• Clinical and Experimental Pediatrics
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• 제62권3호
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• pp.90-94
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• 2019

Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권4호
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• pp.295-304
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• 1992

The author investigated the 162 patients with the condylar fractres of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Hospital of Chosun Dental School from January 1985 to September 1992 clinically, including fracture incidennce, age and sex of the patients, causes of injures, associated injures, treatments and complications and obtained the following results. 1. Of the 449 patients with mandibular fractures, 162patients suffered condylar fractures(36.1%). 2. Of the 162 patients, males with condylar fractures were 128 patients, by a ratio of 3.8 : 1. 3. The most frequently affected age group was the third decade(32.7%). 4. Falls were ranked as the predominant cause(50.6%), followed by traffic accident(27.8%) and violence (16.0%). 5. The incidence of single condylar fractures was 28% and symphysis fractures were the most commomest of the concomittant injuries(60%). 6. The subcondylar fractures occurred most frequently(41.6%) and anteromedial displacement of the condylar fragments occurred most frequently(45.4%) 7. Of the all condylar fracture patients, children under 15 of age comprized 31 patients(19.1%) and condylar head fractures occurred most frequently at those children. 8. Of the managetments in condylar fractures, open reduction was 52.5% and remainder were closed reduction(47.5%). 9. Complications ensured such as TMJ ankylosis, limitation of mouth opening and mandibular movements, TMJ dysfunction, and anterior open bite.

• 대한소아치과학회지
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• 제45권3호
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• pp.378-385
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• 2018

하악의 골절은 아이들의 악안면 영역 골절 중 높은 빈도로 발생하며, 성장기의 환자에서 악골의 골절은 성인의 골절과 구별된 처치가 필요하다. 골편의 변위가 심하지 않다면 비관혈적 정복술과 추가적인 악간 고정을 시행할 수 있으며 악관절 강직을 예방하기 위한 기능적 운동이 필요하다. 하악의 골절 이후 여러 합병증이 발생할 수 있다. 특히 과두 골절의 경우, 골절 이환 측에서 성장장애를 일으켜 부정교합과 안면비대칭을 야기할 수 있다. 하악의 골절 이후 성장 장애가 발생한 경우, 환자에 따라 catch-up growth가 일어날 수 있으므로 주기적인 관찰이 필요하다. 성장장애가 지속되는 경우엔 안면 비대칭이 심해지는 것을 방지하기 위해 기능성 장치의 사용을 고려할 수 있다. 본 증례에서는 하악의 골절 이후 안면비대칭을 보이는 2명의 환자를 장기적으로 관찰하고 의미 있는 결과를 나타내고 있기에 이를 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.17-22
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• 1988

1984년 6월 부터 1987년 8월까지 영남대학교 의과대학 부속병원 정형외과에서 체험한 9예의 대퇴골 결부골절에 대한 분석결과는 아래와 같다. 골절의 원인은 교통사고가 대부분(5예)이었으며, 성별로는 여자 6예, 남자 3예였다. 골절의 유형은 제 2형(transcervical)이 6예로 가장 많았다. 치료는 4예에서 도수정복후 내고정하였으며 3예에서는 관혈적정복 및 내고정했고, 2예에서 견인과 석고붕대 고정하였다. 치료결과는 6예에서 우수하였으나, 3예에서 불량하였다. 불량한 예는 모두 고관절, 대퇴경부 및 대퇴골두에 합병증이 생긴 경우였다. 교통사고 등 사고예방에 관심을 높여야 하고, 빠른 진단과 적절한 내고정방법들이 중요한 것으로 생각되었다.

• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.528-533
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• 2012

Objective : In the pediatric population the skull has not yet undergone ossification and it is assumed that the diagnostic rate of skull fractures by simple X-rays are lower than that of adults. It has been recently proposed that the diagnostic rates of skull fractures by 3-dimensional computer tomography (3D-CT) are higher than simple X-rays. The authors therefore attempted to compare the diagnostic rates of pediatric skull fractures by simple X-rays and 3D-CTs with respect to the type of fracture. Methods : One-hundred patients aged less than 12 years who visited the Emergency Center for cranial injury were subject to simple X-rays and 3D-CTs. The type and location of the fractures were compared and Kappa statistical analysis and the t-test were conducted. Results : Among the 100 pediatric patients, 65 were male and 35 were female. The mean age was $50{\pm}45$ months. 63 patients had simple skull fractures and 22 had complex fractures, and the types of fractures were linear fractures in 74, diastatic fractures 15, depressed fractures in 10, penetrating fracture in 1, and greenstick fractures in 3 patients. Statistical difference was observed for the predictive value of simple skull fractures' diagnostic rate depending on the method for diagnosis. A significant difference of the Kappa value was noted in the diagnosis of depressed skull fractures and diastatic skull fractures. Conclusion : In the majority of pediatric skull fractures, 3D-CT showed superior diagnosis rates compared to simple skull X-rays and therefore 3D-CT is recommended whenever skull fractures are suspected. This is especially true for depressed skull fractures and diastatic skull fractures.

