• Journal of Trauma and Injury
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• 제35권4호
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• pp.240-247
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• 2022

Purpose: Studies on the relationship between obesity and injuries, especially those sustained in pedestrian traffic accidents, are lacking. We aimed to assess the effects of obesity on the severity of injury at the time of admission to the emergency room in patients who experienced pedestrian traffic accidents. Methods: This study included trauma patients registered in the Korean Trauma Database from July 1, 2018 to December 31, 2020, whose mechanism of injury was pedestrian traffic accidents and who were treated at a single institution. Those aged below 15 years were excluded. Patients were assigned to nonobese and obese groups based on a body mass index of 25 kg/m². An Injury Severity Score of 25 or greater was considered to indicate a critical injury. Results: In total, 679 cases of pedestrian traffic accidents were registered during the study period, and 543 patients were included in the final analysis. Of them, 360 patients (66.3%) and 183 patients (33.7%) were categorized as nonobese and obese, respectively. The median age was significantly higher in the nonobese group than in the obese group (60 vs. 58 years). Multivariate analysis demonstrated that the odds ratio for critical injury in obese patients was 1.59 (95% confidence interval, 1.01-2.48) compared with nonobese patients. Conclusions: Obesity affected the likelihood of sustaining severe injuries in pedestrian traffic accidents. Future studies should analyze the effects of body mass index on the pattern and severity of injuries in patients with more diverse injury mechanisms using large-scale data.

• 대한교통학회지
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• 제23권6호
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• pp.103-113
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• 2005

교통사고 중 차대보행자 사고의 원인분석은 차대차 사고에 비해 관련 연구가 미흡한 실정이다. 국내에서도 차대차 사고의 경우에는 실차충돌실험을 통해 많은 자료를 축척하고 이를 체계화하여 다각적인 방법으로 실제 교통사고에 적용하려는 노력이 있으나 차대보행자 사고의 경우에는 아직 시작단계라고 볼 수 있다. 선진국에서는 차대보행자 사고에 대하여 더미를 이용한 실차충돌실험을 통해 많은 모형을 개발하였고, 이를 보행자사고의 정확한 원인분석을 위해 활용하고 있다. 국내에서는 차대보행자 사고의 해석과 관련된 모형이 개발되지 않아 외국의 모형을 그대로 활용하는 것이 일반적이다. 그러나 외국의 모형을 이용하게 되면 차량과 보행자의 체위특성이 다른 경우 왜곡된 결과가 도출될 가능성이 많게 된다. 이러한 문제점을 해결하기 위해 본 연구에서는 그 동안 수집된 보행자 사고자료를 이용하여 국내 실정에 적합한 차대보행자 충돌모형을 개발하였다. 그 결과 차량의 속도에 따라 외국의 모형과는 다소 상이한 결과를 보이는 것으로 나타났다. 외국의 모형 중에서는 차량 및 보행자의 체위 특성이 유사한 일본의 모형과 가장 흡사한 것으로 나타났다. 이 연구 결과는 수십개의 자료를 이용한 것으로 장래에 보다 폭넓은 자료를 통하여 모형의 신뢰성을 높이는 노력이 필요하다고 판단된다.

• Journal of Trauma and Injury
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• 제31권3호
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• pp.151-158
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• 2018

Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.55-61
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• 2009

Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.294-300
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• 2020

Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

• 대한토목학회논문집
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• 제40권1호
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• pp.1-11
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• 2020

도로변에 설치된 중대형 지주구조물은 적절히 방호되지 않고 차량에 노출된 경우 충돌 시 심각한 차량 파손과 탑승자 상해로 이어진다. 북미지역이나 유럽은 차량에 노출된 지주에 대한 충돌피해를 줄이기 위하여 일반적으로 분리식 지주를 사용하고 있으나 분리된 지주의 낙하 시 2차 사고의 위험이 상존한다. 이를 해결하기 위한 방법으로 슬라이딩 지주가 제안되었다. 본 논문은 국도와 지방도에 많이 쓰이는 무게 507 kg의 편주식 지주구조에 대하여 기존의 방식으로 기초에 강결된 경우와 슬라이딩 지주로 개선된 경우에 대한 1.3 ton-60 km/h, 1.3 ton-80 km/h의 충돌실험을 실시하여 강결지주의 위험도를 보이고 슬라이딩지주의 감충성능(Crashworthiness)을 입증하였다. 한편 차량중심에서 계측된 가속도가 차량과 지주의 운동을 동시에 나타낸다고 보는 기존의 충돌해석 방법 대신 고속촬영 데이터를 이용하여 지주를 차량의 운동과 분리시켜 충돌과정을 단계별로 설명함으로써 감충성능을 갖는 지주설계의 기초를 제시하였다.