002 and P =.001, respectively), finger flexion ( P =.047), thumb opposition ( P =.002), function of the hand ( P <.001), and physical quality of life (QOL) ( P =.013). Logistic regression showed that risk for CRPS I was higher in cases of women (odds ratio [OR]=5.774; 95% confidence interval [CI], 1.391–23.966), medium and low energy trauma patients (OR=7.718; 95% CI, 1.136–52.44), patients with a Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning score <40 (OR=4.931; 95% CI, 1.428–17.025), and patients with Patient-Rated Wrist Evaluation pain subscale score >16 (OR=12.192; 95% CI, 4.484–43.478). Conclusions CRPS I occurs frequently during the third and fourth week after cast removal, especially in women who report severe pain and impairment of physical QOL. Additional prospective studies are required to verify these findings in comminuted and operated fractures of the distal radius.</description><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Health Status</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain - etiology</subject><subject>Pain - physiopathology</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Quality of Life</subject><subject>Radiography</subject><subject>Radius Fractures - complications</subject><subject>Radius Fractures - diagnostic imaging</subject><subject>Range of Motion, Articular</subject><subject>Reflex sympathetic dystrophy</subject><subject>Reflex Sympathetic Dystrophy - epidemiology</subject><subject>Reflex Sympathetic Dystrophy - etiology</subject><subject>Reflex Sympathetic Dystrophy - physiopathology</subject><subject>Rehabilitation</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Socioeconomic Factors</subject><subject>Trauma Severity Indices</subject><subject>Wrist Joint - diagnostic imaging</subject><subject>Wrist Joint - physiopathology</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAUhC0EotvCH-CAfOSS8GxnkxghJLR0YaVKVNsiuFmO_UK9TeJgJ4j99zjawoEDJ-vJMyPNN4S8YJAzYOXrQ67HPuQcmMhB5sD4I7Jia8GzmrNvj8kKAEQmpRRn5DzGQzrLtWBPyRkvoAZRyBUZN74fO_xF9_jd-UF39Fq7gd4cBxt8j_T2OCLdvaG7wTiLg0GqB0v3Lt7TrTaTD5Em-bWeHA5TpF_ddEe3If3MAalv6XSH9IOLUwrea-vm-Iw8aXUX8fnDe0G-bC9vN5-yq88fd5v3V5kpGJuyVkPZWl1WTWvqSpeMc6gLyU1bQWVkqW1lm3XVCLAlYxKa2orSMsYqU_OGG3FBXp1yx-B_zBgn1btosOv0gH6Oiq2B1UJwXiQpP0lN8DEGbNUYXK_DUTFQC2l1UAtptZBWIFUinUwvH_Lnpkf71_IHbRK8PQkwtfzpMKho3ELQuoBmUta7_-e_-8duOjc4o7t7PGI8-DmktVIPFbkCdbNsvUzNBIDkqdlvtPejpQ</recordid><startdate>20140301</startdate><enddate>20140301</enddate><creator>Jellad, Anis, MD</creator><creator>Salah, Sana, MD</creator><creator>Ben Salah Frih, Zohra, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140301</creationdate><title>Complex Regional Pain Syndrome Type I: Incidence and Risk Factors in Patients With Fracture of the Distal Radius</title><author>Jellad, Anis, MD ; Salah, Sana, MD ; Ben Salah Frih, Zohra, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-fa06fda67bfc87a612208492cf707c96ad7db57b30d61190b8d36d1117c82b2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Health Status</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain - etiology</topic><topic>Pain - physiopathology</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Quality of Life</topic><topic>Radiography</topic><topic>Radius Fractures - complications</topic><topic>Radius Fractures - diagnostic imaging</topic><topic>Range of Motion, Articular</topic><topic>Reflex sympathetic dystrophy</topic><topic>Reflex Sympathetic Dystrophy - epidemiology</topic><topic>Reflex Sympathetic Dystrophy - etiology</topic><topic>Reflex Sympathetic Dystrophy - physiopathology</topic><topic>Rehabilitation</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Socioeconomic Factors</topic><topic>Trauma Severity Indices</topic><topic>Wrist Joint - diagnostic imaging</topic><topic>Wrist Joint - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jellad, Anis, MD</creatorcontrib><creatorcontrib>Salah, Sana, MD</creatorcontrib><creatorcontrib>Ben Salah Frih, Zohra, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jellad, Anis, MD</au><au>Salah, Sana, MD</au><au>Ben Salah Frih, Zohra, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Complex Regional Pain Syndrome Type I: Incidence and Risk Factors in Patients With Fracture of the Distal Radius</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2014-03-01</date><risdate>2014</risdate><volume>95</volume><issue>3</issue><spage>487</spage><epage>492</epage><pages>487-492</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>Abstract Objective To examine the incidence and predictors of complex regional pain syndrome type I (CRPS I) after fracture of the distal radius. Design Prospective study. Setting University hospital. Participants A consecutive sample of patients (N=90) with fracture of the distal radius treated by closed reduction and casting. Interventions Not applicable. Main Outcome Measures Occurrence of CRPS I, occurrence of pain, wrist and hand range of motion, radiographic measures, Patient-Rated Wrist Evaluation, Hospital Anxiety and Depression Scale, and Medical Outcomes Study 36-Item Short-Form Health Survey at baseline and 1, 3, 6, and 9 months follow-up. Results CRPS I occurred in 29 patients (32.2%) with a mean delay ± SD of 21.7±23.7 days from cast removal. Univariate analyses found significant differences between patients with CRPS I and patients without CRPS I at baseline for sex ( P =.021), socioeconomic level ( P =.023), type of trauma ( P =.05), pain at rest and activity ( P =.006 and P <.001, respectively), wrist dorsiflexion and pronation ( P =.002 and P =.001, respectively), finger flexion ( P =.047), thumb opposition ( P =.002), function of the hand ( P <.001), and physical quality of life (QOL) ( P =.013). Logistic regression showed that risk for CRPS I was higher in cases of women (odds ratio [OR]=5.774; 95% confidence interval [CI], 1.391–23.966), medium and low energy trauma patients (OR=7.718; 95% CI, 1.136–52.44), patients with a Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning score <40 (OR=4.931; 95% CI, 1.428–17.025), and patients with Patient-Rated Wrist Evaluation pain subscale score >16 (OR=12.192; 95% CI, 4.484–43.478). Conclusions CRPS I occurs frequently during the third and fourth week after cast removal, especially in women who report severe pain and impairment of physical QOL. Additional prospective studies are required to verify these findings in comminuted and operated fractures of the distal radius.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24080349</pmid><doi>10.1016/j.apmr.2013.09.012</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Female Health Status Hospitals, University Humans Incidence Male Middle Aged Pain - etiology Pain - physiopathology Physical Medicine and Rehabilitation Quality of Life Radiography Radius Fractures - complications Radius Fractures - diagnostic imaging Range of Motion, Articular Reflex sympathetic dystrophy Reflex Sympathetic Dystrophy - epidemiology Reflex Sympathetic Dystrophy - etiology Reflex Sympathetic Dystrophy - physiopathology Rehabilitation Risk Factors Sex Factors Socioeconomic Factors Trauma Severity Indices Wrist Joint - diagnostic imaging Wrist Joint - physiopathology |
| title | Complex Regional Pain Syndrome Type I: Incidence and Risk Factors in Patients With Fracture of the Distal Radius |
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