We suggest adjuvant treatment of distal radius fractures with Vitamin C for the prevention of disproportionate pain.

Rationale
We were interested in determining the potential benefit of nutritional supplements in recovery of function after treatment of distal radius fractures. Two studies that met our inclusion criteria examined the use of Vitamin C.88, 89 Specifically, the studies found a significant reduction in the incidence of complex regional pain syndrome after treatment of distal radius fracture when the patients were given supplemental Vitamin C. These studies have a serious limitation. The final outcome measure of CRPS is ordinarily difficult to define objectively. The authors used subjective criteria to define pain syndrome in these studies and hence the reliability of the data is limited.  We have hence downgraded the recommendation to “Moderate.”
  1. (88) Zollinger PE, Tuinebreijer WE, Breederveld RS, Kreis RW. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study. J Bone Joint Surg Am 2007;89(7):1424-1431.
  2. (89) Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet 1999;354(9195):2025-2028.