Persistent pain is common 1 year after ankle and wrist fracture surgery: a register-based questionnaire study.
BACKGROUND
Substantial literature documents that persistent postsurgical pain is a possible outcome of many common surgical procedures. As fracture-related surgery implies a risk of developing neuropathic pain and complex regional pain syndrome (CRPS), further studies investigating the prevalence and pain characteristics are required.


METHODS
All patients undergoing primary surgery because of ankle or wrist fracture at Hvidovre and Odense University Hospitals, Denmark, between April 15, 2013 and April 15, 2014, were identified from the Danish Fracture Database. A questionnaire regarding pain characteristics was sent to patients 1 yr after primary surgery.


RESULTS
Replies were received from 328 patients, of whom 18.9% experienced persistent postsurgical pain defined as pain daily or constantly at a level that interfered much or very much with daily activities, 42.8% reported symptoms suggestive of neuropathic pain, and 4.0% fulfilled the diagnostic patient-reported research criteria for CRPS.


CONCLUSIONS
Persistent postsurgical pain 1 yr after wrist and ankle fracture surgery is frequent, and a large proportion of patients experience symptoms suggestive of neuropathic pain and CRPS. Patients should be informed about the substantial risk of developing persistent postsurgical pain. Future studies investigating risk factors for persistent postsurgical pain that include both surgically and conservatively treated fractures are required.
Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Noerrebrogade 44, Building 1A, Aarhus 8000, Denmark Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark k.friesgaard@clin.au.dk.
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Friesgaard
Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
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Gromov
Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Noerrebrogade 44, Building 1A, Aarhus 8000, Denmark.
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Knudsen
Department of Orthopaedic Surgery, Odense University Hospital, Odense C, Denmark.
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Brix
Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
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Troelsen
Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Noerrebrogade 44, Building 1A, Aarhus 8000, Denmark Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark.
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Nikolajsen
D000328:Adult; D000368:Aged; D064386:Ankle Fractures / Q000453:epidemiology / Q000601:surgery*; D059350:Chronic Pain / Q000453:epidemiology / Q000209:etiology*; D020918:Complex Regional Pain Syndromes / Q000453:epidemiology / Q000209:etiology; D016208:Databases, Factual; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D050723:Fractures, Bone / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000453:epidemiology / Q000209:etiology; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000453:epidemiology*; D015995:Prevalence; D012042:Registries; D011795:Surveys and Questionnaires; D014954:Wrist Injuries / Q000453:epidemiology / Q000601:surgery*
chronic pain; orthopaedics; pain; postoperative