Every year, several hundred patients with open fractures pass through one of Europe’s busiest trauma centres, and a significant but poorly understood number will develop Complex Regional Pain Syndrome (CRPS)—a chronic pain condition with few treatment options. This matters because CRPS after open fractures is under-researched. Existing studies are sparse, diagnostic tools are limited, and no reliable way exists to predict which patients will develop the condition. The OTAS-CRPS sub-study will screen 200–300 patients annually at Barts Health NHS Trust, collecting pain profiles, psychological data, and results from Quantitative Sensory Testing at 6 weeks and 6 months post-injury. If successful, the study will create a database and predictive “pain profiles” that allow future randomised controlled trials to target high-risk patients. This could shift trauma care from reactive pain management to early, personalised prevention. Within two years, the results should enable enriched clinical trials aimed at stopping CRPS before it takes hold—a practical change in how chronic pain is diagnosed and treated after serious injury.
View original technical description
The Open Trauma Assessment Study (OTAS) is designed as a prospective cohort study to investigate complications in patients with open fractures. Open fractures pose significant healthcare challenges, including high costs and long-term disabilities. The incidence of Complex Regional Pain Syndrome (CRPS) in these patients is not well documented but produces marked suffering, with sparse existing research and limited diagnostic and therapeutic options. The OTAS-CRPS sub-study aims to create a database to support future randomised controlled trials (RCTs) and develop "pain profiles" to predict CRPS development. The study will enrol patients aged 18 and over from Barts Health NHS Trust, collecting data on patient-reported outcomes, complications, and psychological profiles. Outcomes are aligned to core outcome sets for lower limb fractures and CRPS. Quantitative Sensory Testing (QST) to assess pain responses will be undertaken at 6 weeks and 6 months post-injury, aligned to clinical appointments. Ethical approvals will be sought, and data will be securely managed within Queen Mary University London (QMUL)’s Data Safehaven. The study will screen 200-300 patients for enrolment annually, with feasibility assessed through patient recruitment rates and the utility of QST in predicting CRPS. Within 2 years, the results will inform the design of enriched RCTs aimed at preventing or mitigating CRPS in this high-risk population. This research leverages a synergy between one of Europe's busiest trauma centres, and the expertise of the QMUL precision medicine unit to address a key priority in trauma care and enact a paradigm shift in the diagnosis and treatment of chronic pain.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know