BACKGROUND: The present study aimed to investigate the incidence and seasonal variation of distal radius fractures (DRFs) in Korea. METHODS: We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service from 2011 to 2015. We used International Classification of Diseases, 10th revision codes and procedure codes to identify patients of all ages with newly diagnosed DRFs. RESULTS: An average of about 130,000 DRFs occurred annually in Korea. The incidence of DRF, by age group, was highest in the 10 to 14-year-old age group for males and the highest in the 70s age group for females, with a rapid increase of incidence after 50 years. The peak incidence of DRF occurred during winter; however, the incidence greatly varied annually when compared with that of other seasons. The incidence of DRFs during the winter season was correlated with the average temperature. CONCLUSION: The annual incidence of DRF was 130,000 in Korea. The incidence increased under an intense cold surge during winter. Active preventive measures are recommended especially in women exceeding 50 years considering the higher incidence in this age group.
Adolescent ; Epidemiology ; Female ; Humans ; Incidence ; Insurance, Health ; International Classification of Diseases ; Korea ; Male ; Radius Fractures ; Radius ; Seasons

Purpose: To investigate the etiologic factors related to refractures of the upper extremity in children. Patients and Methods: Eighteen refractures were divided into three groups according to the location of the initial fractures. They were analyzed in terms of the type of refractures, fracture patterns, and the existence of an underlying deformity. Results: Of nine supracondylar fractures of the humerus, two involved refractures at the supracondylar region, and the other seven involved the lateral condyle. Underlying cubitus varus was present in six cases. Of three lateral condylar fractures of the humerus, one had a refracture at the supracondylar region, and two cases involved the lateral condyle. One had an underlying cubitus varus. All but one case in the humeral fractures group were late refractures, and were treated with surgery. Of six repeat forearm fractures, five were early type and occurred at the original site within nine weeks, four at the diaphysis of both bones of the forearm, and one at the diaphysis of the ulna. All cases in the forearm fractures group, save one, had volar angulation before the refracture, and were treated conservatively. Conclusion: In the humerus, the underlying cubitus varus was the most important predisposing factor for refractures and lateral condyle fractures were common. In the forearm, volar angulation of the diaphysis was related to refractures, and complete and circular consolidation of the primary fracture of the forearm was thought to be important in prevention.
Ulna Fractures/epidemiology ; Shoulder Fractures/*epidemiology ; Retrospective Studies ; Recurrence ; Radius Fractures/epidemiology ; Male ; Humeral Fractures/epidemiology ; Humans ; Follow-Up Studies ; Female ; Child, Preschool ; Child

The objective of this study was to investigate national surgical trends for distal radius fractures (DRFs) in Korea and analyze healthcare institution type-specific surgical trends. We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service (HIRA) from 2011 to 2015. International Classification of Diseases, 10th revision (ICD-10) codes and procedure codes were used to identify patients aged ≥ 20 years with newly diagnosed DRFs. A total of 459,388 DRFs occurred from 2011 to 2015. The proportion of DRF cases treated by surgery tended to increase over time, from 32.6% in 2011 to 38.3% in 2015 (P < 0.001). Open reduction with internal fixation (ORIF) using a plate steadily gained in popularity each year, increasing from 39.2% of overall surgeries in 2011 to 60.9% in 2015. The type of surgery for DRFs differed depending on the type of healthcare institution. ORIF (91%) was the most popular procedure in tertiary hospitals, whereas percutaneous pinning (58%) was most popular in clinics. In addition, general hospitals and hospitals with 30–100 beds used external fixation more frequently than tertiary hospitals and clinics did. Overall, our findings indicate that surgical treatment of DRF, particularly ORIF, continues to increase, and that the component ratio of operation codes differed according to the healthcare institution type.
Delivery of Health Care ; Epidemiology ; Hospitals, General ; Humans ; Insurance, Health ; International Classification of Diseases ; Korea* ; Radius Fractures* ; Radius* ; Tertiary Care Centers

PURPOSE: Fracture of the distal radius is one of the most common fractures encountered in the emergency room. The incidence of distal radius fracture has increased substantially according to several studies that estimated the overall incidence in various general populations. However, there is a paucity of epidemiological data regarding distal radius fracture in Korea. The aim of this study was to estimate the epidemiology and seasonal variance of incidence of distal radius fractures in the Korean population. MATERIALS AND METHODS: Medical records and radiographs of the 432 patients who visited the emergency room for distal radius fractures from January 2012 to December 2013 were reviewed retrospectively. Authors analyzed the epidemiologic parameters including age, gender, injury mechanism, fracture classification, combined fracture, treatment method and monthly incidence. RESULTS: The mean age of the patients at the time of injury was 53 years (41.6 years in 171 men, 64.5 years in 261 women). The highest incidence in age distribution was the sixth and seventh decade (45.2%) and male to female ratio was 1.0:2.5. Most fractures (78.4%) were caused by a lower energy fall and the most common combined fractures were the ulnar styloid fracture (38.6%). According to the AO classification, 54.5% were type A, 14.5% were type B and 31.0% were type C and 39.2% of the patient underwent surgery for treatment. The incidence of fracture began to rise in November (12.1%) and peaked in December (14.2%). CONCLUSION: This study examined the epidemiology and seasonal variance of incidence of distal radius fractures from the patient records of a single University hospital. The epidemiological data gathered in this study could be added to our knowledge of distal radius fractures in the Korean population, thus it enables the Korean surgeon to determine the best management for individual patients.
Age Distribution ; Classification ; Emergency Service, Hospital ; Epidemiology* ; Female ; Humans ; Incidence* ; Korea ; Male ; Medical Records ; Radius Fractures* ; Radius* ; Retrospective Studies ; Seasons*

