https://doi.org/10.4081/ejtm.2019.8643
A randomized controlled trial on Aspirin and complex regional pain syndrome after radius fractures
Submitted: 28 October 2019
Accepted: 24 November 2019
Published: 1 April 2020
Accepted: 24 November 2019
Abstract Views: 1415
PDF: 792
HTML: 13
HTML: 13
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Complex regional pain syndrome (CRPS) is often diagnosed in patients who are recovered with surgery or injury. CRPS is usually diagnosed in patients recovering from distal radius fractures. The aim of study was the effects of aspirin in prevention of the complex regional pain syndrome (CRPS) following a fracture of distal radius. In a double-blind, randomized controlled trial, 91 patients with unilateral extra-articular distal radius fractures were randomly allocated to receive either placebo (PLA) or 500 mg of aspirin (ASA) daily for 7 days. The effect of aspirin on the occurrence of CRPS was evaluated. The patients were assessed clinically and radiographically in the second, fourth and twelfth weeks by a physician who was unaware of the treatment allocation. Ninety-one patients (ASA, n=44; PLA, n=47) were enrolled in the study. The prevalence of CRPS in all patients was 16.5%. The prevalence of CRPS in the aspirin group was lower (13.6%) than the placebo group (19.1%), but this difference was not statistically significant. The only significant difference was the lower rate of regional osteoporosis seen in the radiographs of aspirin group. Mean age was significantly higher in the patients with CRPS. Also, comminuted distal radius fractures (A3-type) were significantly more common in the patients with CRPS. Administration of aspirin in patients with a distal radius fracture was associated with a lower incidence of CRPS, but, not statistically significant. Further investigations needs to be done with a larger sample size, longer follow-up period and multi-center design.
Shah, A.S., M.K. Verma, and P.J. Jebson, Use of oral vitamin C after fractures of the distal radius. Journal of Hand Surgery, 2009. 34(9): p. 1736-1738.
DOI: https://doi.org/10.1016/j.jhsa.2009.08.013
Goh, E.L., S. Chidambaram, and D. Ma, Complex regional pain syndrome: a recent update. Burns & trauma, 2017. 5(1): p. 2.
DOI: https://doi.org/10.1186/s41038-016-0066-4
Harden, R.N., et al., Validation of proposed diagnostic criteria (the "Budapest Criteria") for Complex Regional Pain Syndrome. Pain, 2010. 150(2): p. 268-74.
DOI: https://doi.org/10.1016/j.pain.2010.04.030
Goh, E.L., S. Chidambaram, and D. Ma, Complex regional pain syndrome: a recent update. Burns Trauma, 2017. 5: p. 2.
Hooshmand, H., E.M. Phillips, and F. Vero Beach, COMPLEX REGIONAL PAIN SYNDROME (CRPS) REFLEX SYMPATHETIC DYSTROPHY (RSD) DIAGNOSIS AND MANAGEMENT PROTOCOL.
Mackey, S. and S. Feinberg, Pharmacologic therapies for complex regional pain syndrome. Current pain and headache reports, 2007. 11(1): p. 38-43.
Marinus, J., et al., Clinical features and pathophysiology of complex regional pain syndrome. Lancet Neurol, 2011. 10(7): p. 637-48.
DOI: https://doi.org/10.1016/S1474-4422(11)70106-5
Zhao, Z., et al., Spinal cyclooxygenase-2 is involved in development of allodynia after nerve injury in rats. Neuroscience, 2000. 97(4): p. 743-8.
DOI: https://doi.org/10.1016/S0306-4522(00)00052-X
Syriatowicz, J.P., et al., Hyperalgesia due to nerve injury: role of prostaglandins. Neuroscience, 1999. 94(2): p. 587-94.
DOI: https://doi.org/10.1016/S0306-4522(99)00365-6
Mackey, S. and S. Feinberg, Pharmacologic therapies for complex regional pain syndrome. Curr Pain Headache Rep, 2007. 11(1): p. 38-43.