• 대한두개안면성형외과학회지
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• 제23권5호
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• pp.205-210
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• 2022

Background: Nasal bone fractures are the most common type of facial bone fracture, but are under-studied in adults above 65 years of age. Therefore, we investigated the epidemiology and patterns of nasal bone fractures among older adults in comparison to different age groups. Methods: This retrospective study included 2,321 nasal bone fracture patients who underwent surgery at our hospital from January 2010 to December 2017. The patients were classified by age as preschoolers, school-age children, young and middle-aged adults, and the elderly. We performed pairwise comparisons between elderly patients and each other age group in terms of sex, cause of injury, and fracture type. Results: The 2,321 nasal bone fracture patients included 76 elderly patients (50 men [65.8%] and 26 women [34.2%]). In these patients, the two most common injury causes were falling or slipping down (n= 39; 51.3%) and road traffic accidents (n= 19; 25.0%). According to the Stranc and Robertson classification, the most common force vector was lateral, and plane 2 fractures with lateral forces predominated. Conclusion: The elderly showed similar patterns of nasal bone fractures to those observed in young and middle-aged adults, but significant differences from preschoolers (in the injury vector and plane of fracture) and from school-age children (in the sex ratio and plane of fracture). However, elderly patients presented significantly different epidemiological characteristics compared to the other three groups. Therefore, it is necessary to improve the quality of life of the elderly and prepare for the upcoming super-aged society by taking steps to reduce the incidence and severity of fractures. Possible options for doing so include strengthening individual-level safety factors and expanding the social safety net for the elderly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.183-190
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• 2020

Objectives: The purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population. Materials and Methods: Data for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pediatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%. Results: Of 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular fractures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46). Conclusion: Falls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.

• The Korean Journal of Pain
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• 제33권4호
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• pp.386-394
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• 2020

Background: In the emergency department (ED), adequate pain control is essential for managing patients; however, children with pain are known to receive less analgesia than adults with pain. We introduce the Pain Passport to improve pain management in paediatric patients with suspected fractures in the ED. Methods: This was a before-and-after study. We reviewed the medical records of paediatric patients who were primarily diagnosed with fractures from May to August 2015. After the introduction of the Pain Passport, eligible children were enrolled from May to August 2016. Demographics, analgesic administration rates, time intervals between ED arrival and analgesic administration, and satisfaction scores were obtained. We compared the analgesic prescription rate between the two periods using multiple logistic regression. Results: A total of 58 patients were analysed. The baseline characteristics of subjects during the two periods were not significantly different. Before the introduction of the Pain Passport, 9 children (31.0%) were given analgesics, while after the introduction of the Pain Passport, a significantly higher percentage of patients (24/29, 82.8%) were treated with analgesics (P < 0.001). The median administration times were 112 (interquartile range [IQR], 64-150) minutes in the pre-intervention period and 24 (IQR, 20-74) minutes in the post-intervention period. The median satisfaction score for the post-intervention period was 4 (IQR, 3-5). The adjusted odds ratio for providing analgesics in the post-intervention period was 25.91 (95% confidence interval, 4.36-154.02). Conclusions: Patient-centred pain scoring with the Pain Passport improved pain management in patients with suspected fractures in the paediatric ED.

• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.212-214
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• 2014

The synchondrosis between the dens and the body of axis normally fuses between 5 and 7 years of age. Until this age, synchondrosis fractures can occur in children. Most synchondrosis fractures are conventionally treated by external immobilization alone. We report a 10-year-old child with odontoid synchondrosis fracture who was treated by C1 lateral mass and C2 pars screw rod fixation with a successful outcome and discuss the possible reasons for occurrence of odontoid synchondrosis fracture in this older child as well as the indications for surgery in this condition.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.448-456
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• 2011

Introduction: Condylar fractures are common in the maxillofacial region, comprising 29-40 percent of all mandibular fractures, accounting for about 20-62 percent). Previous studies reported that pediatric condylar fractures can cause disorders in facial growth and function, and the treatment methods have been controversial. Recently, conservative treatment has shown good results in skeletal growth and functional recovery but the conservative treatment of pediatric condylar fractures has shown unpredictable and undesirable results in some cases, such as facial asymmetry and temporomandibular joint disorder. This study examined the specific age groups and specific mandibular condylar fracture type in growing children treated conservatively in the past. Materials and Methods: Eighteen patients (10 men and 8 women) who received conservative treatment for unilateral condylar fractures in Dankook University Dental Hospital between 2000 to 2007 were followed up for a mean period of 7.2 years. Results: In the survey of 18 pediatric patients who received conservative treatment for condylar fractures, the incidence of temporomandibular dysfunction and growth disturbance was 45% and 35%, respectively. Conclusion: In all complications, the symptoms observed most frequently was mouth opening displacement of the mandible exceeding 2 mm. The other complications of functional and growth disturbance included facial asymmetry concentrated along specific condylar types. Complications including facial asymmetry and functional and growth disturbances showed an increasing tendency according to the specific fracture types. Functional and growth disturbances in the undisplaced condylar fracture type showed a lower incidence(P <0.05). Functional and growth disturbances differed according to the fracture type, which has poor relationship with articular fossa and condyle(P <0.05). Functional and growth disturbance in the cases of the high-level condylar fracture type showed a higher incidence(P <0.05). The functional and growth disturbances of the fracture types were similar in the fragment-contact and non-contact groups(P >0.05).