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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(06): 924-929
DOI: 10.1055/s-0041-1736526
Artigo Original
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Prevalence of Neuropathic Pain in Patients with Fracture of the Distal Extremity of the Radius Treated with Volar Locking Plate

Article in several languages: português | English
Helbert Luiz Nomura da Silva
1   Médico Ex-residente do Grupo de Cirurgia da Mão e Microcirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Giuliana Olivi Tanaka 
2   Médico Residente de Ortopedia e Traumatologia do Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Thiago Barros Pinheiro
2   Médico Residente de Ortopedia e Traumatologia do Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Yussef Ali Abdouni
3   Médico Assistente do Grupo de Cirurgia da Mão e Microcirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
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Abstract

Objective To evaluate the prevalence of persistent pain in the postoperative period of fractures of the distal extremity of the radius, as well as to detect early signs of neuropathic pain to develop protocols for the prevention of chronic postoperative pain.

Methods Prospective study, carried out with 56 patients who underwent open reduction and internal fixation of fractures of the distal extremity of the radius with a volar locking plate from March to September 2020. The patients were submitted to assessment of neuropathic pain and functional capacity through the Douleur Neuropathique 4 questionnaire (DN4) and Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) questionnaires. Qualitative variables were compared using the Mann-Whitney U test and their correlation was analyzed using the Spearman Correlation and Equality of Two Proportions tests.

Results A total of 43 patients aged between 18 and 66 years old were included in the present study; 39.5% of the participants scored ≥ 4 on the DN4 questionnaire. In relation to Quick-DASH, the average was 38.6. There was no statistically significant difference between the gender of the patient and the DN4 value (p = 0.921). There was also no statistical correlation between the quantitative variables DN4 and Quick-DASH (p = 0.061).

Conclusions The prevalence of neuropathic pain in analyzed postoperative patients was significant, and the presence of signs and symptoms of neuropathic pain was a positive predictive factor for pain persistence beyond 2 months in 100% of cases. Thus, with early diagnosis of the neuropathic component of pain, associated with the nociceptive component, adequate pain control can be achieved, preventing its chronicity, and ensuring better rehabilitation.

Keywords

radius fractures - pain measurement - postoperative complications - fracture fixation, internal

Financial Support

There was no financial support from public, commercial, or non-profit sources.


Work developed in the Hand Surgery and Microsurgery Group, Department of Orthopedics and Traumatology, Faculty of Medical Sciences, Santa Casa de São Paulo, “Pavilhão Fernandinho Simonsen” (DOT – FCMSCSP) (Director: Professor Maria Fernanada Silber Caffaro), São Paulo, SP, Brazil.




Publication History

Received: 04 April 2021

Accepted: 15 June 2021

Article published online:
21 January 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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