DOI: https://doi.org/10.1007/s11916-007-0020-z
Ossipov, M.H., et al., Differential effects of spinal (R)-ketoprofen and (S)-ketoprofen against signs of neuropathic pain and tonic nociception: evidence for a novel mechanism of action of (R)-ketoprofen against tactile allodynia. Pain, 2000. 87(2): p. 193-9.
DOI: https://doi.org/10.1016/S0304-3959(00)00280-3
Arif, H. and S. Aggarwal, Salicylic Acid (Aspirin), in StatPearls [Internet]. 2019, StatPearls Publishing.
Lanas, A., et al., Short-Term Acetylsalicylic Acid (Aspirin) Use for Pain, Fever, or Colds—Gastrointestinal Adverse Effects. Drugs in R & D, 2011. 11(3): p. 277-288.
DOI: https://doi.org/10.2165/11593880-000000000-00000
Harden, R.N., et al., Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med, 2007. 8(4): p. 326-31.
DOI: https://doi.org/10.1111/j.1526-4637.2006.00169.x
Sebastin, S.J., Complex regional pain syndrome. Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 2011. 44(2): p. 298-307.
DOI: https://doi.org/10.4103/0970-0358.85351
Bruehl, S. and O.Y. Chung, Psychological and behavioral aspects of complex regional pain syndrome management. The Clinical journal of pain, 2006. 22(5): p. 430-437.
DOI: https://doi.org/10.1097/01.ajp.0000194282.82002.79
Crijns, T.J., et al., Complex regional pain syndrome after distal radius fracture is uncommon and is often associated with fibromyalgia. Clinical orthopaedics and related research, 2018. 476(4): p. 744.
DOI: https://doi.org/10.1007/s11999.0000000000000070
Pepper, A., et al., Changes resembling complex regional pain syndrome following surgery and immobilization. The Journal of Pain, 2013. 14(5): p. 516-524.
DOI: https://doi.org/10.1016/j.jpain.2013.01.004
Zollinger, P., et al., Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures?: A randomized, controlled, multicenter dose-response study. JBJS, 2007. 89(7): p. 1424-1431.
DOI: https://doi.org/10.2106/00004623-200707000-00003
Atkins, R.M., Principles of complex regional pain syndrome. Fractures in Adults. 7th edn. Philadelphia: Lippincott Williams & Wilkins, 2011.
Demir, S.E., et al., Risk factors for complex regional pain syndrome in patients with traumatic extremity injury. Ulus Travma Acil Cerrahi Derg, 2010. 16(2): p. 144-8.
Roh, Y.H., et al., Factors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture. Arch Orthop Trauma Surg, 2014. 134(12): p. 1775-81.
DOI: https://doi.org/10.1007/s00402-014-2094-5
Ortiz-Romero, J., et al., FACTORS ASSOCIATED WITH COMPLEX REGIONAL PAIN SYNDROME IN SURGICALLY TREATED DISTAL RADIUS FRACTURE. Acta Ortop Bras, 2017. 25(5): p. 194-196.
DOI: https://doi.org/10.1590/1413-785220172505165544
Jellad, A., S. Salah, and Z. Ben Salah Frih, Complex regional pain syndrome type I: incidence and risk factors in patients with fracture of the distal radius. Arch Phys Med Rehabil, 2014. 95(3): p. 487-92.
DOI: https://doi.org/10.1016/j.apmr.2013.09.012
Jo, Y.-H., et al., Incidence of and Risk Factors for Complex Regional Pain Syndrome Type 1 after Surgery for Distal Radius Fractures: A Population-based Study. Scientific reports, 2019. 9(1): p. 4871.
DOI: https://doi.org/10.1038/s41598-019-41152-x
de Mos, M., et al., Medical history and the onset of complex regional pain syndrome (CRPS). Pain, 2008. 139(2): p. 458-66.
DOI: https://doi.org/10.1016/j.pain.2008.07.002
Chung, K.C. and A.L. Mathews, Management of Complications of Distal Radius Fractures. Hand clinics, 2015. 31(2): p. 205-215.
