Vitamin C Therapy
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.”