Distal radius fracture is one of the most common injuries of human beings, particularly in young males and elderly females. There are various classifications among which classification by author' names and the AO fracture classification system are most frequently used. Although the latter one is overall and consummate, a precise classification system with complete description of the fracture remains to be raised. Recently, with the development of wrist biomechanics and microscope anatomy, more and more studies were made to treat distal radius fracture. Good reduction and fixation are the key points for treatment. In tenns uf treatment, several options exist. Nonoperative management consists of closed replacoment and external fixation. Operative treatments includes intrafocal pinning ,non-bridging and bridging external fixation , various methods of open reduction internal fixation and hone or bone substitute transplantation. Besides, arthroscopic-assisted external fixation and artificial joint for wrist become a new hot spot. However,any single therapy could not treat all sorts of distal radius fractures. Therefore, it is better to institute individualized therapy according to different fracture characteristics of each patient in order to achieve the best curative effect. This review aims to make a conclusion about advancement in distal radius fractures, in aspects of epidemiology, classification and treatment.
External Fixators ; Fracture Fixation, Internal ; Humans ; Radius Fractures ; classification ; epidemiology ; surgery

BACKGROUND: To evaluate risk factors of redisplacement and remind surgeons of key factors regarding conservative treatment of distal radius fracture. METHODS: A total of 132 patients who received conservative treatment for distal radius fractures between March 2008 and February 2011 were included in this study. Radial inclination, radial length, volar tilting angle, ulnar variance, fragment translation, and presence of dorsal metaphyseal comminution were measured on the X-rays taken immediately after reduction, one week after injury during the first follow-up outpatient clinic visit, and after the gain of radiological union. Secondary displacement was defined as a loss of reduction during the follow-up period, and was divided into 'early' and 'late' categories. We analyzed the influence of initial displacement radiologic variables, dorsal cortex comminution, and patient age on the development of secondary displacement. RESULTS: Development of secondary displacement was significantly associated only with initial displacement radiologic variables (p < 0.001), development of the late secondary displacement was significantly associated with age (p = 0.005), and initial displacement radiologic variables were associated significantly with a serial increase in ulnar variance (p = 0.003). CONCLUSIONS: Greater displacement on the initial radiographs indicates a higher possibility of development for secondary displacement, and older patients had a higher probability of late secondary displacement development. Furthermore, dorsal comminutions did not affect secondary displacement directly.
Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Fracture Fixation, Internal ; Fractures, Comminuted/radiography/therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Radius Fractures/epidemiology/radiography/*therapy ; *Splints ; Young Adult

The purpose of this study was to assess the incidence and mortality of distal radius fracture among patients 50 years of age and older with diagnosis code (ICD10; S52.5, S52.6) and treatment code using a nationwide claims database from 2008 to 2012. All patients were followed using patient identification code to identify deaths. Standardized mortality ratios (SMRs) of distal radius fracture were calculated based on age and gender-specific rates in the entire Korean population. The number of distal radius fractures increased by 54.2% over the 5-year study (48,145 in 2008 and 74,240 in 2012). The incidence of distal radius fracture increased from 367.4/100,000 in 2008 to 474.1/100,000 in 2012. The cumulative mortality rate over the first 12 months after distal radius fracture was decreased from 2.0% (968/48,145) in 2008 to 1.4% (1,045/74,240) in 2012. The mean year mortality over 5 years in men (2.6%, 1,279/50,128) over the first 12 months was 1.7-times higher than in women (1.5%, 3,952/257,045). The mean of SMR of distal radius fracture at 1 year post-fracture was 1.45 in men and 1.17 in women. This study using a nationwide database demonstrates that the distal radius fractures are increasing with a decreasing mortality in Korea.
Aged ; Aged, 80 and over ; Databases, Factual ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Radius Fractures/*diagnosis/epidemiology/mortality ; Republic of Korea/epidemiology ; Sex Distribution ; Survival Analysis

