Role of vitamin C in prevention of complex regional pain syndrome after distal radius fractures: a meta-analysis

Eur J Orthop Surg Traumatol. 2015 May;25(4):637-41. doi: 10.1007/s00590-014-1573-2. Epub 2014 Dec 9.

Abstract

Background: Complex regional pain syndrome is a well-known complication after distal radius fracture with incidence ranging from 10.5 to 37 %. Some studies recommend the use of vitamin C to prevent complex regional pain syndrome. The objective of this meta-analysis was to evaluate the efficacy of vitamin C in prevention of CRPS.

Methods: We searched the PubMed, EMBASE and Cochrane library databases for randomized controlled trial (RCT) and comparative studies reporting use of vitamin C to prevent distal radius fracture. Dichotomous variable was presented as risk ratio with 95 % confidence intervals.

Results: We obtained 220 articles from the database search. After the exclusion of duplicates, unrelated articles, letter to editor and editorials, we found four articles relevant to our topic. Meta-analysis of the CRPS incidence revealed that the incidence of CRPS was significantly lower in the vitamin C group [RD 0.41 (0.19-0.92), P = 0.03]. There was moderate to high heterogeneity in the studies included I (2) = 63 %).

Conclusions: Our analysis showed a significant reduction in prevalence of CRPS with the use of vitamin C. Further high-quality RCTs with standard dosages and common diagnostic criteria are needed to be able to deliver solid conclusions.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Analgesics / therapeutic use*
  • Ascorbic Acid / therapeutic use*
  • Complex Regional Pain Syndromes / prevention & control*
  • Humans
  • Middle Aged
  • Radius Fractures / complications*
  • Randomized Controlled Trials as Topic
  • Risk Factors

Substances

  • Analgesics
  • Ascorbic Acid