A 55-year-old woman has just been treated conservatively for a distal radius fracture. Which single measure is proven to reduce the incidence of subsequent complex regional pain syndrome?

• A Daily passive range of motion exercises of the fingers
• B Vitamin D 60,000 IU weekly
• C Prophylactic low molecular weight heparin
• D Vitamin C 500 mg daily during immobilization ✓

Explanation

Vitamin C 500 mg daily started soon after injury and continued for about 50 days reduces the incidence of complex regional pain syndrome after distal radius and other wrist fractures, an effect demonstrated in randomized trials and adopted in standard practice. Heparin prevents venous thromboembolism, not CRPS. Passive exercises are actually discouraged because painful forced movement may aggravate the condition; therapy should be gentle and active.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.