A comparison of the accuracy of two sets of diagnostic criteria in the early detection of complex regional pain syndrome following surgical treatment of distal radial fractures.

Abstract

A total of 120 patients were examined for the presence of symptoms of complex regional pain syndrome after surgical treatment of a distal radial fracture. The patients were assessed at six weeks and 71 of them were also assessed at 12 weeks. The International Association for the Study of Pain criteria and the complex regional pain syndrome severity score were used to make the diagnosis. At six weeks, ten patients (8.3%) met the criteria of complex regional pain syndrome in both the International Association for the Study of Pain and complex regional pain syndrome scores. At 12 weeks six patients (8.4%) met International Association for the Study of Pain and two (2.8%) patients the complex regional pain syndrome severity score criteria. Only one of the patients diagnosed with complex regional pain syndrome required treatment for the complex regional pain syndrome. In all the other patients the features of complex regional pain syndrome settled spontaneously. Our results suggest that complex regional pain syndrome after distal radius fractures occurs less frequently than was previously reported. The International Association for the Study of Pain criteria and the complex regional pain syndrome severity scores showed similar sensitivity in early diagnosis of complex regional pain syndrome, but both are poor indicators of the need for treatment.