• Journal of Trauma and Injury
• /
• v.37 no.1
• /
• pp.48-59
• /
• 2024

Purpose: Research on rib fracture management has exponentially increased. Predicting fracture patterns based on the mechanism of injury (MOI) and other possible correlations may improve resource allocation and injury prevention strategies. The Chest Injury International Database (CIID) is the largest prospective repository of the operative and nonoperative management of patients with severe chest wall trauma. The purpose of this study was to determine whether the MOI is associated with the resulting rib fracture patterns. We hypothesized that specific MOIs would be associated with distinct rib fracture patterns. Methods: The CIID was queried to analyze fracture patterns based on the MOI. Patients were stratified by MOI: falls, motor vehicle collisions (MVCs), motorcycle collisions (MCCs), automobile-pedestrian collisions, and bicycle collisions. Fracture locations, associated injuries, and patient-specific variables were recorded. Heat maps were created to display the fracture incidence by rib location. Results: The study cohort consisted of 1,121 patients with a median RibScore of 2 (range, 0-3) and 9,353 fractures. The average age was 57±20 years, and 64% of patients were male. By MOI, the number of patients and fractures were as follows: falls (474 patients, 3,360 fractures), MVCs (353 patients, 3,268 fractures), MCCs (165 patients, 1,505 fractures), automobile-pedestrian collisions (70 patients, 713 fractures), and bicycle collisions (59 patients, 507 fractures). The most commonly injured rib was the sixth rib, and the most common fracture location was lateral. Statistically significant differences in the location and patterns of fractures were identified comparing each MOI, except for MCCs versus bicycle collisions. Conclusions: Different mechanisms of injury result in distinct rib fracture patterns. These different patterns should be considered in the workup and management of patients with thoracic injuries. Given these significant differences, future studies should account for both fracture location and the MOI to better define what populations benefit from surgical versus nonoperative management.

• Journal of Chest Surgery
• /
• v.40 no.12
• /
• pp.831-836
• /
• 2007

Background: Cardiac injuries are the most commonly overlooked injuries in patients who die from trauma. Patients who survive blunt cardiac rupture or penetrating injuries are rare and the incidence is not well defined. Many patients require urgent or emergency operations and operative mortality is very high. Material and Method: A retrospective review of 26 patients with cardiac injuries due to thoracic trauma undergoing emergency thoracotomy from January 1997 to December 2005. Result: There were 17 male and 9 female patients, with a mean age of $45.3{\pm}16.2\;(range:\;17{\sim}80)$. Thirteen patients (50%) were injured in motor vehicle accidents, and five patients (19%) in motorcycle accidents. Six patients (23%) were injured by knives, and two patients (8%) were injured by falling. Anatomic injuries included right atrium (12 [46%]), left atrium (1 [4%]), right ventricle (5 [19%]), left ventricle (5 [19%]), and cardiac chambers (2 [7%]). Diagnosis was made by computer tomography in 12 patients and sonography in 14 patients. The average times from admission to operating room was $89.2{\pm}86.7\;min\;(range:\;10{\sim}335)$. The average time for diagnosis was $51.3{\pm}13.6\;min\;(range:\;5{\sim}280)$. The mean Revised Trauma Score (RTS) was $6.7{\pm}0.8$, and the Glasgow Coma Scale (GCS), was $12.8{\pm}2.8$. The overall mortality rate was 12% (3 out of 26 patients). Conclusion: The mortality rate from cardiac injury is very high. The survival rate can be increased only by a high index of suspicion, aggressive expeditious diagnostic evaluation, and prompt appropriate surgical management.

