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Author | Number of initial sample | Outcome measure listed in italics followed by instrument used | Result for risk towards the onset of CRPS 1 | Diagnostic criteria used for CRPS 1 diagnosis | Number in sample lost to follow-up, declined to participate, or study attrition (%) | Follow-up period |
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Harden et al. 2003 [32] | 77 patients for total knee replacement | Pain intensity: McGill Pain Questionnaire Depression: Beck Depressive Inventory Anxiety: trait form of the State Trait Anxiety Inventory | CRPS 1-like symptoms following total knee replacement were not predicted by preoperative psychological distress or pain levels | IASP | 26 (33.7%) | 6 months |
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Schürmann et al. 2000 [33] | 27 distal radial fracture patients | Oedema: Likert scale Active ROM: Likert scale Sympathetic function: laser Doppler flowmetry, inspiratory gasp test, and contralateral cooling test Age or gender is NOT included in analyses | Failure of the sympathetic nervous system predicted those who developed CRPS 1 in the early stages of patients who had radial fractures and also possibly suffer from a systemic sympathetic dysfunction that is not limited to the affected limb | IASP | None | 12 weeks |
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Puchalski and Zyluk 2005 [34] | 121 distal radial fractures Population group: postmenopausal women, retired, or disability pensioners | Personality traits: Eysenck Personality Questionnaire Depression: Beck Depressive Inventory if <60 years of age or Yesavage’s Geriatric Depression Scale CRPS 1 severity: Zyluk scoring system | In 62 patients with distal radial fractures, 18% developed CRPS 1 (8 females, one male) Their psychological behaviour patterns or depression did not differ with those who had not developed CRPS 1 | Veldman and Zyluk CRPS 1 scoring system | 59 (48.7%) refuse permission for psychological examination Of 62 patients included, 12 (19.4%) were lost to follow-up | 20 months |
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Beerthuizen et al. 2012 [35] | 748 wrist or ankle fractures | Health related quality of life: SF-36 survey Medical fracture details: type, location of fracture with type of fracture and treatment or number of weeks in plaster | Of 596 patients with wrist or ankle fractures, 7% developed CRPS 1; wrist or ankle fracture dislocation and intra-articular fracture contributed significantly to the likelihood of the development of CRPS 1; one year following the fracture, no CRPS 1 patient was pain-free; the highest majority of patients were females (73%); the highest incidence was between 61 and 70 years of age; early reporting of high levels of pain and other musculoskeletal comorbidities made the risk of CRPS 1 more likely | 3 sets of criteria: Veldman, IASP, and Harden/Bruehl as well as confirmation with experienced clinician | 152 (20.3%) decline consent 46 (18.6%) are lost to follow-up | 1 year |
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Dijkstra et al. 2003 [36] | 91 distal radius fractures | Pain: Visual Analogue Scale Stressful events beforefracture: Social Readjustment Rating Scale | Only one female patient (age 69 years) developed CRPS 1 after a follow-up of 88 patients | IASP | 3 are lost to follow-up | 1 year |
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Dilek et al. 2012 [37] | 74 with distal radius fractures treated with closed reduction and plaster casts | Psychological assessment: Anxiety Sensitivity Index, Toronto Alexithymia Scale-20, State Trait Anxiety Inventory, and Beck Depression Inventory | In 50 patients, a high risk for developing CRPS 1 was found in those with a high anxiety personality trait score; of the 50 patients, 26% (13/50) developed CRPS 1; 34% of the females (age 62.38 ± 10.8) developed CRPS; 11% of the males developed CRPS 1 | IASP | 13 (17.6%) refuse permission for psychological examination; 4 (5%) are excluded due to needing surgery; 7 (9%) are lost to follow-up | 16 months |
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Jellad et al. 2014 [38] | 121 consecutive patients with fractures of the distal radius treated conservatively | Pain: Visual Analogue Scale Active rangeof motion: Goniometer and Kapandji distance Hand and wrist function: Patient Related Wrist Evaluation Depression or Anxiety: Arabic adaption of Hospital Anxiety and Depression scale Quality of Life: Arabic adaption of SF-36 | CRPS 1 occurred in 32.2% of patients, mostly females (age 52.9. ± 13.2) [odds ratio 5.774 95% CI 1.391–23.966]; these also reported severe pain and impairment of quality of life where the CRPS 1 onset occurred in the third and fourth week after cast removal | Veldman | 31 (25.6%) excluded as treated operatively or other problems | 9 months |
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Goris et al. 2007 [39] | 114 distal radius fractures 95 females, 19 males, mean age of 62 years (range 22–82 years) | Medical fracture details: type, location of fracture with type of fracture and treatment or number of weeks in plaster Skin temperature: infrared ear thermometer and ThermaCAM E2 infrared camera Oedema: custom made device for measuring accurate finger circumference Active range of motion: Goniometer Skin colour: subjective Likert scale Grip strength: dynamometer Blood analysis: venous blood samples for lactate and oxygen saturation | CRPS 1 onset was associated with an increased regional inflammatory score (sensitivity 100%, specificity 16%); it was not associated with raised inflammatory markers in the blood; age and gender not included in published analyses | IASP and Harden/Bruehl criteria | 25 (21.9%) are lost to follow-up | 1 year |
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Gradl and Schürmann 2005 [40] | 10 CRPS patients, 4 males and 6 females, age 53–79 years with average age of 62 years | Sympathetic function: laser Doppler flowmetry, inspiratory gasp test, and contralateral cooling test | Dysfunction of the sympathetic nervous system evident in the early stage of CRPS 1 was measured in this German study; this dysfunction was transitory; it normalised over the course of the syndrome; the diagnosis of CRPS 1 was able to be made 46 to 72 days following an injury | Harden/Bruehl | None | 3 months |
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Moseley et al. 2014 [41] | 1549 near consecutive patients with radial fractures across 3 hospital out-patients | Pain: NRS Reaction time: seconds Dysynchiria: absent or present Swelling: affected thumb and first 3 fingers’ circumference as a proportion of unaffected hand Catastrophising: Pain Catastrophising Scale | A pain score of ≥5 in the first week of fracture is shown to be predictive and should be considered a “red flag” risk for the likely onset of CRPS 1; 55 patients have developed CRPS 1 at evaluation 112 days after fracture; age and gender were not predictive of CRPS 1 onset | Referred to as “established criteria” without formal reference | 21 likely CRPS 1 patients lost due to administrative error; 93.3.% of all fractures eligible for inclusion and 94.5% agree to participate; 97.2% contacted for follow-up; no numbers of patients given, only percentages | Sequential cohort over 2 years |
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