Evidence map›Paper›PMID 40533679›Full record

ArticleArchives of osteoporosis2025

Staging classification of atypical ulnar fractures.

Tetsushi Kinoshita, Fumihiro Isobe, Hiroshi Yamazaki, Koichi Nakamura, Shun Hashimoto, Teruki Shirayama, Hiroko Iwakawa, Masanori Hayashi, Jun Takahashi

Abstract read
In one paragraph

Article in Archives of osteoporosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Tetsushi KinoshitaDepartment of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Fumihiro IsobeDepartment of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan. fisobe@shinshu-u.ac.jp.
Hiroshi YamazakiDepartment of Orthopaedic Surgery, Aizawa Hospital, Matsumoto, Japan.
Koichi NakamuraDepartment of Orthopaedic Surgery, North Alps Medical Center Azumi Hospital, Ikeda-machi, Japan.
Shun HashimotoDepartment of Orthopaedic Surgery, Nagano Municipal Hospital, Nagano, Japan.
Teruki ShirayamaDepartment of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Hiroko IwakawaDepartment of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Masanori HayashiDepartment of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Jun TakahashiDepartment of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Atypical ulnar fractures (AUFs) are rare fractures associated with long-term bisphosphonate use; their progression pattern is not understood. This study classified AUFs based on imaging characteristics, revealing a progression from cortical bone thickening to complete fractures with osteosclerosis over time. This classification may assist in determining appropriate treatments for AUFs. PURPOSE: The progression and characteristics of AUFs remain unclear, and no definitive treatment method has been established. This study aimed to classify AUFs based on imaging findings to elucidate their characteristic progression patterns.

methodsWe retrospectively reviewed 12 AUFs in 11 patients who had used bisphosphonates in the long term. Based on imaging characteristics, we classified the fractures into 3 stages: Stage I (incomplete fractures with cortical thickening or fracture lines only in the dorsal cortex), Stage II (complete fractures with fracture lines extending to the ventral cortex), and Stage III (complete fractures with osteosclerosis).

resultsAt the initial examination, 2 AUFs were classified as Stage I, 8 as Stage II, and 2 as Stage III. Two fractures progressed from Stage I to Stage II during follow-up. Our imaging analysis showed a consistent pattern, suggesting that AUFs begin with cortical thickening in the dorsal cortex, progress to fractures extending to the ventral cortex, and develop sclerosis resembling pseudoarthrosis.

conclusionAUFs begin with cortical bone thickening and progress to complete fractures. Over time, these complete fractures can become sclerotic, resembling pseudoarthrosis.

Indexed as

Bone Density Conservation AgentsDiphosphonatesUlna FracturesAgedAged, 80 and overDisease ProgressionFemaleHumansMaleMiddle AgedOsteosclerosisRetrospective StudiesBone Density Conservation AgentsDiphosphonatesAtypical ulnar fractureAutologous bone graftingBisphosphonatesOsteoporosis

Identifiers

PMID40533679
PMCPMC12176986

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.