• 제목/요약/키워드: Injury of external cause

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사례 중심의 손상외인코드 별 낙상환자 빈도수 분석에 따른 주진단코드 연구 (A Study on the Main Diagnostic Code according to the Analysis of the Frequency of Fall Patients by Case-Centered Damage External Code)

  • 최은미;박예지;방소현;정진형
    • 한국정보전자통신기술학회논문지
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    • 제16권6호
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    • pp.533-539
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    • 2023
  • 본 연구는 강원도 강릉시에 위치한 A기관의 2020년부터 2021년 중심 데이터로 손상으로 입원한 환자를 손상외인코드를 통해 낙상환자를 분석하고자 하였다. 낙상환자의 손상외인코드인 W00부터 W19까지 20건의 코드를 분류한 후, 많이 발생한 W18, W01, W10, W13을 분석하였다. 손상외인코드 W18은 동일 면상에서의 기타 낙상으로 S72, Z47의 빈도수가 가장 많았으며, S72는 대퇴골의 골절, Z47은 정형외과적 추적치료이다. 손상외인코드 W01은 미끄러짐, 걸림 및 헛디딤에 의한 동일 면상에서의 낙상으로 W18과 같이 대퇴골의 골절인 S72와 정형외과적 추적치료 Z47이 많이 나타나는 것으로 판단하였다. W10은 계단에서의 낙상으로 뇌진탕, 경막외출혈 등이 있는 두개내손상 S06이 많이 나타났다. 마지막으로 W13은 빌딩 또는 구조물에서의 낙상으로 40대~70대에서 91%가 발생하여 중장년층이 많이 발생하는 것을 확인할 수 있었고, Z47은 정형외과적 추적치료가 가장 많았으며, S72는 대퇴골의 골절이 두 번째로 많은 것으로 나타났다. 이와 같이 낙상환자의 빈도수를 분석하여 낙상사고별 많이 발생하는 나이와 주진단코드를 분석하였다.

요골 신경 손상의 수술적 치료 (Surgical Treatment of Radial Nerve Injury)

  • 이광석;박상원;위대곤
    • Archives of Reconstructive Microsurgery
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    • 제5권1호
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    • pp.128-136
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    • 1996
  • Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

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Trend analysis of nasal bone fracture

  • Kim, Kwang Seog;Lee, Han Gyeol;Shin, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
    • 대한두개안면성형외과학회지
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    • 제19권4호
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    • pp.270-274
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    • 2018
  • Background: Nasal bone fractures occur frequently because the nasal bone is located at the forefront of the face. The goal of this study was to examine the cause, change in severity, change in incidence, and demographics of nasal bone fracture according to today's lifestyle. Methods: A total of 2,092 patients diagnosed as having nasal bone fractures at our department between 2002 and 2017 were included in this study. We retrospectively examined patients' medical records to extract information regarding age, sex, cause of injury, combined facial bone fractures, and related injuries such as skull base fracture, spinal cord injury, brain hemorrhage, and other bone fractures. Fracture severity was classified by nasal bone fracture type. Results: No statistically significant difference was found in annual number of patients treated for nasal bone fracture. The proportion of patients who underwent closed reduction was significantly decreased over time for those with nasal bone fractures caused by traffic accidents. However, it was not significantly changed for those with nasal bone fractures due to other causes. The number of patients with combined facial bone fractures increased over time. Incidences of severe nasal bone fracture also increased over time. Conclusion: The study suggested that there is a decrease in the frequency and increase in the severity of nasal bone fracture due to traffic accident. Many protective devices prevent nasal bone fractures caused by a small amount of external force; however, these devices are not effective against higher amounts of external force. This study highlights the importance of preoperative thorough evaluation to manage patients with nasal bone fractures due to traffic accident.

교통사고에 의한 둔상으로 발생한 우심방 파열 - 1예 보고 - (Right Atrium Rupture as a Result of Blunt Trauma from a Traffic Accident - One case report -)

  • 장인석;최준영;김성환;이정은;김종우;이상호
    • Journal of Chest Surgery
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    • 제40권1호
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    • pp.66-68
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    • 2007
  • 외상성 심장 손상은 매우 위중한 의학적인 상황이다. 흉벽의 외상이 없는 경우 심장의 손상은 간과될 수 있다. 저자들은 자동차 추돌사고를 입고 우심방 파열이 발생한 47세 여자 환자를 보고한다. 감속손상으로부터 발생하는 비틀림의 힘은 고정점에서 심장의 파열을 일으킬 수 있다. 심장의 심각한 손상을 의심할 수 있는 가장 흔한 증상은 활력증후의 변화이다. 그러므로 감속손상을 입은 환자에서 흉벽의 외상이 없더라도, 이유가 설명되지 않는 저혈압이 관찰될 때 심장의 손상을 의심하여야겠다.

