Article

Abstract : Complex regional pain syndrome type I (CRPS-I), previously known as
reflex sympathetic dystrophy, is common after conservatively or surgically
treated wrist fractures. Several studies support the efficacy of vitamin C in
preventing CRPS-I, although the data are somewhat conflicting. The primary
objective of this systematic literature review and meta-analysis was to assess
the efficacy of vitamin C therapy in preventing CRPS-I after a wrist fracture.
METHODS: Randomised, placebo-controlled trials of vitamin C to prevent CRPS-I
after wrist fractures were sought in the three main databases: PubMed (1980 to
December 2015), CENTRAL (Central 2015, number 12), and Embase (1980 to December
2015). Two authors worked independently to select articles. Data from selected
articles were collected independently.
RESULTS: Three randomised
placebo-controlled trials in a total of 875 patients were included. Treatment was
non-operative in 758/890 (85.1%) fractures and operative in 132 (14.9%)
fractures. Vitamin C supplementation was started on the day of the injury and
continued for 50 days. In the group given 500mg of vitamin C daily, the risk
ratio for CRPS-I was 0.54 (95%CI, 0.33-0.91; P=0.02). Thus, the risk of
developing CRPS-I was significantly decreased by prophylactic treatment with
500mg of vitamin C per day. The heterogeneity rate was 65% (non-significant).
CONCLUSION: Daily supplementation with 500mg of vitamin C per day for 50 days
decreases the 1-year risk of CRPS-I after wrist fracture. LEVEL OF EVIDENCE: II,
systematic review of level I and II studies.
CI - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS