Complex Regional Pain Syndrome and Factitious Disorders-Testing the Validity of Preventing Complex Regional Pain Syndrome With Vitamin C After Distal Radius Fracture

Testing the Validity of Preventing Complex Regional Pain Syndrome With Vitamin C After Distal Radius Fracture

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The purpose of the article is to test the validity of the American Academy of Orthopaedic Surgeons' recommendation to use vitamin C to prevent complex regional pain syndrome (CRPS) in patients with distal radius fractures (DRFs). The authors conducted a literature review and found 4 relevant articles and 1 systematic review on the topic. Six out of 9 Hill criteria for establishing a causal relationship were met, including strength of association, consistency, biological gradient, experimental evidence, temporality, and analogy. However, criteria like biological plausibility, specificity, and coherence were not met. The authors concluded that there is sufficient epidemiological evidence to support the use of vitamin C in preventing CRPS after DRF. They also noted that vitamin C administration is relatively low-cost and has few complications, except when administered in large doses. The AAOS recommendation of vitamin C to prevent CRPS has practical merit due to the available evidence. However, the authors acknowledged limitations in the methodology and conduct of the included studies, such as selection bias and lack of a reference standard to diagnose CRPS. They recommend future studies to address these limitations and determine the optimal dosage of vitamin C for prevention of CRPS.

Keywords

American Academy of Orthopaedic Surgeons

vitamin C

complex regional pain syndrome

CRPS

distal radius fractures

literature review

systematic review

Hill criteria

epidemiological evidence

low-cost