Author:
Zollinger Paul E.,Kreis Robert W.,van der Meulen Hub G.,van der Elst Maarten,Breederveld Roelf S.,Tuinebreijer Wim E.
Abstract
Operative and conservative treatment of wrist fractures might lead to complex regional pain syndrome (CRPS) type I.In our multicenter dose response study in which patients with distal radial fractures were randomly allocated to placebo or vitamin C in a daily dose of 200mg, 500mg or 1500mg during 50 days, an operated subgroup was analyzed.48 (of 427) fractures) were operated (11.2%). Twenty-nine patients (60%) were treated with external fixation, 14 patients (29%) with K-wiring according to Kapandji and five patients (10%) with internal plate fixation. The 379 remaining patients were treated with a plaster.In the operated group of patients who received vitamin C no CRPS (0/37) was seen in comparison with one case of CRPS (Kapandji technique) in the operated group who received placebo (1/11 = 9%, p=.23). There was no CRPS after external fixation.In the conservatively treated group 17 cases of CRPS (17/379 = 4.5%) occurred in comparison with one in case of CRPS in the operated group (1/48 = 2.1%, p=.71).External fixation doesn’t necessarily lead to a higher incidence of CRPS in distal radial fractures. Vitamin C may also play a role in this. This subgroup analysis in operated distal radial fractures showed no CRPS occurrence with vitamin C prophylaxis.
Publisher
Bentham Science Publishers Ltd.
Reference25 articles.
1. Atkins RM, Duckworth T, Kanis JA. Features of algodystrophy after Colles' fracture J Bone Joint Surg Br 1990; 72 : 105-.
2. Dijkstra PU, Groothoff JW, Duis ten HJ, Geertzen JHB. Incidence of complex regional pain syndrome type I after fractures of the distal radius Eur J Pain 2003; 7 : 457-62.
3. Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: A randomised trial Lancet 1999; 354 : 2025-8.
4. Raay van JJAM, Boot C, Oostvogel HJM, Werken van der C. External fixation of unstable distal radius fractures (Article in Dutch with English summary) Ned Tijdschr Geneeskd 1990; 134 : 1607-1.
5. Hegeman JH, Oskam J, Palen van der J, Ten Duis ten HJ, Vierhout PAM. Primary external fixation of the intra-articular unstable distal radial fracture in the elderly Akt Traumatol 2004; 34 : 64-70.
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献