• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.266-270
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• 2020

The musculoskeletal system can be damaged by massive contractions of the muscles in the case of systemic attacks by epilepsy. Several studies or case reports of multiple thoracic vertebrae fractures following generalized seizures without underlying diseases or falls have been reported, but there are few domestic studies or case reports. This paper reports the case of a 42-year-old male patient without any specific underlying disease, who was diagnosed with multiple fractures of the thoracic vertebrae caused by generalized myoclonic epilepsy during sleep.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.104-107
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• 2010

Acute respiratory distress syndrome (ARDS) is difficult to treat and it is often fatal. If the medical treatment for ARDS is not effective, then extracorporeal membrane oxygenation (ECMO) can be applied to the patient. A 22-year-old female who suffered multiple traumatic injuries due to a car accident presented with acute respiratory distress syndrome. Veinarterial extracorporeal membrane oxygenation (VA ECMO) was started to treat her respiratory failure. With the VA ECMO, the systemic oxygen saturation remained at only 84%, and so the ECMO system was switched to V-VA ECMO via an additional venous outflow through the right jugular vein to increase both the systemic and pulmonary oxygen saturation. After conversion to the V-VA type ECMO, the systemic oxygen saturation increased to 94% and the partial pressure of oxygen ($PaO_2$) increased to 65 mmHg. We report here on a successful case of ECMO conversion from the VA type to the V-VA type in a patient with severely hypoxic respiratory failure.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.8.2-8
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• 1977

There are in many instances emergent cases in traumatic lesions of neck, which require emergency treatment for life saving. The authors experienced a case of multiple lacerations including anterior neck, both forearms and abdomen, that have psychological problems. This is the report of this case along with literature survey.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.47-52
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• 2010

Background: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. Material and Method: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. Result: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. Conclusion: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.23-26
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• 2007

관절와 병변은 급성 외상으로 인한 골절뿐 아니라 불안정성으로 인한 골 침윤으로 정의할 수 있으며, 이는 통상의 방사선학적 검사를 통하여 진단을 하지 못하는 경우도 있다. 전방 탈구와 동반된 전방 관절와 골절의 빈도는 5.4%에서 32%까지 보고되었다. Hovelius 등이 226명의 탈구환자를 대상으로한 연구에서 8%의 관절와 골절이 있었다고 보고하였고, 노령의 환자에서 약간의 빈도가 증가한다고 하였다. 또한 Rowe는 전방 관절와 골절이 있는 27명의 환자에서 기계적 안정성의 결함으로 62%의 재발성 탈구가 있었다고 보고하였다. 보다 최근의 방카르트 술기에 대한 보고에서 수술적 처치를 한 환자중 44%가 관절와 골절을 동반하였다고 보고하였다. Rowe 와 Zarins는 다발성 전방탈구 환자에서 관절와 병변이 잘 치료되었는지 여부에 따라 다른 결과를 낸다고 보고하였다. 전자에 따르면, 관절와 병변을 진단하는 것은 중요하며 환자의 최종적 예후는 이를 어떻게 치료했는지 여부에 따라 결정된다고 하였다. 관절와 상완관절의 불안정성에서 동반된 관절와 병변의 진단은 보존적 치료시나 수술적 치료 시 모두 중요한 인자라고 하겠다.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.185-188
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• 2008

Acromioclavicular joint injuries usually occur as a result of direct trauma to the superolateral aspect of the shoulder. Roockwood Type IV injuries are relatively uncommon, and they are easily misdiagnosed or neglected in patients who have suffered multiple traumas. Therefore, to correctly treat a patient with type IV injury, we need to take a careful physical examination and conduct proper radiologic evaluation for the acromioclavicular joint. We report here on two cases of modified Weaver-Dunn reconstruction for neglected type IV acromioclavicular joint injuries that were associated with multiple rib fractures.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.373-376
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• 2008

Surgery is the general treatment modality for thoracic aortic pseudoaneurysm combined with traumatic aortic rupture. However, we should select other treatment modalities for patients who can't tolerate surgery due to severe multiple injuries. Herein we report on a case of successful stent-graft treatment for a traumatic descending thoracic aortic pseudoaneurysm combined with severe multiple trauma, and we include a review of the relevant literature.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.255-265
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• 2000

The term 'myositis ossificans' encompasses four categories of clinicopathological disorders. The first, myositis ossificans progressive(fibrodysplasia ossificans progressive), is a rare genetic disease characterized by progressive heterotopic ossification involving skeletal muscle, tendon, ligaments, and fascia, with congenital malformation of the great toes, and usually microdactyly, monophalangism, and mal formed proximal phalanges. with valgus deformity of metatarsophalangeal joint. The ossification begins shortly after birth and may contribute to the patient's death. The second, heterotopic ossificans, can occur in patients with neuromuscular and chronic diseases such as paraplegia, poliomyelitis, polymyositis, bum, tetanus, and infection. But the lesions in these cases often lack the typical histologic features of myositis ossificans. The third, myositis ossificans traumatica, is the most common; it develops in response to soft tissue trauma such as a single severe injury, minor repetitive injures, fracture, joint dislocation, stab wound, or surgical incision. The forth, nontraumatic myositis ossificans, also designated :pseudomalignant osseous tumors of extraskeletal soft tissues' and 'psedomalignant myositis ossificans', occurs in persons repeated small mechanical injures or nonmechanical soft tissue injuries due to local ischemia, inflammation. or other factors cannot be ruled out in such cases.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.226-228
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• 2013

Elderly patients with acute subdural hematomas have higher mortality and lower functional recovery rates compared with those of other head-injured patients. Early and widely surgical decompression and active intensive care represent the best way to assist these patients. However, abrupt decompression of the hematoma can lead to brain disruption and secondary ischemia in the brain surrounding the craniectomy site. Acute brain swelling and brain extrusion, which take place shortly after decompression, can lead to a catastrophic situation during the operation due to the impossibility of appropriate closure of the dura and scalp. To avoid the deleterious consequences of disruption of brain tissue, we have adopted multiple fenestrations of the dura in a mesh-like fashion and gradual release of subdural clots through the small dural openings that are left open. This is especially important in cases in which there are massive amount of subdural hematomas with small parenchymal lesion and severe midline shifts in elderly patients. Further clinical experiences should be conducted in a more selected series patients to estimate the impact of this technique on morbidity and mortality rates.

• Journal of Trauma and Injury
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• v.26 no.2
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• pp.58-62
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• 2013

A cerebral fat embolism is an uncommon but serious complication of long bone fracture. It can be fatal, and early detection is not easy. Neurologic symptoms are variable, and the clinical diagnosis is difficult. The pathogenesis remains controversial, and several theories have been proposed. Magnetic resonance imaging can detect a cerebral fat embolism with a higher sensitivity than cerebral computed tomography. We report a case of a posttraumatic cerebral fat embolism without pulmonary involvement and review the existing literature.