Abstract
Background:Complex regional pain syndrome type I (CRPS) is a symptom-based diagnosis of which the reported incidence varies widely. In daily practice, there appears to be a decrease in incidence of CRPS after a distal radius fracture and in general.Questions/purposes:The aim of this study was to assess the trend in the incidence of CRPS after a distal radius fracture and in general in the Netherlands from 2014 to 2018.Methods:The incidence of CRPS after a distal radius fracture was calculated by dividing the number of confirmed cases of CRPS after distal radius fracture by the total number of patients diagnosed with a distal radius fracture. Medical records of these patients were reviewed. Hospital-based data were used to establish a trend in incidence of CRPS in general. A Dutch national database was used to measure the trend in the incidence of CRPS in the Netherlands by calculating annual incidence rates: the number of new CRPS cases, collected from the national database, divided by the Dutch mid-year population.Results:The incidence of CRPS after distal radius fracture over the whole study period was 0.36%. Hospital data showed an absolute decrease in CRPS cases from 520 in 2014 to 223 in 2018. National data confirmed this with a decrease in annual incidence from 23.2 (95% CI: 22.5–23.9) per 100,000 person years in 2014 to 16.1 (95% CI: 15.5–16.7) per 100,000 person years in 2018.Conclusion:A decreasing trend of CRPS is shown in this study. We hypothesize this to be the result of the changing approach towards CRPS and fracture management, with more focus on prevention and the psychological aspects of disproportionate posttraumatic pain.Level of Evidence:level 3 (retrospective cohort study).
Highlights
Complex regional pain syndrome type I (CRPS), known as posttraumatic dystrophy or Sudeck’s dystrophy, is an unexplained pain syndrome that can occur following a variety of events
A newly opened DBC code for CRPS was interpreted as a suspected case of CRPS, since they are used for validated diagnoses as well as for patients who are seen by a specialist but who are eventually not diagnosed with CRPS
The proportion of suspected cases that were confirmed after review of medical records was 0.67
Summary
Complex regional pain syndrome type I (CRPS), known as posttraumatic dystrophy or Sudeck’s dystrophy, is an unexplained pain syndrome that can occur following a variety of events. We aimed to determine the 5-year trend in the incidence of CRPS after DRF in the Netherlands from hospital data. We aimed to validate this by estimating the 5-year trend in the incidence of CRPS in the Netherlands from both population-based data and hospital data. Questions/purposes: The aim of this study was to assess the trend in the incidence of CRPS after a distal radius fracture and in general in the Netherlands from 2014 to 2018.
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