Complex Regional Pain Syndrome Following Distal Radius Fracture: Does Surgical Method Matter?

Background: The purpose of this study was to compare the risk of complex regional pain syndrome (CRPS) following surgical treatment of distal radius fractures (DRFs) with either a volar locking plate (VLP) or an external fixator (EF). Materials and Methods: Data from two randomized controlled trials (RCTs) were merged and analyzed. A logistic regression analysis was conducted to identify independent risk factors for the occurrence of CRPS. Results: A total of 322 patients were included from the two RCTs; 159 patients were operated upon with VLP and 163 patients with EF. CRPS was diagnosed in 6 patients treated with VLP (4%) and in 16 patients receiving EF (11%), overall 22 cases of CRPS (7%). None of the other independent risk factors had a significant influence on the risk for CRPS (all p  > 0.05). Conclusion: Patients treated with an EF had a higher risk of developing CRPS compared to those treated with a VLP. We found no other independent variable predicting CRPS. Level of evidence: III.