جستجوی مقالات مرتبط با کلیدواژه "complex regional pain syndrome (crps)" در نشریات گروه "پزشکی"

The inflammatory response following trauma is the possible pathophysiology of complex regional pain syndrome (CRPS) I, caused by the release of pro-inflammatory factors and neuropeptides. Vitamins C and D are two antioxidants that can effectively prevent the occurrence of CRPS I.

The primary aim of this study was to compare the effectiveness of vitamins C and D in preventing the occurrence of CRPS following the fixation of distal radius fractures.

The study was performed from January 1, 2018 to the end of December 2019. Patients who had fractured distal radius were candidates for external fixation and PCP. The patients were divided into three groups: 1) Receiving 500 mg of vitamin C daily for 50 days, 2) Receiving an oral dose of vitamin D of 5000 IU weekly for 50 days, and 3) Receiving no complementary medicine (control group). 

Of the 150 fractures, 62 type C3, 56 type C2, and 32 type C1 were observed, constituting 41.3%, 37.3%, and 21.3% of the total. During the two follow-up sessions, CRPS occurred in 28 patients (18.7%). Among the 28 patients mentioned, 14 patients (50%) belonged to group C, 8 patients (28.6%) belonged to group B, and 6 patients (21.4%) belonged to group A. 

The use of vitamins C and D reduced the incidence of CRPS in patients with distal radius fractures. Also, the use of these vitamins was significantly effective in improving CRPS and reducing pain and ROM limitation.

 Complex regional pain syndrome (CRPS) is characterized by extreme pain in a limb disproportional to the clinical history or physical findings accompanied by the signs of autonomic dysfunction. The pathophysiology of CRPS is obscure, making it challenging to treat. Treatment options include medications, physical therapy, and psychological support. In some cases, surgery or other minimally-invasive procedures such as nerve blocks may be recommended, while several novel treatments, such as ozone therapy, lack sufficient clinical evidence.

 A 40-year-old man with CRPS was referred to our clinic with pain in his right arm and left lower leg. The patient had a history of trauma to the ulnar nerve and had undergone a sural to ulnar nerve autograft surgery. After the surgery, the patient’s symptoms began, primarily in the right arm. Despite receiving conventional drugs, multiple nerve blocks, and lidocaine patches, the patient’s symptoms persisted. In addition, we tried medical ozone for 14 sessions along with ketamine infusion, but these treatments were also ineffective.

 We emphasize the importance of studying and developing more effective treatments for CRPS and suggest that further randomized clinical trials are needed to determine whether ozone therapy is effective for patients with severe, intractable CRPS symptoms.