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Algodystrophy (CRPS) in minor orthopedic surgery.

Costantino Corradini1, Claudia Bosizio1, Antimo Moretti2

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Chronic Regional Pain Syndrome (CRPS) is a painful limb disorder following fractures. Early diagnosis and bisphosphonate treatment in the acute phase improve remission rates, while vitamin C and electroanalgesia show preventative and chronic phase benefits.

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Area of Science:

  • Orthopedics
  • Pain Medicine
  • Neurology

Background:

  • Chronic Regional Pain Syndrome (CRPS), also known as algodystrophy, is a debilitating condition often developing after limb fractures.
  • It involves complex mechanisms including bone microvascular changes and sympathetic nervous system dysfunction.
  • CRPS is characterized by disproportionate pain, hyperalgesia, and autonomic and trophic disturbances.

Purpose of the Study:

  • To review the incidence, risk factors, and current treatment strategies for CRPS.
  • To highlight the importance of early diagnosis and intervention for favorable outcomes.
  • To discuss emerging therapeutic options for different phases of the syndrome.

Main Methods:

  • Literature review of CRPS pathogenesis, epidemiology, and clinical management.
  • Analysis of diagnostic challenges and treatment efficacy data.
  • Synthesis of information on pharmacological and non-pharmacological interventions.

Main Results:

  • CRPS incidence varies up to 37%, influenced by fracture severity.
  • Risk factors include female sex, older age, smoking, and reduced bone strength.
  • Early diagnosis correlates with 80-90% remission rates.

Conclusions:

  • Delayed diagnosis significantly contributes to chronic, disabling CRPS complications.
  • Intravenous bisphosphonates are the first-line treatment in acute/subacute phases, yielding high remission rates.
  • Vitamin C may aid prevention, and electroanalgesia shows promise for chronic CRPS management.