ArticleJournal of hand and microsurgery2025
Complex regional pain syndrome of wrist and hand following distal radius fracture: A long-term follow-up study: 16 years (range 10-22 years).
Article in Journal of hand and microsurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The objective of this longitudinal prospective research on distal radius fractures was to identify and analyse impairments resulting from complex regional pain syndrome at long term follow up. Material and methods: The clinical and radiological assessment was performed up to 16 weeks then at 6, 9, 12 months following distal radius fracture for 62 patients of diagnosed complex regional pain syndrome and were treated between 2000 and 2011 at one institute. All patients were invited for re-examination at final long term follow up and the clinical assessment which was performed after an average of 16 years (range 10 years-22 years). Out of the 62 patients 44 (70.9 %) attended for this long term clinical follow up. Women constituted 11 (25.0 %). The main outcome measures were the impairments assessed by standard physical examination, pain, grip strength, vasomotor instability and finger mobility. The mean duration of treatment was 274.4 ± 24.2 days. Results: The mean interval between distal radius fracture, inciting event and the diagnosis complex regional pain syndrome was 2.3 (range 1-5) months. At long term follow-up the pain and tenderness were present in 41 (93.2 %) and 36 (81.8 %) patients, this association was highly significant (chi-square = 29.3, P < 0.001). The prevalence of vasomotor instability was high, in 37 (84.1 %) patients. Grip strength was significantly lower on the affected fracture side than normal hand (57.4 ± 8.2 against 148.2 ± 12.4 mm of Hg, P < 0.001). There was a strong association between all three manifestations of sensory, motor and autonomic features in this study report (p < 0.001. Conclusion: Pain along with loss of full fist muscle strength and restricted activities of daily living were the most evident factors leading to perceived disabilities, at long term follow-up of 16 (range-10 to 22) years after the onset of complex regional pain syndrome. Pain was the most important factor contributing to handicap. This study supports with strong evidence for long term loss of productive effort with prolonged treatment period having most unpredictable functional impairment.
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