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Incidence and risk factors for complex regional pain syndrome in radius fractures: meta-analysis

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

This meta-analysis aimed to evaluate the incidence and risk factors for complex regional pain syndrome (CRPS) in radius fractures.

Methods

The meta-analysis was performed using the PubMed, Embase, Scopus, and Cochrane Collaboration Library databases. Studies focusing on patients with conservative or surgically treated radius fractures leading to CRPS were included. A control group consisting of patients with radius fractures and no CRPS (−) was included. The outcome measures were incidence and risk factors. Comparative studies were also included. Data were combined using Review Manager 5.4.

Results

Out of 610 studies, nine studies were included. The incidence of CRPS after radius fractures ranged from 0.19 to 13.63% (95% CI: 11.12–16.15%). Open fractures, high-energy mechanisms in radial head fractures, and associations with ulnar fractures were risk factors for CRPS [(RR: 0.98; 95% CI: 0.97–1.00), (RR: 0.18; 95% CI: 0.07–0.47), and (RR: 1.25; 95% CI: 1.17–1.35), respectively]. Other risk factors were female sex and high body mass index [(RR: 1.20; 95% CI: 1.05–1.37) and (MD: 1.17; 95% CI: 0.45–1.88)]. Psychiatric factors also increased the incidence of CRPS (RR: 2.04; 95% CI: 1.83–2.28). On the other hand, the type of surgery (external fixation or open reduction and internal fixation) and manipulations; associated comorbidities (diabetes and hypertension) together with tobacco and alcohol abuse; marital status, educational level, employment status, and socioeconomic status were not risk factors (p > 0.05).

Conclusion

The incidence of CRPS in radius fractures was 13.63%. Fractures with greater complexity or greater associated tissue damage, female sex, high BMI, and psychiatric disorders were risk factors for the development of CRPS.

Level of evidence

Meta-analysis of cohort and case series studies; II.

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Data availability

The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author.

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Acknowledgements

We thank the Mediterranean Observatory for Clinical and Health Research (https://omedics.org/) for their statistical assistance with the meta-analysis.

Funding

No funding was received.

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Authors and Affiliations

  1. Department of Traumatology and Orthopaedic Surgery, University Hospital Ramón y Cajal, Madrid, Spain

    Alejandro Lorente

  2. Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Carrer de Quevedo, 2, 46001, València, Valencia, Spain

    Gonzalo Mariscal

  3. Mediterranean Observatory for Clinical and Health Research, Valencia, Spain

    Gonzalo Mariscal

  4. Department of Orthopedic Surgery and Traumatology, University Hospital of Badajoz, Badajoz, Spain

    Rafael Lorente

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Contributions

GM is the corresponding author for this article. Contributor Roles: conceptualization: AL, GM, RL; data curation AL, GM, RL; formal analysis: AL, GM, RL; investigation: AL, GM, RL; methodology: AL, GM, RL; project administration: AL, GM, RL; software: AL, GM, RL; supervision: RL; validation: AL, GM, RL; visualization: AL, GM, RL; writing original draft: JAL., GM, RL; writing–review and editing: AL, GM, RL.

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Correspondence to Gonzalo Mariscal.

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Lorente, A., Mariscal, G. & Lorente, R. Incidence and risk factors for complex regional pain syndrome in radius fractures: meta-analysis. Arch Orthop Trauma Surg 143, 5687–5699 (2023). https://doi.org/10.1007/s00402-023-04909-8

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  • DOI: https://doi.org/10.1007/s00402-023-04909-8

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