Background: Postoperative radiocarpal joint stiffness (RJS) is common in patients with distal radius fractures (DRFs). The purpose of this study was to record the incidence of RJS and to determine potential risk factors that may be associated with it. Methods: We retrospectively included a series of patients who suffered from DRFs and underwent volar plate fixation. Patients' basic data, radiographic data, and postoperative data were collected. The incidence of RJS during follow-up was recorded, and both univariate analyses and multivariate logistic regression were used to determine factors associated with it. Results: A total of 119 patients were included in this study. After surgical procedures, there were 42 (35.3%) patients with RJS and 77 (64.7%) patients without. The incidence of RJS after surgical treatment is 35.3%. Multivariate analysis showed that intra-articular fracture (OR, 1.43; 95% CI, 1.13-1.81), pre-operative severe swelling (OR, 1.35; 95% CI, 1.05-1.74), post-operative unsatisfied volar tile (OR, 1.38; 95% CI, 1.01-1.89), and improper rehabilitation exercise (OR, 1.72; 95% CI, 1.18-2.51) were correlated with the incidence of RJS during follow-up. Conclusions: Patients with intra-articular fracture, pre-operative severe swelling, post-operative unsatisfied volar tile, and improper rehabilitation exercise were factors associated with the incidence of wrist stiffness. Preoperative risk notification and postoperative precautions are necessary for relevant patients.

No abstract

Background The objective of this study was to predict the function of the forearm rotation on the basis of the articular surface of the sigmoid notch from three-dimensional reconstruction images. Methods We retrospectively reviewed patients who underwent volar plate fixation for intra-articular distal radius fractures (DRFs) in our institution between January 2017 and July 2019. The 3D image of the sigmoid notch on the fractured distal radius was reconstructed and looked up from the ulnar view to determine the existence of gaps or steps. Patients with or without gaps/steps on the sigmoid notch were included in the case group or control group, respectively. The patients’ basic data and postoperative data were collected and compared. Results A total of 81 patients were included. There were 33 patients in the case group, and 48 patients in the control group. There was no significant difference between the two groups at baseline. The total range of motion (ROM) of rotation in the case group and control group was 130.3 ± 6.2° and 145.3 ± 6.7°, respectively (P < 0.001). The percentage of rotation ROM of contralateral limb in the case group and control group was 72.3 ± 3.1% and 80.7 ± 3.6%, respectively (P < 0.001). VAS during forearm rotation was 2.1 ± 0.7 in the case group, which is significantly higher than that in the control group (1.5 ± 0.5, P < 0.001). Conclusion This study proposed a new method to assess the articular surface of the sigmoid notch which is based on 3D reconstruction images. With the assistance of this method, we found that gaps or steps on the sigmoid notch not only limit forearm pronation rotation and supination rotation, but also cause apparent wrist pain during forearm rotation movement and poor wrist ability.

No abstract

Rationale Rhapontigenin, a stilbene compound isolated from the medicinal plant of rhubarb rhizomes, has shown a variety of biological activities. The purpose of this study was to identify and characterize the metabolites of rhapontigenin in rat liver microsomes, hepatocytes, urine, and human liver microsomes and hepatocytes. Methods The samples were analyzed by ultra‐high‐performance liquid chromatography combined with electrospray ionization quadrupole/orbitrap high‐resolution mass spectrometry (UPLC‐Q/Orbitrap‐HRMS). The structures of the metabolites were interpreted by MS, MS/MS data, and elemental compositions. Results A total of 11 metabolites were detected and tentatively identified. M1, identified as piceatannol, was unambiguously identified using reference standard. Our results suggested that rhapontigenin was metabolized through the following pathways: (a) demethylation to produce piceatannol (M1), which further underwent oxidation to form ortho‐quinone intermediate. This intermediate was reactive and conjugated with GSH (M10 and M11), which were further converted into N‐acetyl‐cysteine and excreted in urine. M1 also underwent sulfation (M8) and glucuronidation (M5); (b) direct sulfation, forming M6 and M7; and (c) direct glucuronidation to form M2, M3, and M4. Glucuronidation was a major metabolic pathway in hepatocytes and urine. Conclusions The current study provides an overview of the metabolism of rhapontigenin, which is of great importance for us to understand the disposition of this compound.