Prevention of Complex Regional Pain Syndrome type 1 after conservative reatment of a distal radius fracture with a home exercise program: A proof-of-concept study


complex regional pain syndrome ; reflex symptomatic dystrophy ; distal radius fracture ; home exercise program ; prevention

Published online: Sep 30 2018

Emily Boersma , Henk van de Meent , Jan Paul Frolke

From the University Nijmegen, Medical Center Surgery 618, Nijmegen


Prevention of CRPS-1, a post-traumatic pain syndrome, after a distal radius fracture is important as this syndrome might lead to chronic pain and serious disabilities. In several studies, it was shown that CRPS-1 can be cured with exercise and graded activities.

In a prospective cohort study, a home exercise program with progressive loading exercises was applied immediately after cast removal in patients with a distal radius fracture. After three months, patients were interviewed by telephone using the subjective Budapest diagnostic criteria for CRPS-1. In our study, 56 patients were included and 9 patients (16%) scored positive on the subjective diagnostic criteria. None of the 9 patients was diagnosed with CRPS-1.

This study indicates that a home exercise program after conservative treatment of distal radius fracture is a safe and effective option to prevent CRPS-1. A larger study is needed to prove the preventive power of this home exercise program.

Ethics approval : approved by the local ethics committee of the Radboudumc.

Level of evidence : 3.