경골과 골절의 치료 (Treatment of Tibial Condyle Fracture)

  • 이동철;손욱진;박성혁
    • Journal of Yeungnam Medical Science
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    • 제20권2호
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    • pp.177-186
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    • 2003
  • 교통사고의 증가로 심한 경골 고평부 골절이 점진적으로 증가되는 양상이며, 경골 고평부 골절 후 동반손상의 적절한 치료, 해부학적 정복 및 견고한 고정, 조기 관절운동이 좋은 예후를 보이며 외상성 관절염을 줄일 수 있을 것으로 사료된다.

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Characterizing Viscoelastic Property of Soft Tissue Over the Hip as a Risk Factor of Pressure Ulcer

  • Lim, Kitaek;Kim, Seung-su;Choi, Woochol Joseph
    • 한국전문물리치료학회지
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    • 제28권1호
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    • pp.72-76
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    • 2021
  • Background: A pressure ulcer is common in soft tissue over the greater trochanter (GT) in side-lying position, and sustained tissue deformation induced by the prolonged external force is a primary cause, which can be discussed with soft tissues' viscoelastic properties (i.e., stress relaxation, creep response). Objects: Using an automated hand-held indentation device, we measured the viscoelastic properties of soft tissue over the hip area, in order to examine how the properties are affected by site with respect to the GT. Methods: Twenty participants (15 males and 5 females) who aged from 21 to 32 were participated. An automated hand-held indentation device was used to measure the stress relaxation time and creep response. Trials were acquired for three different locations with respect to the GT (i.e., right over the GT, 6 cm anterior or posterior to the GT). For each location, five trials were acquired and averaged for data analyses. Results: Soft tissues' stress relaxation time and creep response were associated with site (F = 23.98, p < 0.005; F = 24.09, p < 0.005; respectively). The stress relaxation time was greatest at posterior gluteal region (19.22 ± 2.49 ms), and followed by anterior region (15.39 ± 2.47 ms) and right over the GT (14.40 ± 3.18 ms). Similarly, creep response was greatest at posterior gluteal region (1.16 ± 0.14), and followed by anterior region (0.95 ± 0.14) and right over the GT (0.89 ± 0.18). Conclusion: Our results showed that the stress relaxation and creep were greatest at the posterior gluteal region and least at right over the GT, indicating that the gluteal soft tissue is more protective to the prolonged external force, when compared to the trochanteric soft tissue. The results suggest that a risk of pressure ulcer over the GT may decrease with slightly posteriorly rotated side-lying position.

Comparison of Impulses Experienced on Human Joints Walking on the Ground to Those Experienced Walking on a Treadmill

  • So, Byung-Rok;Yi, Byung-Ju;Han, Seog-Young
    • International Journal of Control, Automation, and Systems
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    • 제6권2호
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    • pp.243-252
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    • 2008
  • It has been reported that long-term exercise on a treadmill (running machine) may cause injury to the joints in a human's lower extremities. Previous works related to analysis of human walking motion are, however, mostly based on clinical statistics and experimental methodology. This paper proposes an analytical methodology. Specifically, this work deals with a comparison of normal walking on the ground and walking on a treadmill in regard to the external and internal impulses exerted on the joints of a human's lower extremities. First, a modeling procedure of impulses, impulse geometry, and impulse measure for the human lower extremity model will be briefly introduced and a new impulse measure for analysis of internal impulse is developed. Based on these analytical tools, we analyze the external and internal impulses through a planar 7-linked human lower extremity model. It is shown through simulation that the human walking on a treadmill exhibits greater internal impulses on the knee and ankle joints of the supporting leg when compared to that on the ground. In order to corroborate the effectiveness of the proposed methodology, a force platform was developed to measure the external impulses exerted on the ground for the cases of the normal walking and walking on the treadmill. It is shown that the experimental results correspond well to the simulation results.

