Abstract
Study Design
Prospective cohort study.
Introduction
Identification of risk factors for CRPS development in patients with surgically treated
traumatic injuries attending hand therapy allows to watch at-risk patients more closely
for early diagnosis and to take precautionary measures as required.
Purpose of the Study
The aim of this study was to evaluate the risk factors for the development of complex
regional pain syndrome (CRPS) after surgical treatment of traumatic hand injuries.
Methods
In this prospective cohort, 291 patients with traumatic hand injuries were evaluated
3 days after surgery and monitored for 3 months for the development of CRPS. The factors
assessed for the development of CRPS were age, sex, manual work, postoperative pain
within 3 days measured on a Pain Numerical Rating Scale (0-10), and injury type (crush
injury, blunt trauma, and cut laceration injury).
Results
CRPS was diagnosed in 68 patients (26.2 %) with a duration of 40.10 ± 17.01 days between
the surgery and CRPS diagnosis. The mean postoperative pain score was greater in patients
with CRPS than in those without CRPS (P < .001). Patients with pain scores ≥ 5 had a high risk of developing CRPS compared
with patients with pain scores <5 (odds ratio: 3.61, confidence interval = 1.94-6.70).
Patients with crush injuries were more likely to develop CRPS (odds ratio: 4.74, confidence
interval = 2.29-9.80).
Conclusions
The patients with a pain score of ≥5 in the first 3 days after surgery and the patients
with crush injury were at high risk for CRPS development after surgical treatment
of traumatic hand injuries.
Level of Evidence
II b.
Keywords
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JHT Read for Credit
Quiz: #545
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- #1.The study design was
- a.RCTs
- b.prospective cohort
- c.retrospective chart reviews
- d.case series
- a.
- #2.The PNRS utilized was
- a.0-100
- b.1-100
- c.1-10
- d.0-10
- a.
- #3.Initial pain scores were recorded at
- a.the day of surgery
- b.3 days pre op
- c.3 days post op
- d.3 weeks post op
- a.
- #4.Tendon repaired patients were treated with
- a.PROM for extensors and AROM for flexors
- b.PROM for flexors and AROM for extensors
- c.PROM for flexors and extensors
- d.AROM for flexors and extensors
- a.
- #5.The authors identified patients with crush injuries or pain scores of 5 or greater as at risk to develop CRPS
- a.true
- b.false
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: May 10, 2017
Accepted:
March 30,
2017
Received:
November 14,
2016
Footnotes
Conflict of interest: none.
Identification
Copyright
© 2017 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.
