OBJECTIVE: To investigate clinical efficacy of dual plate internal fixation triceps through approach for the treatment of type C3 fracture of distal radius. METHODS: Totally 21 patients with type C3 fracture of distal radius were retrospectively analyzed from December 2011 to June 2017. Among them, including 13 males and 8 females, aged from 15 to 68 years old with an average of (40.7±3.4) years old. The time from injury to operation ranged from 3 to days with an average of (5.0±1.2)days. Fracture healing and postoperative complications were observed, Mayo elbow joint performance score(MEPS) was used to evaluate recovery of elbow joint function, VAS score was used to evaluate relieve degree of pain at 3 months after operation. RESULTS: All patients were followed up for 8 to 24 months with an average of (14.0±2.6) months. The time of fracture healing ranged from 2.5 to 4.0 months with an average of(3.0±1.2) months without complications. Postoperative MEPS score at 3 months was 91.0±2.3, and 15 patients got excellent results, 4 good, and 2 moderate; VAS score was 1.95±0.34 at 3 months after operation. CONCLUSIONS Dual plate internal fixation triceps through approach for the treatment of type C3 fracture of distal radius could provide satisfactory surgical field exposure, facilitate for reduction and internal fixation of joint fracture, could obtain good elbow joint function and is beneficial for early functional exercise.
Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Radius ; Radius Fractures ; diagnosis ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUND: A history of osteoporotic fractures is strongly associated with the subsequent osteoporotic fractures. To prevent subsequent fractures, the diagnosis and treatment of osteoporosis following osteoporotic fractures are very important. A distal radius fracture (DRF) is the second most common type of osteoporotic fracture in South Korea. We analyzed the rate of osteoporosis diagnosis within 6 months post-DRF.METHODS: We used data from the Korean Health Insurance Review and Assessment Service nationwide claims database from 2010 to 2016. International Classification of Diseases, 10th revision codes and procedures codes were used to identify patients aged over 50 years with newly diagnosed DRFs; the osteoporosis assessments of these patients were then analyzed. We used Cochran-Armitage trend test to examine trends in osteoporosis diagnosis.RESULTS: A search of database identified 77,209 DRFs in patient aged above 50 years of age from 2011 to 2016. Among these patients, only 19,305 (25.0%) underwent diagnostic examination for osteoporosis. The number of osteoporosis examinations increased slightly, but not significantly, every year (P=0.061).CONCLUSIONS: Clinicians who treat DRFs shoulder also evaluated patients for osteoporosis after DRFs.
Diagnosis ; Humans ; Insurance, Health ; International Classification of Diseases ; Korea ; Osteoporosis ; Osteoporotic Fractures ; Radius Fractures ; Radius ; Shoulder

BACKGROUND: We determined the prevalence of sarcopenia according to fracture site and evaluated the associated risk factors in female patients with osteoporotic fractures. METHODS: A total of 108 patients aged 50 years or older with an osteoporotic fracture (hip, spine, or wrist) were enrolled in this retrospective observational study. A diagnosis of sarcopenia was confirmed using whole-body densitometry for skeletal muscle mass measurement. Logistic regression analysis was used to analyze the risk factors for sarcopenia. RESULTS: Of 108 female patients treated for osteoporotic fractures between January 2016 and June 2017, sarcopenia was diagnosed in 39 (36.1%). Of these, 41.5% (17/41) had hip fractures, 35% (14/40) had spine fractures, and 29.6% (8/27) had distal radius fractures. Body mass index (BMI; P=0.036) and prevalence of chronic kidney disease (CKD; P=0.046) and rheumatoid arthritis (P=0.051) were significantly different between the groups. In multivariable analysis, BMI (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.55–1.05, P=0.098) and CKD (OR 2.51; 95% CI, 0.38–16.2; P=0.233) were associated with an increased risk of sarcopenia; however, this was not statistically significant. CONCLUSIONS: This study evaluated the prevalence of sarcopenia according to the fracture site and identified associated risk factors in patients with osteoporotic fractures. A longterm, observational study with a larger population is needed to validate our results.
Arthritis, Rheumatoid ; Body Mass Index ; Densitometry ; Diagnosis ; Female ; Hip Fractures ; Humans ; Logistic Models ; Muscle, Skeletal ; Observational Study ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Radius Fractures ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors ; Sarcopenia ; Spine

