ABSTRACT
<p><b>OBJECTIVE</b>To analyze the relationship between radiographic parameters and clinical outcomes of patients with distal radius fractures in elderly patients following conservative treatment, and find the important radiographic parameters with distal radius fractures in elderly patients.</p><p><b>METHODS</b>From May 2012 to May 2015, a retrospective analysis was performed of 45 elderly patients with distal radius fractures treated by conservative treatment, which including 17 males and 28 females with an average age of 64.49 years old from 60 to 89 years old. The imaging parameters were measured and the clinical efficacy was evaluated. The imaging parameters on the standard wrist joint X-ray picture were measured including metacarpal angle, the radius height, the ulna variation, the ulnar angle, and so on. The clinical effect of wrist joint was evaluated by Dienst score standard. Multiple factor linear regression was used to analyze the relationship between the image parameters and the clinical efficacy.</p><p><b>RESULTS</b>All patients were followed up for 12 to 24 months with an average of 17.6 months. All fractures of the distal radius were healed. According to the Dienst evaluation, at the final follow-up the result was excellent in 27 cases, good in 10 cases, fair in 6 cases and poor in 2 cases. There was a significant correlation between the height of the radius, the angle of the palmar and the variation of the ulna and the function of the wrist joint in the imaging parameters. When the radius height more than 8.12 mm, the palmar angle more than -1.64 degree and the ulna variant less than 4.05 mm, the result of Dienst function was better.</p><p><b>CONCLUSIONS</b>The imaging parameters such as the radius height, the palmar angle and the ulna variation are related to the recovery of the clinical efficacy of the distal radius fractures in the elderly. The most important parameter is the radius height, which reminds the surgeon to pay special attention to the reduction of the radius fracture in the elderly.</p>
ABSTRACT
Some cases of psoriatic arthritis [PsA] cannot be explicitly diagnosed, especially when the skin and nail lesions present years after the joint disease or are absent. Autoimmunity may also play a role in the development of Dupuytren's disease. However, the simultaneous presence of PsA and Dupuytren's disease is very rare. We present a patient displaying arthritis in multiple small joints, with bone erosions and bony fusions in all four extremities, combined with Dupuytren's disease. Because of the atypical clinical manifestation, the diagnosis perplexed doctors for decades. Without formal treatment, the disease followed a natural course over time. Reviewing the patient's data, a potential diagnosis of PsA, combined with Dupuytren's disease, was eventually made. After surgery, contractures of palmar and plantar fascia as well the thumb web were released, and the hallux valgus was corrected