Complex Regional Pain Syndrome Type 1 after Fractures of the Distal Radius: A Prospective Study of the Role of Psychological Factors

Abstract

A prospective study was designed to investigate the question "Do patients who develop Complex Regional Pain Syndrome Type 1 (CRPS Type 1) after fracture of the distal radius display different psychological behaviour patterns and/or are more depressive than those who recover uneventfully after this fracture?" Sixty-two patients of mean age 56 years with displaced distal radius fractures were operated on by closed reduction and percutaneous fixation with K-wires. All these patients were examined psychologically on the day after the operation. A series of standardized, self-administered questionnaires was used to assess personality and depression. Fifty of the 62 patients were reassessed at 2 months for symptoms and signs of CRPS Type 1 and a diagnosis of this condition made on clinical grounds. Nine patients (18%) were diagnosed as having CRPS Type 1. There were no significant differences in scores on any of the personality and depression scales between CRPS Type 1 and non-CRPS Type 1 patients. Therefore, patients who eventually developed CRPS Type 1 after radial forearm fracture had neither a unique psychological pattern nor displayed more symptoms of depression than those who recovered uneventfully.

The role of peripheral nerve injections in the diagnosis and treatment of CRPS

“…Female gender can be considered a risk factor for CRPS [15,[18][19][20][23][24][25][26] and, since there is a higher incidence in older patients, the postmenopausal status is also related higher incidence of CRPS [14][15][16]21], although this association could be an epiphenomena linked to higher incidence of fractures and others traumas in this population. However, the common factor in many of these risks may be nerve entrapment.…”

“…Dilek et al [18] also showed that high anxiety was correlated with a higher incidence of CRPS after distal radial fracture. However, others have failed to link anxiety and stress to CRPS [19,20].…”

Distal radius kırıklarına genel bakış ve konservatif tedavisi

“…[41][42][43] Burada; sıkı alçılar, medyan sinirin basısı, medyan veya ulnar sinir yaralanmaları, distal radyoulnar eklemde stabilite bozukluğu, eşlik eden ulna kırık-ları, KBAS oluşmasına yol açabilir. Atkins ve arkadaşla-rı, kırığın şiddeti ile KBAS gelişme sıklığı arasında ilişki bulamazken, Bickerstaff, ciddi kırıklarda KBAS oluşu-munun daha fazla olduğunu belirtmiştir.…”

Quoi de neuf dans le syndrome douloureux régional complexe (SDRC) encore appelé algoneurodystrophie ?

“…La littérature actuelle ne met pas en évidence une origine psychogène ou des traits de personnalité prédisposants dans le SDRC [34,50]. En fait, les patients présentant un SDRC de type 1 présentent les mêmes traits psychologiques et les mêmes taux d'anxiété et de dépression que les patients souffrant de fibromyalgie ou présentant des entorses à répétition [30].…”