760 Complex Regional Pain Syndrome (CRPS) Following Distal Radius Fractures: An Audit to Improve Service Provision to the Distal Radius Fracture Patient Population
V Muddaluru, S Imam, O Daly, A Butler, T O’Donovan, J van der StokAbstract
Aim
Complex regional pain syndrome (CRPS), characterized by severe sensitivity to touch, skin changes, and joint stiffness, is a post-traumatic complication affecting the upper and lower extremities. This audit evaluated numerous clinical endpoints in the management of distal radius fracture (DRF) patients who developed CRPS, with the aim of improving service provision. Clinical endpoints were audited against the BSSH guidelines for DRF management.
Method
DRF patients with CRPS symptoms who underwent hand therapy between January 2023 to October 2024 were included. Clinical endpoints included duration from injury to definitive management and rehabilitation, type and duration of post-injury and post-operative immobilisation, and casting complications.
Results
Thirteen patients (100% female) were identified. Post-injury, all DRFs were immobilized in a backslab. Six patients (46%) were managed conservatively in a full cast for 6-weeks, on average 4-days from injury. Seven patients (54%), all with an intra-articular DRF, underwent surgery on average 6-days for injury, with six (46%) requiring an open reduction and internal fixation (ORIF) and one (8%) managed with closed reduction and percutaneous pinning (CRPP) and full cast. Post-ORIF, Futura splint immobilization was used for five patients (86%) and backslab followed by Futura splint for one patient (14%), with 6-weeks of immobilization on average. Average duration from casting to physiotherapy was 54-days, in comparison to 35-days post-operatively.
Conclusions
Patients with intra-articular DRFs underwent surgery on average 6-days post-injury, while BSSH recommends surgery within 72hrs. The average duration of casting and post-operative immobilization was 6-weeks, whereas BSSH recommends 4-weeks. These findings aim to improve the management of DRFs.