Anaphylaxis during anesthesia is rare, but often fatal. Rocuronium is a neuromuscular relaxant used for induction of anesthesia. We experienced a case of anaphylaxis after rocuronium administration during induction of anesthesia. A 64-year-old female patient was scheduled for bilateral radius fracture fixation. The history of patient showed no specific findings other than hypersensitivity to mackerel. She had no previous experience of anesthesia. Anesthesia was induced by intravenous injection of propofol 100 mg and continuous infusion was begun with remifentanil 0.25 µg/kg/min, followed by rocuronium 40 mg. Immediately after intravenous administration of rocuronium, the manual ventilation became difficult, and the patient developed erythema and severe hypotension. The patient was diagnosed with anaphylaxis based on clinical features and started treatment. First, we performed endotracheal intubation promptly. Then, immediate intravenous administration of epinephrine and fluid followed. Despite adequate treatment, hypotension was not corrected and intravenous epinephrine was administered. However, ventricular tachycardia occurred which was successfully treated with a defibrillator. Later, the patient uneventfully recovered in the intensive care unit. The patient was not tested for skin prick test, but rocuronium was the most likely cause of anaphylaxis at that time. The authors unexpectedly experienced drug-induced anaphylaxis, which is life-threatening to the patient. Clinicians should be aware of the diagnosis, treatment, and prevention as anaphylaxis can be hazardous to the patient.
Administration, Intravenous ; Anaphylaxis* ; Anesthesia* ; Defibrillators ; Diagnosis ; Epinephrine ; Erythema ; Female ; Humans ; Hypersensitivity ; Hypotension ; Injections, Intravenous ; Intensive Care Units ; Intubation, Intratracheal ; Middle Aged ; Perciformes ; Propofol ; Radius Fractures ; Skin ; Tachycardia, Ventricular ; Ventilation

BACKGROUND: Authors assessed lean body mass (fat free tissue), upper and lower, and bone mineral density (BMD) in patients of osteoporotic bone distal radius fracture (DRF) and degenerative rotator cuff tear (RCT) patients of shoulder. We predict inferior muscle mass and osteoporosis are more frequent in DRF group than RCT group. METHODS: Between January 2016 and June 2017, overall 38 of DRF and 30 of RCT were eligible for this retrospective comparison study after excluding of patients with compounding factors. BMD and other body composition, fat and lean body mass, were assessed with a single dual energy X-ray absorptiometry in one hospital. RESULTS: T-score of spine were −2.2 and −1.6 in DRF and RCT patients with significant difference (P=0.040). Final BMD score, lower score of patient between spine and femoral score, of both group also presented difference with significance, −2.4 of DRF and −1.9 of RCT patients (P=0.047). Diagnosis of osteoporosis was confirmed in 19 patients (50%) from DRF compared with 9 patients (30%) from RCT. The mean lean soft tissue mass of the arm was 3.7 kg and 3.8 kg in the DRF and RCT, respectively, without significant difference (P=0.882). The mean lean body mass of the leg was 11.0 kg and 10.5 kg in the DRF and RCT, respectively, without significant difference (P=0.189). The relative overall appendicular lean mass was not significantly different between groups. CONCLUSIONS: Even though BMD difference, we did not find muscle mass difference between DRF and RCT patients.
Absorptiometry, Photon ; Arm ; Body Composition ; Bone Density* ; Diagnosis ; Female ; Humans ; Leg ; Muscle Strength ; Osteoporosis ; Radius Fractures* ; Radius* ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Spine ; Tears* ; Upper Extremity

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 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

