• 제목/요약/키워드: Multiple fractures

검색결과 226건 처리시간 0.027초

Rapidly growing pediatric trampoline-related injuries in Korea: a 10-year single center retrospective study

  • Cho, Min Jeng;Kim, Jihoon;Kim, Sung Jeep;Kyoung, Kyu Hyouck;Keum, Min Ae;Park, Sung Kyun
    • 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.

Reduction of comminuted fractures of the anterior wall of the frontal sinus using threaded Kirschner wires and a small eyebrow incision

  • Lee, Da Woon;Kwak, Si Hyun;Choi, Hwan Jun;Kim, Jun Hyuk
    • 대한두개안면성형외과학회지
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    • 제23권5호
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    • pp.220-227
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    • 2022
  • Background: Frontal sinus fractures are relatively rare. Their surgical management significantly differs depending on whether the posterior wall is invaded and the clinical features vary. A bicoronal incision or endoscopic approach can be used. However, the minimally invasive approach has been attracting attention, leading us to introduce a simple and effective surgical method using multiple-threaded Kirschner wires. Methods: All patients had isolated anterior wall fractures without nasofrontal duct impairment. The depth from the skin to the posterior wall was measured using computed tomography to prevent injury. The edge of the bone segment on the skin was marked, a threaded Kirschner wire was inserted into the center of the bone segment, and multiple Kirschner wires were gently reduced simultaneously. Results: Surgery was performed on 11 patients. Among them, seven patients required additional support for appropriate fracture reduction. Therefore, a periosteal elevator was used as an adjunct through a small sub-brow incision because the reduction was incomplete with the Kirschner wire alone. The reduction results were confirmed using facial bone computed tomography 1 to 3 days postoperatively. The follow-up period was 3 to 12 months. Conclusion: The patients had no complications and were satisfied with the surgical results. Here we demonstrated an easy and successful procedure to reduce a pure anterior wall frontal sinus fracture via non-invasive threaded Kirschner wire reduction.

Extreme Multi-Level Percutaneous Vertebroplasty for Newly Developed Multiple Adjacent Compression Fractures

  • Kim, Han-Woong;Song, Jae-Wook;Kwon, Austin;Kim, In-Hwan
    • Journal of Korean Neurosurgical Society
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    • 제45권6호
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    • pp.378-380
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    • 2009
  • Osteoporotic patients who undergo percutaneous vertebroplasty (PVP) have the risk of a repeated collapse of their adjacent vertebral body due to alteration of load transfer into the adjacent vertebral body. The authors have experienced a rare case of repeated osteoporotic vertebral compression fractures (VCF) resulting in extreme multi-level PVP. A 74-year-old female developed severe back pain after slipping down one month ago. Her X-ray and MR images indicated a T11 VCF. She underwent successful PVP with polymethylmethacrylate (PMMA). Two weeks later, she returned to our hospital due to a similar back pain. Repeated X-ray and MR images showed an adjacent VCF on T12. A retrial of PVP was performed on T12, which provided immediate pain relief. Since then, repeated collapses of the vertebral body occurred 12 times in 13 levels within a 24-month period. Each time the woman was admitted to our hospital, she was diagnosed of newly developed VCFs and underwent repeated PVPs with PMMA, which finally eased back pain. Based on our experience with this patient, repeated multiple PVP is not dangerous because its few and minor complications. Therefore, repeated PVP can serve as an effective treatment modality for extreme-multi level VCFs.

Posttraumatic Intracranial Tuberculous Subdural Empyema in a Patient with Skull Fracture

  • Kim, Jiha;Kim, Choonghyo;Ryu, Young-Joon;Lee, Seung Jin
    • Journal of Korean Neurosurgical Society
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    • 제59권3호
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    • pp.310-313
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    • 2016
  • Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M.tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.

