Baseline predictors related to functional outcomes in patients older than sixty years with complex regional pain syndrome type 1 after distal radius fracture treated conservatively: a prospective observational study

• Published in: International orthopaedics Vol. 47; no. 9; pp. 2275 - 2284
• Main Authors: Román-Veas, Javier, Gutiérrez-Monclus, Rodrigo, López-Gil, José Francisco, Valenzuela-Fuenzalida, Juan, Araya-Quintanilla, Felipe, Gutiérrez-Espinoza, Héctor, Hagert, Elizabet
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2023
• Subjects: Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Functional status; Baseline predictors; Radius fractures; Multivariate analysis; Complex regional pain syndrome
• ISSN: 0341-2695; 1432-5195; 1432-5195
• DOI: 10.1007/s00264-023-05880-0

Purpose
This study aimed to analyze baseline predictors of functional outcomes six weeks and at one year follow-up in patients older than 60 years with complex regional pain syndrome type 1 (CRPS I) after distal radius fracture (DRF).
Methods
A total of 120 patients with CRPS I after DRF were prospectively recruited. Presumptive relevant factors were collected and analyzed as potential baseline predictors. Additionally, functional outcomes were assessed at the beginning of physiotherapy treatment, at six weeks after finishing physiotherapy treatment, and at one year follow-up. Patient-Rated Wrist Evaluation; Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire; Jamar dynamometer; and visual analog scale (VAS) were assessed.
Results
All participants completed the study. At 6 weeks, the main results showed an association of lower values of grip strength with female sex (
p
= 0.010), intra-articular DRFs (
p
= 0.030), longer immobilization time (
p
= 0.040), lower levels of physical activity (
p
< 0.001), higher levels of kinesiophobia (
p
= 0.010), and anxiety (
p
= 0.020). At 1-year follow-up, the results showed an association of lower values of DASH with higher BMI (
p
< 0.001) and longer immobilization time (
p
< 0.001); and higher values of VAS showed an association with older age (
p
= 0.010), higher BMI (
p
= 0.010), and lower levels of physical activity (
p
= 0.040).
Conclusion
At six weeks, factors such as BMI, immobilization time, physical activity, and kinesiophobia are associated with lower functional outcomes. Additionally, at one year follow-up, BMI, immobilization time, and physical activity continue to be associated with lower functional outcomes in patients with CRPS I after DRF treated conservatively.