Kim, Seong-Hyun;Kim, Yong-Yook;Kwon, Tae-Kyu;Kim, Dong-Wook;Kim, Nam-Gyun
Journal of Biomedical Engineering Research
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v.28
no.6
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pp.811-816
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2007
The social activities of the elderly have been increasing as our society progresses toward an aging society. As their activities are increased, the occurrence of falls that could lead to fractures are increased. Falls are serious health hazards to the elderly and we need more thorough understanding of falls including the progress of falls and the impact area in various fall directions. Many of the traditional methods of falls research dealt with voluntary falls by younger subject since older subject can easily get fracture from voluntary falls. So, it has been difficult to get exact data about falls of the elderly. Here, we tried to capture the characteristics of the movements of major joints using three dimensional motion capture system during falls experiments using a moving mattress that can safely induce unexpected falls. Healthy younger subjects participated in the actual falls experiment and the moving mattress was actuated by a pneumatic system. The kinematic parameters such as velocities and accelerations of major segments were imported to a computer simulation environment and falls to hard surfaces were simulated in a computational environment using a realistic human model of aged persons. The simulation was able to give approximations to contact forces which can occur during actual falls.
Understanding sciences behind fall-related hip fractures in older adults is important to develop effective interventions for prevention. The aim of this review is to provide biomechanical understanding and prevention strategies of falls and related hip fractures in older adults, in order to guide future research directions from biomechanical perspectives. While most hip fractures are due to a fall, a few of falls are injurious causing hip fractures, and most falls are non-injurious. Fall mechanics are important in determining injurious versus non-injurious falls. Many different biomechanical factors contribute to the risk of hip fracture, and effects of each individual factors are known well. However, combining effects, and correlation and causation among the factors are poorly understood. While fall prevention interventions include exercise, vision correction, vitamin D intake and environment modification, injury prevention strategies include use of hip protectors, compliant flooring and safe landing strategies, vitamin D intake and exercise. While fall risk assessments have well been established, limited efforts have been made for injury risk assessments. Better understanding is necessary on the correlation and causation among factors affecting the risk of falls and related hip fractures in older adults. Development of the hip fracture risk assessment technique is required to establish more efficient intervention models for fall-related hip fractures in older adults.
Purpose: This study was done to propose and test a predictive model that would explain and predict fall prevention behaviors in postmenopausal women. The health belief model was the theoretical basis to aid development of a nursing intervention fall prevention program. Methods: Data for 421 postmenopausal women were selected from an original data set using a survey design. The structural equation model was tested for 3 constructs: modifying factors, expectation factors, and threat factors. Expectation factors were measured as relative perceived benefit (perceived benefit minus perceived barrier), self-efficacy, and health motivation; threat factors, as perceived susceptibility (fear of falling) and perceived severity (avoiding activity for fear of falling); and modifying factors: level of education and knowledge about fall prevention. Data were analyzed using SPSS Windows and AMOS program. Results: Mean age was 55.7 years (range 45-64), and 19.7% had experienced a fall within the past year. Fall prevention behaviors were explained by expectation and threat factors indicating significant direct effects. Mediating effect of health beliefs was significant in the relationship between modifying factors and fall prevention behaviors. The proposed model explained 33% of the variance. Conclusion: Results indicate that fall prevention education should include knowledge, expectation, and threat factors based on health belief model.
Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, Young-Kyun;Park, In-Soon
Maxillofacial Plastic and Reconstructive Surgery
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v.17
no.2
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pp.163-170
/
1995
The purpose of this study was to investigate the epidemiology of midface fractures. We observed clinically 71 patients with midface fracture who visited the Department of oral and maxillofacial-surgery, Chosun University, Dental Hospital, from 1991 to 1994. The results obtained were as follows. 1. There was the highest age incidence in the third decade(29.6%). 2. There was the highest incidence in the summer(36.6%). 3. The most etiologic factor of midface fracture was traffic accidents(43.6%) and next factor was fall down(38.0%). 4. The highest incidence fracture was zygomatic arch(38.7%) and next fracture was ZMC fracture(31.5%). 5. Most midface fracture was treated within 2 weeks(86.7%). 6. Midface fractures was most frequently combined with mandibular fracture(15.5%), head injuries(14.1%), orthhopedic injuries(8.5), thorax & abdomen(5.6%). 7. The highest complication was the nerve injury(8명), and next complications were infection(3명), epiphora(3명) etc.
Purpose: Because of traffic accidents and many criminal violences, the incidence of facial trauma has been increasing not only in adults but also in children. We planed this study to introduce our experience about pediatric blow out fracture and provide more information. Methods: We made retrospective study in 76 children with blow out fracture from January 2001 to September 2005 by retrospective chart review including detailed preoperative and postoperative evaluations, age, sex, cause, symptom and sign, and their post-operative complications. Results: Among our patients, 69 were male and 7 were female. The ages ranged from 7 to 18 years, which shows the greatest incidence of blow out fracture. Physical violence(46%) was the most common cause in this group and was followed by vehicle accident(28%), and fall down accident(17%). Left side(64%) showed slightly more incidence than right side(36%), but there were no statistical importance. Ecchymosis(88%) was the most common symptom and followed by periorbital swelling(68%) and diplopia(30%). 30 patients was diagnosed with another facial bone fracture and nasal bone(51%) was the most common associated facial bone fracture. Fourty four Patients(60%) got an orbital wall reconstruction in 7 days after trauma. After the operation, only 3 patients(4%) suffered from diplopia postoperative 3 month, and resolved in 4 years. Conclusion: The incidence of blow out fracture in children has been increasing every year, and violence has become more important etiology of pediatric blow out fracture and public and private education institutions were the most common place that blow out fracture originated. Accurate diagnosis and careful treatment plans are important in pediatric blow out fracture.