• Archives of Reconstructive Microsurgery
• /
• v.5 no.1
• /
• pp.137-146
• /
• 1996

There has been no general agreement about optimal time for nerve surgery in the closed brachial plexus injury(BPI). From our early experiences, we knew by chance that spontaneous recovery in BPI patients may begin even later than 8 months after injury. Authors' strategy, which was based on our early experiences, for the treatment of closed fresh injury was 'wait and see' unlit 8 months after injury. From 1985 to 1994, we observed 103 patients with BPI. All of them did not have any operation until 8 months after injury. There were 95 men and 8 women with a mean age of 29 years. Motorcycle injury(31%) and vehicle accident(28%) were main causes of injury. Whole plexus types were observed in 56 patients(54%), upper plexus types in 29(28%), lower plexus types in 3(3%), and infraclavicular types in 15(15%). Electromyography was performed in all patients. This was repeated every three months to detect the recovery. Results were evaluated by authors' criteria, in which AMA system of brachial plexus impairment was modified. Duration of follow up was average 25 months. 47 patients(46%) showed spontaneous improvement, which was initially detected at average 7.8 months(range,3 months-16 months) after trauma by electromyography. The average score of these 47 patients improved from 14.8 points to 39.8 points.31 patients(30%) had nerve surgery such as nerve graft, neurotization or neurolysis. Average duration from injury to nerve surgery, was 10 months. Among 31 patients who had nerve surgery, 16 patients improved from preoperative 21.5 points to postoperative 36.3 points in average. Because spontaneous recovery began in average 7.8 months after injury, we think that it would be better to 'wait and see' for at least one year in patients with closed BPI expecting spontaneous recovery.

• Journal of Cadastre & Land InformatiX
• /
• v.47 no.2
• /
• pp.233-254
• /
• 2017

The purpose of this study is to analyze the main factors influencing the severity of traffic accidents and to visualize spatiotemporal characteristics of traffic accidents in Seoul. To do this, we collected the traffic accident data that occurred in Seoul for four years from 2012 to 2015, and classified as slight, serious, and death traffic accidents according to the severity of traffic accidents. The analysis of spatiotemporal characteristics of traffic accidents was performed by kernel density analysis, hotspot analysis, space time cube analysis, and Emerging HotSpot Analysis. The factors affecting the severity of traffic accidents were analyzed using decision tree model. The results show that traffic accidents in Seoul are more frequent in suburbs than in central areas. Especially, traffic accidents concentrated in some commercial and entertainment areas in Seocho and Gangnam, and the traffic accidents were more and more intense over time. In the case of death traffic accidents, there were statistically significant hotspot areas in Yeongdeungpo-gu, Guro-gu, Jongno-gu, Jung-gu and Seongbuk. However, hotspots of death traffic accidents by time zone resulted in different patterns. In terms of traffic accident severity, the type of accident is the most important factor. The type of the road, the type of the vehicle, the time of the traffic accident, and the type of the violation of the regulations were ranked in order of importance. Regarding decision rules that cause serious traffic accidents, in case of van or truck, there is a high probability that a serious traffic accident will occur at a place where the width of the road is wide and the vehicle speed is high. In case of bicycle, car, motorcycle or the others there is a high probability that a serious traffic accident will occur under the same circumstances in the dawn time.

• Journal of Appropriate Technology
• /
• v.7 no.2
• /
• pp.127-135
• /
• 2021

To respond to the threat of global warming, countries around the world are promoting the spread of renewable energy and reduction of carbon emissions. In accordance with the United Nation's Sustainable Development Goal to combat climate change and its impacts, global automakers are pushing for a full transition to electric vehicles within the next 10 years. Electric vehicles can be a useful means for reducing carbon emissions, but in order to reduce carbon generated in the stage of producing electricity for charging, a power generation system using eco-friendly renewable energy is required. In this study, we propose a smart electric mobility operating system integrated with off-grid solar power plants established in Tanzania, Africa. By applying smart monitoring and communication functions based on Arduino-based computing devices, information such as remaining battery capacity, battery status, location, speed, altitude, and road conditions of an electric vehicle or electric motorcycle is monitored. In addition, we present a scenario that communicates with the surrounding independent solar power plant infrastructure to predict the drivable distance and optimize the charging schedule and route to the destination. The feasibility of the proposed system was verified through test runs of electric motorcycles. In considering local environmental characteristics in Tanzania for the operation of the electric mobility system, factors such as eco-friendliness, economic feasibility, ease of operation, and compatibility should be weighed. The smart electric mobility operating system proposed in this study can be an important basis for implementing the SDGs' climate change response.