Risk Factors and Prevention Strategies for Complex Regional Pain Syndrome Following Fractures: A Scoping Review.

Area of Science:

• Orthopedics
• Pain Management
• Neurology

Background:

• Complex regional pain syndrome (CRPS) is a debilitating neuropathic pain disorder following injury.
• CRPS significantly impairs functional outcomes, yet risk factors and prevention remain poorly understood.
• Fracture management requires effective strategies to mitigate CRPS development.

Purpose of the Study:

• To systematically review evidence on CRPS risk factors after fracture.
• To evaluate existing preventive strategies for CRPS following fractures.
• To identify research gaps in CRPS prevention and risk stratification.

Main Methods:

• Comprehensive literature search of PubMed, Embase, and Scopus databases.
• Inclusion of human studies of any design evaluating CRPS risk factors or prevention post-fracture.
• Narrative synthesis of data extracted by two independent reviewers.

Main Results:

• Thirty-one studies were included in the review.
• Early mobilization and Vitamin C were common preventive strategies, with heterogeneous evidence for Vitamin C.
• Female sex, psychiatric comorbidities, high pain intensity, and fracture severity were key risk factors.

Conclusions:

• Evidence for CRPS prevention post-fracture is limited and varied.
• Early mobilization appears beneficial, but pharmacologic options need further validation.
• Multifactorial risk factors necessitate validated tools for risk stratification and high-quality research.