Department of Anesthesiology, Wuxi No. 9 People's Hospital Affiliated to Soochow University, Wuxi, China.
Soochow University, Soochow, China.
Orthop Surg. 2022 Jul;14(7):1395-1403. doi: 10.1111/os.13320. Epub 2022 Jun 8.
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.
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 χ 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.
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.
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.
本研究旨在评估行桡骨头关节成形术的桡骨头骨折患者中复杂性区域疼痛综合征 I 型（CRPS I）的比例，并探讨相关因素。
这是一项前瞻性观察性研究。2016 年 3 月至 2019 年 5 月，连续纳入 221 例桡骨头骨折患者进行单侧关节成形术，并完成 1 年随访。所有患者均接受单侧关节成形术治疗。在每次随访时，采用视觉模拟评分法测量患者的疼痛程度。根据布达佩斯标准诊断为 CRPS I 是本研究的主要结局，在基线和 1、3、6 和 9 个月随访时进行收集。基线数据在手术前收集，包括人口统计学和临床数据。采用独立样本 t 检验和 χ 检验作为单变量分析，比较 CRPS I 患者和非 CRPS I 患者的基线数据。采用多变量分析（Backword-Wald）确定与 CRPS I 相关的独立因素。
桡骨头骨折患者行单侧关节成形术后，CRPS I 的发生率为 11%（n=24）。术后 1 个月内共有 19 例（79%）患者被诊断为 CRPS I。多变量逻辑回归分析显示，女性（比值比[OR]：1.537；95%置信区间[CI]：1.138-2.072）、年龄<60 岁（OR：1.682；95%CI：1.246-2.267）、中度和重度 Mayo 肘关节功能评分（MEPS）疼痛（OR：3.229；95%CI：2.392-4.351）和焦虑（OR：83.346；95%CI：61.752-112.320）与 CRPS I 独立相关。
本探索性研究报告桡骨头关节成形术后 CRPS I 的发生率为 11%。女性、年龄较小、中度和重度 MEPS 疼痛和焦虑的患者似乎更容易发生 CRPS I。
