Role of vitamin C in prevention of complex regional pain syndrome after distal radius fractures: a meta-analysis

• Published in: European journal of orthopaedic surgery & traumatology Vol. 25; no. 4; pp. 637 - 641
• Main Authors: Meena, Sanjay, Sharma, Pankaj, Gangary, Shreesh Kumar, Chowdhury, Buddhadev
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-05-2015; Springer Nature B.V
• Subjects: Analgesics - therapeutic use; Ascorbic Acid - therapeutic use; Chronic pain; Complex Regional Pain Syndromes - prevention & control; General Review; Humans; Medicine; Medicine & Public Health; Meta-analysis; Middle Aged; Prevention; Radius Fractures - complications; Randomized Controlled Trials as Topic; Risk Factors; Surgical Orthopedics; Traumatic Surgery; Vitamin C; Reflex sympathetic syndrome; Ascorbic acid; Complex regional pain syndrome; Distal radius fracture; Vitamin C
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-014-1573-2

Background
Complex regional pain syndrome is a well-known complication after distal radius fracture with incidence ranging from 10.5 to 37 %. Some studies recommend the use of vitamin C to prevent complex regional pain syndrome. The objective of this meta-analysis was to evaluate the efficacy of vitamin C in prevention of CRPS.
Methods
We searched the PubMed, EMBASE and Cochrane library databases for randomized controlled trial (RCT) and comparative studies reporting use of vitamin C to prevent distal radius fracture. Dichotomous variable was presented as risk ratio with 95 % confidence intervals.
Results
We obtained 220 articles from the database search. After the exclusion of duplicates, unrelated articles, letter to editor and editorials, we found four articles relevant to our topic. Meta-analysis of the CRPS incidence revealed that the incidence of CRPS was significantly lower in the vitamin C group [RD 0.41 (0.19–0.92),
P
 = 0.03]. There was moderate to high heterogeneity in the studies included
I
2
 = 63 %).
Conclusions
Our analysis showed a significant reduction in prevalence of CRPS with the use of vitamin C. Further high-quality RCTs with standard dosages and common diagnostic criteria are needed to be able to deliver solid conclusions.