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Background: It is known that there are large regional variations in treatment methods for the management of proximal humeral fractures. The objective of this study was to investigate the national surgical trends in elderly patients with proximal humeral fractures in South Korea., Methods: We analyzed the Korean Health Insurance Review and Assessment Service database from 2008 to 2016. International Classification of Diseases, 10th revision codes and procedure codes were used to identify patients aged ≥65 years with proximal humeral fractures., Results: A total of 69,120 proximal humeral fractures were identified from 2008 to 2016. The overall operative rate for proximal humeral fractures increased steadily from 24.6% in 2008 to 36.8% in 2016 (p < 0.001). The rate of cases treated with open reduction and internal fixation tended to increase each year, from 71.5% of the overall surgeries in 2008 to 85.6% in 2016; conversely, the rate of cases treated with closed reduction and internal fixation tended to decrease from 19.9% in 2008 to 4.5% in 2016. In terms of type of arthroplasty procedure, the rate of cases treated with reverse shoulder arthroplasty tended to increase significantly each year, from 8.2% of the overall arthroplasty procedures in 2008 to 52.0% in 2016 (p < 0.001). The proportion of reverse shoulder arthroplasty was shown to increase especially in patients aged 80 years or older., Conclusion: Overall, our findings indicated that surgical treatment of proximal humeral fractures, particularly by open reduction and internal fixation, continues to increase; in terms of type of arthroplasty procedure, the rate of cases treated with reverse shoulder arthroplasty tended to increase.

This study aimed to evaluate the incidence rates of and risk factors for complex regional pain syndrome type 1 (CRPS-1) after surgery for distal radius fractures (DRFs). Using data from January 2007 to December 2014, we analysed the data from the Korean Health Insurance Review and Assessment (HIRA) service. After extracting the data of patients aged ≥18 years whose diagnostic and operation codes for DRFs were entered into the HIRA database, we analysed the incidence rates of and risk factors for CRPS-1. From 2007 to 2014, 172,194 DRFs were treated surgically. Within 1 year postoperatively, 1,103 CRPS-1 cases were diagnosed, with an incidence of 0.64%. On univariate and multivariate analyses, the risk factors that significantly correlated with the incidence of CRPS-1 included female sex, rheumatoid arthritis, open reduction, open fracture, and accompanying ulnar fracture, whereas old age, psychiatric disease, and external fixation were not statistically significant. The incidence of CRPS-1 after surgery for DRF was very low (0.64%) in South Korea. Careful monitoring is necessary for patients with complex fractures and rheumatoid arthritis who are at increased risk of developing CRPS-1.

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., Competing Interests: Disclosure: The authors have no potential conflicts of interest to disclose.

Aim: To assess the incidence rate of carpal tunnel syndrome (CTS) in patients with rheumatoid arthritis (RA) and investigate the correlations between CTS and disease activity and duration in patients with RA., Materials and Methods: This retrospective cohort study was conducted to assess the incidence rate of CTS in 1070 patients with RA who had visited our rheumatism center between March 2001 and May 2013, and had participated in follow-up at least once over a 5-year period. We also investigated duration of RA and C-reactive protein (CRP) levels at time of CTS occurrence to identify correlations between CTS occurrence and duration of RA, and disease activity of RA., Results: The cumulative incidence for 12 years of CTS in patients with RA was 6.8% (12/176), and 37 cases of CTS occurred in 1070 patients with RA. The incidence rate of CTS in patients with RA was found to be 4.18 per 1000 person-years (37 in 8849 person-years). There was no statistically significant correlation between CTS occurrence and duration of RA, and no positive correlation between CTS occurrence and CRP levels., Conclusion: Our incidence rate of CTS in patients with RA was similar to the incidence rate of CTS in the general population (0.3-5.0 per 1000 person-years). CTS occurrence did not correlate with duration of RA and had no positive correlation with disease activity of RA., (© 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.)