DOI: https://doi.org/10.1016/j.hcl.2014.12.002
Zyluk, A., Complex regional pain syndrome type I. Risk factors, prevention and risk of recurrence. J Hand Surg Br, 2004. 29(4): p. 334-7.
DOI: https://doi.org/10.1016/J.JHSB.2004.01.003
Cao, Y., et al., Aspirin promotes bone marrow mesenchymal stem cell-based calvarial bone regeneration in mini swine. Stem Cell Res Ther, 2015. 6: p. 210.
Du, M., et al., [Effect of aspirin on cell biological activities in murine bone marrow stromal cells]. Zhonghua Kou Qiang Yi Xue Za Zhi, 2016. 51(3): p. 160-5.
Chin, K.Y., A Review on the Relationship between Aspirin and Bone Health. J Osteoporos, 2017. 2017: p. 3710959.
Carbone, L.D., et al., Association between bone mineral density and the use of nonsteroidal anti-inflammatory drugs and aspirin: impact of cyclooxygenase selectivity. J Bone Miner Res, 2003. 18(10): p. 1795-802.
DOI: https://doi.org/10.1359/jbmr.2003.18.10.1795
Lane, N.E., et al., Aspirin and nonsteroidal antiinflammatory drug use in elderly women: effects on a marker of bone resorption. The Study of Osteoporotic Fractures Research Group. J Rheumatol, 1997. 24(6): p. 1132-6.
Bauer, D.C., et al., Aspirin and NSAID use in older women: effect on bone mineral density and fracture risk. Study of Osteoporotic Fractures Research Group. J Bone Miner Res, 1996. 11(1): p. 29-35.
DOI: https://doi.org/10.1002/jbmr.5650110106
Lack, W.D., et al., Effect of aspirin on bone healing in a rabbit ulnar osteotomy model. J Bone Joint Surg Am, 2013. 95(6): p. 488-96.
DOI: https://doi.org/10.2106/JBJS.L.00462
David Clark, J., et al., Autoinflammatory and autoimmune contributions to complex regional pain syndrome. Molecular pain, 2018. 14: p. 1744806918799127.
Van der Laan, L., et al., Complex regional pain syndrome type I (RSD): pathology of skeletal muscle and peripheral nerve. Neurology, 1998. 51(1): p. 20-25.
DOI: https://doi.org/10.1212/WNL.51.1.20
van der Laan, L., et al., Soft tissue repair capacity after oxygen-derived free radical-induced damage in one hindlimb of the rat. Journal of Surgical Research, 1997. 72(1): p. 60-69.
DOI: https://doi.org/10.1006/jsre.1997.5167
Atkins, R.M., Complex Regional Pain Syndrome, in Rockwood and Green's Fractures in Adults. 2015.
Koseoglus, M.H., et al., Effects of Aspirin on Serum Total Antioxidant Activity in A Short Term Period. Siriraj Medical Journal, 2014. 66(2).
Demirci, B., et al., Antioxidative effect of aspirin on vascular function of aged ovariectomized rats. Age, 2014. 36(1): p. 223-229.
DOI: https://doi.org/10.1007/s11357-013-9569-0
Podhaisky, H.P., et al., Aspirin protects endothelial cells from oxidative stress--possible synergism with vitamin E. FEBS Lett, 1997. 417(3): p. 349-51.
DOI: https://doi.org/10.1016/S0014-5793(97)01307-0
Ristimae, T., et al., Effect of low-dose aspirin on the markers of oxidative stress. Cardiovasc Drugs Ther, 1999. 13(6): p. 485-90.
DOI: https://doi.org/10.1023/A:1007867402152
How to Cite
Eraghi, A. . S., Khazanchin, A., Hosseinzadeh, N., & Pahlevansabagh, A. (2020). A randomized controlled trial on Aspirin and complex regional pain syndrome after radius fractures. European Journal of Translational Myology, 30(1), 202–209. https://doi.org/10.4081/ejtm.2019.8643
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.