Left External Iliac and Common Femoral Artery Occlusion Following Blunt Abdominal Trauma without Associated Bone Injury

  • Byun, Chun Sung;Park, Il Hwan;Do, Hye-Jin;Bae, Keum Seok;Oh, Joong Hwan
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.214-216
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    • 2015
  • Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.

후과 골절을 동반한 Lauge-Hansen 회내-외회전형 4단계 족관절 골절에서 원위 경비인대 결합 손상에 대한 원위 경비 나사 고정술과 후과 고정술의 결과 비교: 수술 1년째 추시 결과 (Results of Syndesmotic Screw Fixation versus Posterior Malleolus Fixation in Syndesmotic Injury at Pronation External Rotation Stage IV Ankle Fracture with Posterior Malleolus Fracture: Postoperative One Year Follow-up)

  • 박세진;정화재;신헌규;서동석;최영민;김유진
    • 대한족부족관절학회지
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    • 제18권1호
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    • pp.29-35
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    • 2014
  • Purpose: The purpose of this study is to compare the radiologic and clinical results of syndesmotic screw fixation and posterior malleolar fixation for syndesmotic injury in Lauge-Hansen classification pronation-external rotation (PER) stage IV ankle fractures with posterior malleolus fracture. Materials and Methods: We designed a retrospective study that included patients with Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture. Of 723 patients who underwent ankle fracture surgery from March 2005 to November 2012, 29 were included in this study. In this study, syndesmotic injury was treated with syndesmotic screw fixation or posterior malleolus fixation. There were 15 cases of syndesmotic screw fixation and 14 cases of posterior malleolar fixation. We compared the radiologic and clinical results at one year postoperatively. Posterior malleolus fragment size on a pre-operative computed tomographic image, and tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, and Takakura classification on a postoperative one year followup radiograph were used for comparison of the radiologic results. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society score, visual analogue scale score, and patient subjective satisfaction score. Results: Posterior malleolar fragment size was $12.62%{\pm}3.01%$ of the joint space in the syndesmotic screw fixation group and $27.04%{\pm}4.34%$ in the posterior malleolar fixation group. A statistical difference was observed between the two groups. However, other results, including tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, Takakura classification, and clinical scores showed no statistical difference. Conclusion: In the Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture, if the posterior malleolus fracture can be reduced anatomically and fixated rigidly, syndesmotic screw fixation, which can cause several complications, is usually not required for achievement of a satisfactory syndesmotic stability; this would be a recommendable option for treatment of syndesmotic injury.

DNA 분석에 의한 팔색조의 암수 구분 및 암수별 피해 현황 그리고 크기 차이에 관한 연구 (The Study on the Sexual Difference in the Cause and the Time of Casualty and in the Size of the Fairy Pitta (Pitta nympha) through DNA Analysis in Republic of Korea)

  • 김은미;전연선;정길상;김세재;강창완;오미래;노푸름;원현규
    • 한국환경과학회지
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    • 제23권8호
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    • pp.1447-1453
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    • 2014
  • The differentiation of sex is important for species preservation. However, Fairy Pitta is sexually monomorphic and sex of an individual is indistinguishable with its external characteristics. We determined the sex of Fairy Pitta through DNA analysis and investigated the causes and time of injury and mortality and the size based on sex. We collected 21 samples at Jeju Island, Korean Peninsula from 2004 to 2013 and extracted DNA from them and amplified chromo helicase DNA-binding gene from Z and W chromosomes through Polymerase Chain Reaction (PCR). We confirmed their sex with the banding pattern through Agarose gel electrophoresis, i.e. male (ZZ): one banded and female (ZW) two banded. We distinguished the sex of 17 of 21 samples resulting in 9 males and 8 females. Most casualties were recorded in adult of both sexes. Causes of injury and mortality proved that female casualties occurred from window strikes, dehydration, car accident, predation by natural enemies, and male occurred from window strikes, car accident and dehydration. The time of injury and mortality in adults differ by sex. There was no difference between sexes in any of the six size parameters. As the time of injury and mortality differ by sex, the survey on the role and ecological nature by sex in breeding season must be carried out in the future. External measurements may not be reliable for sexing of Fairy Pitta and other traits such as vocal or characteristics are required to identify the sex of individuals in the field.