title: Factors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture.
abstract: OBJECTIVE
  Wrist fracture is considered a typical initiating trauma for complex regional pain syndrome type I (CRPS I). However, few studies have comprehensively evaluated factors associated with the occurrence of CRPS I after the surgical treatment of a distal radius fracture (DRF). This study evaluates the factors influencing the occurrence of CRPS I after the surgical treatment of a DRF.
  
  
  METHODS
  A total of 477 patients with a DRF who had been treated surgically were enrolled in this prospective observational study. Patients were followed for 6 months after surgery, and CRPS I was diagnosed using the Budapest diagnostic criteria for research. The factors assessed for the development of CPRS I were age, gender, the body mass index, the type of fracture, the energy of trauma, the number of trial reductions, the type of surgery, and the duration of immobilization. A multivariate logistic regression analysis was conducted to identify independent predictors of the occurrence of CRPS I.
  
  
  RESULTS
  Among the 477 patients, 42 (8.8 %) satisfied the Budapest criteria for CRPS I within 6 months of surgery. Female patients developed CRPS I more frequently, and the patients who developed CRPS I were older and more likely to sustain a high energy injury or have a comminuted fracture. According to the multivariate analysis, female patients and those with a high energy trauma or severe fracture type were significantly more likely to develop CRPS I (p = 0.02, 0.01, and 0.01, respectively).
  
  
  CONCLUSIONS
  High energy injuries, severe fractures, and the female gender contribute to the development of CRPS I after the surgical treatment of DRF. The results have important implications for physicians who wish to identify patients at high risk for CRPS I after operative fixation for DRF and instigate treatment accordingly.
authors.affiliation: Department of Orthopaedic Surgery, Gil Medical Center, Gachon University School of Medicine, 1198 Kuwol-dong, Namdong-gu, 405-760, Incheon, Korea.
authors.forename: Young Hak
authors.initials: YH
authors.lastname: Roh
authors.forename: Beom Koo
authors.initials: BK
authors.lastname: Lee
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Noh
authors.forename: Jong Ryoon
authors.initials: JR
authors.lastname: Baek
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Oh
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery*; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D012737:Sex Factors; D014954:Wrist Injuries / Q000601:surgery*