Role of vitamin C in prevention of complex regional pain syndrome after distal radius fractures: a meta-analysis.

BACKGROUND: Complex regional pain syndrome is a well-known complication after distal radius fracture with incidence ranging from 10.5 to 37 %. Some studies recommend the use of vitamin C to prevent complex regional pain syndrome. The objective of this meta-analysis was to evaluate the efficacy of vitamin C in prevention of CRPS. METHODS: We searched the PubMed, EMBASE and Cochrane library databases for randomized controlled trial (RCT) and comparative studies reporting use of vitamin C to prevent distal radius fracture. Dichotomous variable was presented as risk ratio with 95 % confidence intervals. RESULTS: We obtained 220 articles from the database search. After the exclusion of duplicates, unrelated articles, letter to editor and editorials, we found four articles relevant to our topic. Meta-analysis of the CRPS incidence revealed that the incidence of CRPS was significantly lower in the vitamin C group [RD 0.41 (0.19-0.92), P = 0.03]. There was moderate to high heterogeneity in the studies included I (2) = 63 %). CONCLUSIONS: Our analysis showed a significant reduction in prevalence of CRPS with the use of vitamin C. Further high-quality RCTs with standard dosages and common diagnostic criteria are needed to be able to deliver solid conclusions.