title: Incidence of Complex Regional Pain Syndrome I Following Foot and Ankle Fractures Using the Budapest Criteria.
abstract: OBJECTIVE : Fractures are a well-recognized inciting event in the development of complex regional pain syndrome. This study aimed to prospectively determine the incidence of complex regional pain syndrome following foot and ankle fractures. METHODS : A prospective study was conducted of patients presenting to two metropolitan hospitals with plain radiograph diagnosis of fractures to the foot or ankle. Patients were initially screened by phone 3 months after injury using the validated International Association for the Study of Pain Budapest criteria. Patients who fulfilled the screening criteria were then physically examined by a pain specialist to assess clinical signs as part of the Budapest criteria. RESULTS : A total of 306 consecutive eligible patients were included. One hundred and ten patients reported at least one symptom of complex regional pain syndrome; however, only three fulfilled the minimum requirements to necessitate clinical review. Of these three, only one patient fulfilled the combination of symptom and sign criteria for a positive diagnosis according to the validated Budapest criteria. The incidence of complex regional pain syndrome following foot and ankle fracture in this study was 0.3%. CONCLUSION : Although many patients may experience vasomotor, sensory, and sudomotor disturbance following a fracture to the foot and ankle, the observed incidence of complex regional pain syndrome using a prospectively collected validated criteria is significantly lower than previously published.
authors.affiliation: *Western Health Department of Orthopaedics, Melbourne, Victoria michael.bullen@wh.org.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Bullen
authors.affiliation: Western Health Department of Anaesthesia and Pain Medicine, Melbourne, Victoria.
authors.forename: Coran
authors.initials: C
authors.lastname: Lang
authors.affiliation: Western Health Head of Department of Orthopaedics, Melbourne, Victoria, Australia.
authors.forename: Phong
authors.initials: P
authors.lastname: Tran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064386:Ankle Fractures / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D018409:Foot Injuries / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012019:Reflex Sympathetic Dystrophy / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Ankle; Complex Regional Pain Syndrome; Foot; Fracture; Incidence; Prospective