Humerus Shaft Fractures Occurring in Fly Fishing Boat Riding: Injury Scene Analysis / 대한스포츠의학회지

PURPOSE: The aim of this study was to analyze an injury scene during fly fish boat riding (FBR).METHODS: We conducted survey on 12 patients who had humerus shaft fractures during FBR between 2011 and 2016 at three university-based emergency rooms. Individual information, injury mechanism, classification of humerus shaft fracture, and combined injury were recorded from medical document and telephone interview.RESULTS: The injury happened when the kite was turned over and fall into the water in 10 patients (82%); the kite was turned over in the air in one patient (9%), and a leash between kite and boat was broken in one patient (9%). All patients showed 12-B1 or 12-B3 type distal humerus shaft fracture. And there were combined contralateral distal humeral shaft fractures in two patients, vertebral compression fracture in one patient, and radial nerve injury in four patients.CONCLUSION: Riding position and injury mechanism such as turning over may affect distal humerus shaft fractures with butterfly fragment during FBR.

Incidence and Seasonal Variation of Distal Radius Fractures in Korea: a Population-based Study

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.

The Epidemiology of Dupuytren's Disease in Korea: a Nationwide Population-based Study

BACKGROUND: To date, there have been few reports on the nationwide population-based epidemiology of Dupuytren's disease (DD). We investigated the prevalence and incidence of DD in Korea using the large dataset provided by the Korean Health Insurance Review and Assessment Service. This study is the second nationwide epidemiological study of DD after the study in Taiwan. METHODS: Records of patients diagnosed with DD between 2007 and 2014 were extracted from the large dataset by diagnostic code searching (International Classification of Disease 10th revision code M72.0) and were included in the study. We calculated the prevalence and incidence of DD based on the total population of Korea provided by the Korean Statistical Information Service. Diseases associated with DD and the trends in surgery for DD were also analyzed. RESULTS: A total 16,630 patients were diagnosed with DD during the study period. The mean annual prevalence was 32.2 per 100,000 population (41.8 per 100,000 for men; 22.5 per 100,000 for women). The mean annual incidence was 1.09 per 100,000 population (1.80 per 100,000 for men; 0.38 per 100,000 for women). The common diseases associated with DD were hypertension (30.5%), diabetes mellitus (26.7%), hyperlipidemia (20.4%), ischemic heart disease (7.9%), and cerebrovascular disease (4.6%). The mean annual proportion of the patients who had surgery for DD was 5.24% of all DD patients. CONCLUSION: The prevalence and incidence of DD in Korea were 100–1,000 times lower than those in western countries; however, it was slightly larger than that in Taiwan.

National Surgical Trends for Distal Radius Fractures in Korea

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.

The Change of the Ulnar Variance in Accordance with the Wrist Position in Ulnocarpal Impaction Syndrome

PURPOSE: We evaluated the change of the ulnar variance (UV) as forearm rotation in patients with ulnocarpal impaction syndrome (UIS). METHODS: Twenty patients who suffered from ulnar side pain of the wrist and had abnormal lesions at ulno-basal side of the lunate in the radiologic examinations were included in this study. Their UVs in six wrist position (neutral, supination, pronation, neutral and grip, supination and grip, pronation and grip) were measured by the method of perpendiculars. UVs and the maximum change of UV in patients with UIS were compared with those of control group statistically. RESULTS: There were statistically significant differences in UVs of all forearm rotation and grip status. The maximum change of UV was in supination position to pronation and grip status for all cases. The mean maximum change of UV in patients with UIS was 2.03+/-1.03 mm, and that of control group was 1.86+/-0.86 mm. But there was no significant difference between them. The ulnar shortening osteotomy was performed for thirteen UIS patients, and one patient with osteoarthritis at distal radio-ulnar joint was operated with Darrach procedure. Six patients underwent conservative treatment. CONCLUSION: There were no significant differences in the maximum change of UV as forearm rotation between UIS patients and control group.

Bilateral Slipped Capital Femoral Epiphysis Due to Primary Hyperparathyroidism: A Case Report / 대한정형외과학회잡지

Slippage of the upper femoral epiphysis can occur in association with endocrine disorder. A 14-year-old male patient, who complained of pain on multiple joints including both hips, was diagnosed with bilateral slipped femoral epiphysis due to primary hyperparathyroidism. At a single operation, the epiphyses were pinned-in situ, and the tumor was removed. After parathyroidectomy, the calcium and the parathyroid hormone levels promptly resolved. The pinning-in situ of both femoral heads was done for the purpose of preventing further displacement of the femoral epiphyses, and we aimed for epiphysiodesis. The permanent biopsy of the tumor was parathyroid adenoma. The physes of both femoral heads were closed and the widened physes of both distal tibias resolved postoperatively.

A Study on the Criteria for Lateral Retinacular Release in Total Knee Arthroplasty: The No Thumb Technique with One Stitch Method

PURPOSE: This study was performed to determine new criteria for performing lateral retinacular release (LRR) without having a detrimental effect on patellar tracking. MATERIALS AND METHODS: For 17 patients who underwent bilateral TKAs, LRR was not performed at one side (A) due to improvement of patellar tracking after deflation of tourniquet although maltracking existed with the inflation of tourniquet. At the other side (B), LRR was not performed either because patellar tracking improved with one stich method although maltracking existed regardless of tourniquet status. We measured the lateral patellar tilt angle (LPTA) of each side inthose 17 patients after 1 year after TKAs and compared them. We also surveyed the incidence of LRR in 225 primary TKAs with the staged method of patellar tracking evaluation during the same period. RESULTS: The average LPTA was 3.4degrees at side (A) and 4.6degrees at side (B) respectively. There was no significant difference in LPTA between side (A) and side (B) (p=0.337). From the survey for incidence of LRR in 225 primary TKAs during the same period, LRR was not required in 19% of patients showing good patellar tracking with inflation of tourniquet, 58% of patients showing improved patellar tracking after deflation of tourniquet and 21% of patients showing improved patellar tracking by one stitch method regardless of tourniquet status. Consequently, only 2% of patients required LRR in primary TKA. CONCLUSION: One stitch method under the deflation of tourniquet in evaluating process of patellar tracking during primary TKAs is supposed to be very effective and to reduce the incidence of LRR to only 2% without influencing the LPTA.