In my article “CRPS and Surgery – unhappy bed fellows”, I considered the treatment protocols in existence for those already suffering CRPS who are faced with the prospect of surgery. However, CRPS (both Type 1 and Type 2) is a risk factor for everybody facing surgery, not just those already suffering from the condition.
Now, figures drawn from a variety of research papers have been collated, tabulated and published (see here). These figures show the reported incidence of the development of CRPS following a number of surgical procedures for fractures to the upper and lower limb.
It is of course dangerous to simply take these figures at face value without further reading and better understanding the background and methodology behind each paper. However, it has to be said that, at least at first glance, some of these figures are quite shocking. If 4.4% of people developing CRPS following surgery to the foot seems high, 31% developing the condition following tibial fractures is, frankly, startling.
Of course, the papers from which the figures are drawn suggest that a significant proportion of those who develop a primary CRPS following surgery do go into remission. Indeed, in an earlier article, “Remission and Recurrence in CRPS”, I mention my direct experience of that.
Even factoring in a significant margin of error, these figures highlight clearly the critical importance of CRPS awareness in fracture management. Given the potential preventative benefits of taking Vitamin C (see earlier article), it is increasingly seen as good practice for fracture management to include advising patients to take 500 mg of Vitamin C for 50 days following limb fracture or surgery.