mtomaino
03-21-2010, 10:42 AM
If one surveys the literature regarding the complications after sustaining a broken wrist ("fracture of the distal radius"), there is a reported risk as high as 25% of developing some degree of "complex regional pain syndrome" . CRPS, as it is often referred to by abbreviation, is characterized by unexplained pain and swelling, vasomotor instability and stiffness. Two landmark, randomized, controlled studies by Zollinger et al have demonstrated that Vitamin C reduces the incidence of CRPS in the setting of distal radius fractures (Zollinger PE et al. Lancet 1999; J Bone Joint Surg 2007.) Beyond its potential role in the prevention of CRPS, vitamin C is integral to collagen formation and bone synthesis. Though diarrhea and abdominal bloating make be unwanted side effects when several grams of Vitamin C are taken at once, generally adverse side effects can be avoided with doses below 1000mg daily in healthy people.
In summary, based on the existing literature, patients with distal radius fractures should consider oral treatment with Vitamin C to limit the risk of developing CRPS. Specifically, a daily dose of 500mg for a period of 50 days is recommended. Dietary intake alone is insufficient. There may be an incidental benefit of reduced time to fracture healing, although this potential benefit merits further clinical investigation. The use of Vitamin C does not obviate the need for careful traetment of the fracture itself with either splinting, casting, or operative stabilization (Shah AS, Verma MK, and Jebson PJ. Use of Vitamin C after fractures of the distal radius. J Hand Surg 34A, 2009.)
In summary, based on the existing literature, patients with distal radius fractures should consider oral treatment with Vitamin C to limit the risk of developing CRPS. Specifically, a daily dose of 500mg for a period of 50 days is recommended. Dietary intake alone is insufficient. There may be an incidental benefit of reduced time to fracture healing, although this potential benefit merits further clinical investigation. The use of Vitamin C does not obviate the need for careful traetment of the fracture itself with either splinting, casting, or operative stabilization (Shah AS, Verma MK, and Jebson PJ. Use of Vitamin C after fractures of the distal radius. J Hand Surg 34A, 2009.)