Purpose: The human face is the most exposed part of the body, and in patients with simple or complex trauma from traffic accidents, industrial calamities, sports injuries, human assaults, and daily accidents, facial trauma occupies an important portion. The etiology of facial trauma vary on a society's economic, cultural, and environmental status. Methods: Regarding patients who were admitted from between the years 2000 to 2009 at the Hanyang University hospital, the authors studied how the changes in the economic status in the past 10 years of our country influences the incidence of facial bone fractures. Results: In this study, 1) The unemployment rate showed a strong negative relationship with the total number of inpatients with facial bone fractures, the number of male patients, the number of female patients, the number of patients with facial bone fractures caused by fall down, the number of patients who were admitted for shorter than 7 days, and the number of the facial bone fracture patients with their age in the twenties. 2) The consumer price index showed a strong positive relationship with the number of female patients, the number of patients who were admitted for shorter than 7 days, and the number of the facial bone fracture patients with their age in the teens and fifties. Conclusion: Looking at the results of correlation analysis and multiple regression analysis with economic indicators, the unemployment rate showed negative influence to the total number of inpatients with facial bone fractures, and the number of inpatients with facial bone fractures caused by fall down, with statistical significance.
Background: The epidemiology of nasal fractures varies according to factors such as the era and area of the study, as well as the age of the patient. We compared the characteristics and causes of pediatric nasal fractures. Methods: A total of 2,321 patients with nasal fractures from 2010 to 2017 were examined. The patients were divided into age groups using the Korean school system of age classification. The causes of injury were divided into five groups: violence, fall or slip down, sports, road traffic accidents, and others. Fractures were classified using the Stranc and Robertson standard: vector of force and plane of fracture. Results: Violence was the most common cause of nasal fracture in patients older than 12 years. Violence was a significantly less frequent cause among patients younger than 12 years old than among adolescent and adult patients. Nasal fractures due to violence were not observed in patients younger than 10 years. Plane 2 and lateral force fractures were the most common; however, in patients younger than 12 years, frontal force fractures were significantly more frequent than were lateral force fractures. Conclusion: As children may simply be injured due to a fall or slip down, it is important for the parents and guardians to ensure their safety. As they become older, children should abstain from violence and be monitored. It is therefore very important to ensure that the environment is free of violence in order to prevent such injuries.
Objectives: This study was conducted to find out risk factors related to elderly hip fracture, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. Methods: The data were collected from 199 cases hospitalized in 4 university hospitals in Pusan from January, 1996 to December, 1998, 193 healthy controls who visited elderly facilities in Pusan. The data were obtained from medical records and by using questionnaires through telephone contact or direct personal interview with the subjects or their family, and were analyzed for 2-test and multiple logistic regression. The risk factors were shown with odds ratios and their 95% confidence intervals. Results: In univariate analysis, the odds ratio of hip fracture risk was estimated to be 1.9 for the elderly aged 75 years as compare with those aging less than 65 years; 42 for those with job as compared with those without job; 3.3 for those with more than 6 children as compared with those with one or two children. For the variables related to physical characteristics, small height (p=0.015), light weight (p=0.000), and low BMI (p=0.014) were risk factors for elderly hip fracture. Sane variables related to health, such as previous history of illness (OR=3.3.), abnormal blood pressure (OR=1.6), previous fracture history (OR=22), lower limbs weakness (OR=12.1) and gait disturbance (OR=42.6), were significantly associated with the risk of hip fracture. In multiple logistic regression, risk factors for hip fracture were age, having job, lower limb weakness and previous history of illness. The adjusted odds ratios of hip fracture risk among the elderly were age (OR=1.1), having jobs (OR=11.7), weak lower limb (OR=10.8) and previous history of illnesses (OR=3.3), respectively. Conclusion: This study suggests that the plan for improving the daily living environment for the elderly systematically should be implemented to avoid the chances of fall, and that programs encouraging to practice regular exercise for physical activity and to promote health of the elderly should be developed.
For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.
Kim, Joong Suck;Sul, Young Hoon;Go, Seung Je;Ye, Jin Bong;Park, Sang Soon;Ku, Gwan Woo;Kim, Yeong Cheol
Journal of Trauma and Injury
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v.28
no.4
/
pp.272-275
/
2015
Pelvic bone fracture with unstable vital signs is a life-threatening condition demanding proper diagnosis and immediate treatment. Unlike long bones, the pelvic bone is a three dimensional structure with complex holes and grooves for vessels and nerves. Because of this complexity, a pelvic bone fracture can lead to complicated and serious bleeding. We report a case of a fifty-year-old male suffering from a pelvic bone fracture due to a fall. An imaging study showed fractures of both the superior and the inferior ramus of the pubic bone, with contrast extravasation underneath them, resulting in a large preperitoneal hematoma. He was sent for angiography, which revealed a hemorrhage from a branch of the left obturator artery. Embolization was done with a glue and lipiodol mixture. The patient recovered without complication, and was discharged at four weeks after admission.
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