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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2025; 60(03): s00451810402
DOI: 10.1055/s-0045-1810402
Original Article

Vitamin C in Complex Regional Pain Syndrome in Patients with Distal Radius Fracture

Vitamina C na síndrome da dor complexa regional em pacientes com fratura distal do rádio
Fernando Antonio Silva de Azevedo Filho 
1   Hospital do Subúrbio, Salvador, Bahia, Brazil
2   Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil
,
Roberta Muniz Blunck 
1   Hospital do Subúrbio, Salvador, Bahia, Brazil
,
Abdouni Y Ali 
3   Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
,
Patrícia Maria de Moraes Barros Fucs 
2   Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil
,
Ricardo Britto Cotias 
1   Hospital do Subúrbio, Salvador, Bahia, Brazil
› Institutsangaben
Financial Support The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.
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Abstract

Objective

To evaluate the effect of vitamin C in preventing complex regional pain syndrome (CRPS) in patients with fracture of the distal end of the radius (FDER).

Methods

The present study included FDER patients with an indication for surgical treatment and aged over 18 years. We evaluated the age group, gender, dominant side, presence of comorbidities, affected side, trauma mechanism, and the surgical technique. Participants were randomized into 2 groups: placebo (n = 64), which received microcrystalline cellulose, and intervention (n = 58), treated with 1 g/day of vitamin C in a single dose for 60 days, starting immediately after surgery.

Results

The average incidence of neuropathic pain was 17% higher in the placebo group than in the vitamin C one during the evaluation period (p = 0.008). The average visual analog scale (VAS) for pain was 1.22 points higher in the placebo group regardless of evaluation moment (p = 0.001). The CRPS at 12 and 24 weeks were statistically more frequent in the placebo group (p = 0.014 and 0.007, respectively).

Conclusion

Vitamin C has an effect on preventing neuropathic pain and CRPS, as well as on controlling postoperative pain control.

Resumo

Objetivo

Avaliar o efeito da vitamina C na prevenção da síndrome da dor complexa regional (SDCR) em pacientes com fratura da extremidade distal do rádio (FEDR).

Métodos

Foram incluídos pacientes com FEDR com indicação de tratamento cirúrgico e idade acima de 18 anos, sendo avaliados faixa etária, gênero, dominância, presença de comorbidades, lado acometido, mecanismo do trauma e técnica cirúrgica. Os participantes foram randomizados em dois grupos: placebo (N = 64), que recebeu celulose microcristalina, e intervenção (N = 58) , que recebeu 1 g/dia de vitamina C, em dose única durante 60 dias, iniciando no pós-operatório imediato.

Resultados

A incidência de dor neuropática foi em média 17% maior no grupo placebo do que no grupo vitamina C nas semanas avaliadas (p = 0,008). A escala visual análoga (EVA) foi em média 1,22 pontos maior no grupo placebo independente do momento de avaliação (p = 0,001). A SDCR, em 12 e 24 semanas, foi estatisticamente mais frequente no grupo placebo (p = 0,014 e 0,007 respectivamente).

Conclusão

A vitamina C tem efeito na prevenção da dor neuropática e da SDCR, bem como no controle da dor pós-operatória.

Keywords

ascorbic acid - chronic pain - complex regional pain syndromes - radius fractures

Palavras-chave

ácido ascórbico - dor crônica - fraturas do rádio - síndrome da dor regional complexa

Authors' Contribution

Each author contributed individually and significantly to the development of the present article: FASA: research project preparation, patient assessment, data collection, data analysis, manuscript writing, paper reviewing and editing, and intellectual study conception; RMB: patient assessment, data collection, data analysis, paper review; YAA: data analysis, research project preparation, paper writing, reviewing, and editing, and intellectual study conception; PMBBF: data analysis, research project preparation, paper writing and reviewing, and intellectual study conception; RBC: data analysis and paper writing, reviewing, and editing.


Work developed at Hospital do Subúrbio, Salvador, BA, Brazil.




Publikationsverlauf

Eingereicht: 20. Februar 2025

Angenommen: 22. Mai 2025

Artikel online veröffentlicht:
25. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Fernando Antonio Silva de Azevedo Filho, Roberta Muniz Blunck, Abdouni Y Ali, Patrícia Maria de Moraes Barros Fucs, Ricardo Britto Cotias. Vitamin C in Complex Regional Pain Syndrome in Patients with Distal Radius Fracture. Rev Bras Ortop (Sao Paulo) 2025; 60: s00451810402.
DOI: 10.1055/s-0045-1810402