Síndrome de dolor regional complejo tras fractura del extremo distal del radio

• Autores: Julián Segura Nuez, Diana Elena Mandu, Álvaro Aragües Milagros, Francisco Javier Miguel Bielsa, Laura Villarroya Martínez, Javier Adán Laguna
• Localización: Revista Sanitaria de Investigación, ISSN-e 2660-7085, Vol. 5, Nº. 2, 2024
• Idioma: español
• Enlaces
  • Texto completo
• Resumen
  • español

    Introducción: La fractura en el extremo distal del radio representa una de las urgencias traumatológicas más frecuentes. Una de sus posibles complicaciones es el desarrollo de un síndrome de dolor regional complejo a nivel distal. El objetivo de este trabajo es realizar una revisión de los últimos estudios disponibles acerca de esta patología.

    Metodología: Se ha realizado una búsqueda en la base de datos de PubMed seleccionando los artículos más recientes acerca de la fisiopatología, etiología, diagnóstico, prevención y tratamiento del SDRC tras la FEDR.

    Resultados: El SDRC tras FEDR tiene una incidencia variable según las series. Su diagnóstico es principalmente clínico. Las fracturas abiertas, los mecanismos de alta energía, la fractura de cúbito asociada y el tratamiento quirúrgico frente al conservador aumentan el riesgo de padecerlo. Se observa una mayor incidencia en mujeres y en pacientes con un elevado IMC. Un dolor inusualmente elevado durante la primera semana tras la fractura parece ser un factor predictor para el desarrollo de este síndrome. El método de prevención más utilizado clásicamente es la vitamina C, aunque aún no hay consenso sobre su efectividad. Existen distintas opciones para su tratamiento: analgésicos, fármacos neuromoduladores, fisioterapia y alternativas invasivas como el bloqueo del ganglio estrellado; no obstante, la mejoría sintomática es variable.

  • English

    Introduction: Distal radius fracture (DRF) represents one of the most frequent trauma emergencies. One of its possible complications is the development of a complex regional pain syndrome (CRPS) at distal level. The aim of this work is to review the latest studies available on this pathology.

    Methodology: A search was carried out in the PubMed database, selecting the most recent articles on the pathophysiology, etiology, diagnosis, prevention and treatment of CRPS after DRF.

    Results: CRPS after DRF has a variable incidence depending on the series. Its diagnosis is mainly clinical. Open fractures, high-energy mechanisms, associated ulnar fracture and surgical versus conservative treatment increase the risk of CRPS. A higher incidence is seen in women and in patients with a high BMI. Unusually, high pain during the first week after fracture appears to be a predictor for the development of this syndrome. The most classically used method of prevention is vitamin C, although there is still no consensus on its effectiveness. There are different options for its treatment: analgesics, neuromodulatory drugs, physiotherapy and invasive alternatives such as stellate ganglion block; however, symptomatic improvement is variable.

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