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Observational Study
. 2022 Jul;14(7):1395-1403.
doi: 10.1111/os.13320. Epub 2022 Jun 8.

Determinants of Complex Regional Pain Syndrome Type I among Radial Head Fracture Patients with Unilateral Arthroplasty

Ye Wang  1 , Menglu Jiang  1   2 , Xu Dai  1 , Qin Zhang  1
Affiliations
Observational Study

Determinants of Complex Regional Pain Syndrome Type I among Radial Head Fracture Patients with Unilateral Arthroplasty

Ye Wang et al. Orthop Surg. 2022 Jul.

Abstract

Objective: This study aims to assess the proportions of complex regional pain syndrome type I (CRPS I) in radial head fracture patients undergoing unilateral arthroplasty and to explore associated factors.

Methods: This is a prospective observational study. From March 2016 to May 2019, a total of 221 adult patients with radial head fracture patients were included in consecutive studies and completed the 1-year follow-up. All patients were treated by unilateral arthroplasty. At each follow-up visit, the visual analogue scale was used to measure patients' pain level. Occurrence of CRPS I, which was diagnosed by Budapest criteria, was the main outcome collected at baseline and the 1-, 3-, 6-, and 9-month follow-ups. The baseline data were collected before surgery and included demographic and clinical data. Independent t-tests and χ2 tests were used as univariate analyses to compare the baseline data of patients with and without CRPS I. Multivariate analysis (Backword-Wald) was used to identify factors independently associated with CRPS I.

Results: The proportion of CRPS I cases among radial head fracture patients undergoing unilateral arthroplasty was 11% (n = 24). A total of 19 (79%) patients were diagnosed with CRPS I within 1 month after surgery. Multivariable logistic regression analysis revealed that female gender (odds ratios [OR]: 1.537; 95% confidence interval [CI]: 1.138-2.072), age younger than 60 years (OR: 1.682; 95% CI: 1.246-2.267), moderate and severe Mayo Elbow Performance Score (MEPS) pain (OR: 3.229; 95% CI: 2.392-4.351) and anxiety (OR: 83.346; 95% CI: 61.752-112.320) were independently associated with CRPS I.

Conclusions: This exploratory study reported that the incidence of CRPS I developing after radial head arthroplasty was 11%. Female sex, younger age, moderate and severe MEPS pain and anxiety patients seems more likely to develop CRPS I.

Keywords: Arthroplasty; Complex regional pain syndromes; Fractures; Logistic models; Radial heads.

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Figures

Fig. 1
Fig. 1
Postoperative anteroposterior (A) and lateral (B) radiographs (radial head prosthesis; Wright Medical Technology, Memphis, TN, USA).
Fig. 2
Fig. 2
Flow chart of patient inclusion in the present study: radial head fracture patients underwent prosthesis treatment and completed the 1‐year follow‐up.
Fig. 3
Fig. 3
Determinants of complex regional pain syndrome type I among radial head fracture patients with unilateral arthroplasty.
See this image and copyright information in PMC

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