Department of Physical Medicine and Rehabilitation, Dokuz Eylul University Faculty of Medicine, Inciralti, Izmir, Turkey.
Rheumatol Int. 2012 Apr;32(4):915-20. doi: 10.1007/s00296-010-1714-9. Epub 2011 Jan 15.
The aim of this study was to investigate the role of psychological factors in the development of complex regional pain syndrome (CRPS) type I following the fracture of the distal radius. Fifty patients (average age 57.70 ± 13.43 years) with a distal radius fracture were enrolled in the present study. All of the patients were treated by closed reduction and cast immobilization. The Toronto Alexithymia Scale-20, Anxiety Sensitivity Index, State-Trait Anxiety Inventory, and Beck Depression Inventory were used to determine the patients' psychological features 2 days after the fracture. The patients were followed for 2 months after cast immobilization was completed using the International Association for the Study of Pain criteria to diagnose CRPS type I. CRPS type I developed in 13 (26%) patients of the 32 (34.4%) female patients and 18 (11.1%) male patients. The risk of CRPS type I was significantly increased in patients with high trait anxiety scores (P = 0.038). The results show that, after fracturing the distal radius, patients who have an anxious personality have a higher risk of developing CRPS type I. Following these patients closely for the development of CRPS type I may be advantageous for early preventative and therapeutic interventions.
本研究旨在探讨心理因素在桡骨远端骨折后Ⅰ型复杂性区域疼痛综合征(CRPS)发展中的作用。本研究纳入了 50 名(平均年龄 57.70±13.43 岁)桡骨远端骨折患者。所有患者均接受闭合复位和石膏固定治疗。在骨折后 2 天,使用多伦多述情障碍量表-20、焦虑敏感指数、状态-特质焦虑量表和贝克抑郁量表来确定患者的心理特征。在石膏固定完成后 2 个月,根据国际疼痛研究协会的标准诊断Ⅰ型 CRPS。32 名(34.4%)女性患者和 18 名(11.1%)男性患者中有 13 名(26%)患者发展为Ⅰ型 CRPS。特质焦虑得分高的患者发生Ⅰ型 CRPS 的风险显著增加(P=0.038)。结果表明,桡骨远端骨折后,具有焦虑性格的患者发生Ⅰ型 CRPS 的风险更高。密切关注这些患者是否发生Ⅰ型 CRPS 可能有利于早期预防和治疗干预。