PURPOSE: Distal radius fracture is one of the most common factures, but incidence of concomitant scaphoid fracture is rare. The rarity makes diagnosing the concomitant scaphoid fracture often delayed. Thus, in this study, the authors examined the frequency of concomitant scaphoid injury in distal radius fracture and the type of distal radius fracture that is more commonly associated with simultaneous scaphoid fracture. METHODS: We examined a total of 212 patients who had received treatment for the fracture in our institution. They were divided into two groups, isolated distal radius fracture group and distal radius fracture group with simultaneous scaphoid fracture, and their age, gender, body mass index and distal radius fracture type in accordance with AO classification were compared between the two groups. RESULTS: Concomitant scaphoid fractures were found in 12 (5%) patients, and among them 10 cases were associated with type C distal radius fracture. Statistical comparison between the group with isolated distal radius fracture and the group with both distal radius and scaphoid fractures was made, and only comparison of distal radius fracture types showed statistical significance. CONCLUSION: It is imperative to make timely and appropriate diagnosis of accompanying scaphoid fracture, since delay in making the diagnosis usually lead to many complications. We conclude that further diagnostic imaging such as computed tomography is necessary to make the correct diagnosis of concomitant scaphoid fracture, especially in type C distal radius fractures.
Body Mass Index ; Classification ; Diagnosis ; Diagnostic Imaging ; Humans ; Incidence ; Radius Fractures* ; Radius* ; Wrist Joint

Osteoporotic fractures are one of the most common causes of disability and a major contributor to medical care costs worldwide. Prior osteoporotic fracture at any site is one of the strongest risk factors for a new fracture, which occurs very soon after the first fracture. Bone mineral density (BMD) scan, a conventional diagnostic tool for osteoporosis, has clear limitations in diagnosing osteoporotic fractures and identifying the risk of subsequent fractures. Therefore, early and accurate diagnosis of osteoporotic fractures using the clinical definition which is applicable practically and independent of BMD, is essential for preventing subsequent fractures and reducing the socioeconomic burden of these fractures. Fractures caused by low-level trauma equivalent to a fall from a standing height or less at major (hip, spine, distal radius, and proximal humerus) or minor (pelvis, sacrum, ribs, distal femur and humerus, and ankle) sites in adults over age 50, should be first regarded as osteoporotic. In addition, if osteoporotic fractures are strongly suspected on history and physical examination even though there are no positive findings on conventional X-rays, more advanced imaging techniques such as computed tomography, bone scan, and magnetic resonance imaging are necessary as soon as possible.
Adult ; Bone Density ; Diagnosis ; Femur ; Health Care Costs ; Humans ; Humerus ; Magnetic Resonance Imaging ; Osteoporosis ; Osteoporotic Fractures* ; Physical Examination ; Practice Guidelines as Topic ; Radius ; Ribs ; Risk Factors ; Sacrum ; Spine

OBJECTIVETo investigate the diagnostic value of MRI in radial head fracture with forearm interosseous membrane injuries.

METHODSFrom December 2011 to December 2012,26 patients with fractures of capitulum radial in our hospital were collected. There were 15 males and 11 females, ranging in age from 21 to 53 years old,with an average of 37.6 years old. All the patients visited hospital within 72 hours after injuries. X-ray radiography of full ulnar radial length in injured side, CT in injured side (three-dimensional reconstruction if necessary) and MRI (including the elbow and wrist joints) were performed within a week after the injury. The MRI manifestations of the forearm interosseous membrane (with or without damage, the injured location and the injury degree ) and the fractures degree of radial head were observed and compared for the relativity.

RESULTSRadial head fracture from Mason type I to III was associated with the forearm interosseous membrane injury. Radial head fracture degree was positive correlated with forearm interosseous membrane injury degree (P < 0.05).

CONCLUSIONRadial head fracture with suspicious forearm interosseous membrane injury is necessary to take MRI for checking for any interosseous membrane injury and injury degree, then choose the right treatment for radial capitulum fracture, only in this way can be helpful for the functional recovery of elbow and forearm.

Adult ; Female ; Forearm ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Membranes ; injuries ; Middle Aged ; Radius Fractures ; diagnosis ; pathology ; Young Adult