Impact of Prophylactic Vitamin C on Complex Regional Pain Syndrome after Distal Radius Fractures in Elderly Indian Patients: A Prospective Clinical Outcomes Study.

Background: Although vitamin C has been proposed to prevent complex regional pain syndrome (CRPS), evidence remains inconsistent. This study evaluated the effect of vitamin C on the incidence of CRPS-I in elderly patients with distal radius fractures. Methods: This prospective, non-randomised comparative study included elderly patients undergoing conservative or surgical treatment for distal radius fractures. Patients were allocated alternately to receive either oral vitamin C (500 mg/day) plus standard care or standard care alone for 3 months. Participants were followed for 9 months, and CRPS-I was diagnosed using the Budapest criteria. Results: CRPS-I developed in 15.5% (19/122) of the vitamin C group and 35.2% (43/122) of the control group. The difference was statistically significant (p = 0.021; OR 0.44, 95% CI 0.21-0.94). Vitamin C supplementation significantly reduced the likelihood of developing CRPS-I. Conclusions: Vitamin C supplementation (500 mg/day) was associated with a lower incidence of acute CRPS-I following distal radius fractures. It may represent a simple, inexpensive preventive strategy in elderly patients. Amongst patients who developed CRPS-I, vitamin C was also associated with better functional and quality-of-life outcomes. Level of Evidence: Level II (Therapeutic).