A randomized controlled trial on Aspirin and complex regional pain syndrome after radius fractures

Abstract

Background: Complex regional pain syndrome (CRPS) is often diagnosed in patients who are recovered with surgery or injury. CRPS is usually diagnosed in patients recovering from distal radius fractures. The aim of study was the effects of aspirin in prevention of the complex regional pain syndrome (CRPS) following a fracture of distal radius.
 Material & methods: In a double-blind, randomized controlled trial, 91 patients with unilateral extra-articular distal radius fractures were randomly allocated to receive either placebo (PLA) or 500 mg of aspirin (ASA) daily for 7 days. The effect of aspirin on the occurrence of CRPS was evaluated. The patients were assessed clinically and radiographically in the second, fourth and twelfth weeks by a physician who was unaware of the treatment allocation.
 Results: Ninety-one patients (ASA, n=44; PLA, n=47) were enrolled in the study. The prevalence of CRPS in all patients was 16.5%. The prevalence of CRPS in the aspirin group was lower (13.6%) than the placebo group (19.1%), but this difference was not statistically significant. The only significant difference was the lower rate of regional osteoporosis seen in the radiographs of aspirin group. Mean age was significantly higher in the patients with CRPS.Also, comminuted distal radius fractures (A3-type) were significantly more common in the patients with CRPS.
 Conclusions: Administration of aspirin in patients with a distal radius fracture was associated with a lower incidence of CRPS, but, not statistically significant. Further investigations needs to be done with a larger sample size, longer follow-up period and multi-center design

Treatment Modalities of Complex Regional Pain Syndrome After Hand Surgery a Systematic Review and Meta-Analysis Study

“…In addition to the above findings, the current review reported that the disease subtype was warm (237), cold (52), NA (21) as regard localization was Upper limb in (158) cases and Lower limb in (119) cases, as regard Predisposing event was either due to distal radius fractures, wrist fracture, other surgery, carpal tunnel surgical intervention, cervical spine, extraarticular distal radius fractures, Ischemic cerebral infarction, Hemorrhagic cerebral infarction, Traumatic brain injury, Carpal tunnel syndrome surgery, In this research, crushing injuries were the most prevalent kind of injury, followed by clean-cut injuries, traction injuries, and gunshot injuries. Jankovic, 28 was conducted and reported that the average age of CRPS patients is 36 to 46 years old, with women accounting for 60% to 80% of cases.…”

“…Another research by Eraghi et al 21 was done at Rasoul Akram Hospital in Tehran, Iran, from August 2016 to September 2017. It was a double-blind, randomized controlled experiment.…”

“…In research by Eraghi et al, 21 a total of 103 patients with unilateral, extra-articular distal radius fractures took part in the research for 14 months. Fifty-one individuals were given aspirin and the other fifty-two were given placebos.…”

“…Disease subtype was warm(237), cold (52), NA (21) as regard localization was Upper limb in (158) cases and Lower limb in (119) cases, as regard Predisposing event was either due to distal radius fractures, wrist fracture, other surgeries, carpal tunnel surgical intervention, cervical spine, Ischemic cerebral infarction, Hemorrhagic cerebral infarction, Traumatic brain injury, as shown in (Table 5).…”

Complex Regional Pain Syndrome: A Comprehensive Review

“…However, current studies have demonstrated no evidence to support the use of NSAIDs [ 58 ]. A recent 2020 double-blind RCT of 91 patients with distal radius fractures found a slightly lower incidence of CRPS in patients who took a 7-day course of 500 mg aspirin, but it was not statistically significant [ 59 ]. One high-quality RCT of 60 patients demonstrated a positive effect of oral prednisolone compared to the NSAID piroxicam on CRPS symptoms following stroke, although the study groups exhibited some baseline differences [ 60 ].…”