Complex Regional Pain Syndrome Related Factors Analysis After Foot And Ankle Surgery

Background:Complex regional pain syndrome (CRPS) is an uncommon complication of orthopedic surgery, may occur in the physical trauma or peripheral and central nervous system lesions. CRPS long history and easy relapse can lead to disability. Pathological, physiological mechanism of CRPS is not very clear. CRPS diagnosis relies on clinical history and clinical manifestations, no diagnostic laboratory and imaging data as a CRPS criteria. Now there is rarely retrieved literature about related factors of complex regional pain occurred after the foot and ankle surgery.Objective:To explore the incidence of CRPS and the occurrence of CRPS factors that undergone of foot and/or ankle surgery.Methods:In the present retrospective study of474patients who had undergone elective foot and/or ankle surgery in Orthopaedic in Lishui Center Hospital from January2010to December2012, selection criteria:1, experienced foot and/ankle surgery,2, by the same surgical team,3, check their records and outpatient phone follow-up after foot and/ankle surgical, to determine coincidence with the International Pain Society symptoms symptom diagnostic criteria (Budapest standards) of "CRPS"(either CRPS I type, reflex sympathetic dystrophy syndrome, or CRPS type Ⅱ, causalgia).Results:A total of474cases of patients screened,28patients postoperative (5.9%) were diagnosed as CRPS. Their average age was49.6±9.1years (34years old to65years), of which women accounted for the majority (N=23,82.14%), interval Surgery to correct diagnosis of CRPS was2.2±4.9months.21cases (75%) is CRPS Ⅰ type, and7(25%) is CRPS Ⅱ type. All patients had pain, and25patients (89.29%) had skin changes. All patients occurred CRPS, of which7cases (25%) underwent ankle surgery,6cases (21.43%) after foot,5(17.86%) in the foot,10cases (35.71%) in the forefoot. Reviewed CRPS patients medical records,17(60.71%) had a history of anxiety or depression, and8(28.57%) were smokers,23cases (82.14) patients were non-farm work (Table3.1).28patients diagnosed with CRPS,23(82.14%) have test results of inflammatory markers available, their white blood cell count and C-reactive protein levels are normal.Conclusions:This study we defined the middle-aged women and those with a history of anxiety or depression, after foot and or/ankle surgery have a greater risk of CRPS.