The aim of this study was to evaluate the bone mineral density and the prevalence of osteoporosis in postmenopausal Korean women with low-energy distal radius fractures and compared with those of aged-matched normal Korean women. Two hundred and six patients with distal radius fractures between March 2006 and March 2010 were included in this study. Patients were divided into three groups by age; group 1 (50-59 years), group 2 (60-69 years), and group 3 (70-79 years). Controls were age-matched normal Korean women. The bone mineral density values at all measured sites, except for the spine, were significantly lower in group 1 than those of control. While the bone mineral density values in group 2 and 3 were lower than those of controls, these differences were not statistically significant. All groups had significantly higher prevalence of osteoporosis at the Ward's triangle; however, at the spine, femoral neck and trochanteric area it was not significantly different from those of age-matched controls. Although the prevalence of osteoporosis of the postmenopausal women with low-energy distal radius fractures may not be higher than that of the control, osteoporosis should be evaluated especially in younger postmenopausal patients to prevent other osteoporotic hip and/or spine fractures.
Aged ; Body Mass Index ; Bone Density ; Female ; Femoral Neck Fractures/diagnosis ; Humans ; Middle Aged ; Osteoporosis/*epidemiology ; Postmenopause ; Prevalence ; Radius Fractures/*diagnosis ; Republic of Korea/epidemiology ; Retrospective Studies ; Spinal Fractures/diagnosis

The aging of the Korean population is expected to increase the prevalence of osteoporosis and related fractures. This study aimed to perform an intensive review of osteoporosis and related fractures in Korea during the last decade. Although direct comparison of the prevalence of osteoporosis reported in different studies is difficult, the prevalence of osteoporosis reported in the last decade has ranged from 6.1% in men and 24.3% in women to 13.1% in men and 35.5% in women in studies of Korean populations. According to reimbursement records from the National Health Insurance Servicesdatabase in 2012, the incidence and mortality of osteoporotic fracture including in the spine, hip, distal radius, and proximal humerus are 655.4/100,000 and 7.0%, 171.3/100,000 and 16%, 474.1/100,000 and 1.7%, and 90.9/100,000 and 7.0%, respectively. The numbers and incidence of hip and spine fracture were trending upward during the study period. However, mortality from osteoporotic fractures was steady or trended downward. Gender-specific assessment showed that although the incidence of osteoporotic fracture in men is less than in women, the mortality of men after osteoporotic fracture ranged from 1.4- to 2.2- fold that of women. Our review of epidemiologic studies regarding osteoporosis and related fractures demonstrated that Korea is a country with increasing trends of osteoporosis and related fractures. Therefore, a public health strategy for treating osteoporosis and preventing osteoporotic fracture is mandatory.
Aging ; Epidemiologic Studies ; Epidemiology* ; Female ; Hip ; Humans ; Humerus ; Incidence ; Korea* ; Male ; Mortality ; Multiple Endocrine Neoplasia Type 1 ; National Health Programs ; Osteoporosis* ; Osteoporotic Fractures ; Prevalence ; Public Health ; Radius ; Spine

BACKGROUND: Plate fixation is the most commonly used technique for the treatment of shaft fractures of both forearm bones (SFBFBs). However, all fractures are difficult to treat with plate fixation because of soft tissue injuries, fracture patterns, or the patient's condition. The purpose of this study is to compare the functional results of plate fixation only and combined plate and intramedullary (IM) nail fixation in SFBFBs. METHODS: Fifty-nine cases of SFBFBs that were surgically treated from June 2007 to July 2012 were retrospectively reviewed. In this study, 47 cases that were followed up for more than 12 months were included. All SFBFBs were divided into two groups according to the methods used for internal fixation: plate fixation only (group A) and combined plate and IM nail fixation (group B). The fixation methods were determined intraoperatively. Plate fixation was considered as the first option in all cases, but combined plate and IM nail fixation was selected as the second option if it was difficult to be fixed with plate only. Groups A and B comprised of 31 and 16 cases, respectively. The functional results were evaluated by the Grace and Eversmann rating system and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. RESULTS: In groups A and B, a radiologic union was achieved in 30/31 and 14/16 cases and average union time was 11.1 and 17.8 weeks, respectively. According to the Grace and Eversmann rating system, group A had excellent results in 15 cases, good in 14, acceptable in one, and unacceptable in one. Group B had excellent results in three cases, good in nine, acceptable in two, and unacceptable in two. The average DASH score was 7.1 points (range, 0 to 19.2 points) in group A and 15.1 points (range, 0 to 29.6 points) in group B. Three cases of nonunion with unacceptable results achieved a bony union by additional procedures and the functional results of these cases improved to good or excellent. CONCLUSIONS: The functional results and the average union time were superior in group A than in group B. However, we think that combined fixation is a useful method for SFBFBs that cannot be treated with plate fixation only.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Nails/*statistics & numerical data ; Bone Plates/*statistics & numerical data ; Female ; Forearm/surgery ; Fracture Fixation, Intramedullary/adverse effects/*methods/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Radius Fractures/epidemiology/*surgery ; Range of Motion, Articular/*physiology ; Retrospective Studies ; Treatment Outcome ; Ulna Fractures/epidemiology/*surgery ; Young Adult