경운기 사고에 의한 흉부손상 8례의 임상적 고찰 (Chest Trauma by Triller Accident: 8 Cases)

  • 이지원
    • Journal of Chest Surgery
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    • 제14권1호
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    • pp.83-86
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    • 1981
  • Eight cases by power tiller accidents experienced for 3 years from Jan. 1978 to Dec. 1980 were studied clinically. The results are as follows: 1. The most of the patients were thirties to fifties, and the incidence rate of male to female 7:1. 2. The common injuries were hemopneumothorax and multiple rib fractures [respectively and the other associated injuries were hepatic and delayed splenic ruptures, and fractures of the another sites. 3. The accident forms were overturning [50.0%], falling down from the power tiller [37.5%], and collision against the power tiller [12.5%]. 4. All of the drivers and 75% of the passengers in the patients were drunken states at the accident time. 5. The common methods of treatment were closed thoracostomy [62.5%], conservative treatment [37.5%], and exploratory laparotomy [25.0%].

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강선 고정술을 이용한 관골골절의 치료 (Intraoral Approach and K-Wire Fixation of Zygomatic Tripod Fractures)

  • 최시호
    • Journal of Yeungnam Medical Science
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    • 제5권1호
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    • pp.85-92
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    • 1988
  • 저자는 관골 골절 환자중 일부 안서 골절로 안와내용물의 탈출이 동반된 관골 골절, 경구개 골절이 동반된 관골 골절, 소아의 관골 골절을 제외한 대다수의 삼격면 관골 골절 환자 37례를 구강내 절개와 K-강선고정술을 이용하여 수술 하였던 바, 첫째, 안면부 반흔을 남기지 않고, 둘째, 간단하며, 셋째, 직시하 수술이 가능하며 만족할 만한 결과를 얻을 수 있었다.

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서울지역(地域) 중(中).고등학생(高等學生)의 전치외상(前齒外傷)에 관(關)한 연구(硏究) (A SURVEY OF TRAUMATIZED ANTERIOR TEETH IN A SCHOOL POPULATION)

  • 김종철
    • 대한소아치과학회지
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    • 제6권1호
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    • pp.21-25
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    • 1979
  • The author surveyed traumatized anterior teeth of 12~17 year old 9453(male 4740, female 4713) school students. The results were as follows: 1. The prevalence of traumatized anterior teeth was $10.3{\pm}0.6%$. 2. The prevalence of traumatized anterior teeth of male was $12.2{\pm}0.9%$, and that of female was $8.4{\pm}0.8%$. The prevalence of male was higher than that of female. 3. The distribution of traumatized teeth by severity was as follows: Class I-65.3%, Class II-20.7%, Class III-8.2%, Missing teeth-5.4%, Others-0.4%. 4. Maxillary central incisors had the highest trauma frequence. 5. Single fractures were found to occur more commonly than multiple fractures. 6. The percentage of treated person was 5.1%. 7. 72.3% of the sample was not affected by the traumatized anterior teeth, and 27.7% of the sample thought the traumatized anterior teeth ugly.

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Spinal Cord Stimulation for the Neuropathic Pain Caused by Traumatic Lumbosacral Plexopathy after Extensive Pelvic Fracture

  • Choi, Kyoung-Chul;Son, Byung-Chul;Hong, Jae-Taek;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • 제38권3호
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    • pp.234-237
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    • 2005
  • The neuropathic pain caused by lumbosacral plexopathy as a sequela to extensive pelvic and sacral fractures is rare because many posttraumatic cases remain undiagnosed as a result of the high mortality associated with these types of injury and because of the survivors of multiple trauma, including pelvic fractures, frequently have an incomplete work-up. Although surgical treatments for medically refractory lumbosacral plexus avulsion pain have been reported, an effective surgical technique for pain relief in lumbosacral plexopathy has not been well documented. We describe the effectiveness of spinal cord stimulation [SCS] in a patient suffering from severe neuropathic pain caused by lumbosacral plexopathy after an extensive pelvic fracture.

Pain Management with Extracorporeal Shockwave Treatment in Multiple Level Clay-shoveler's Fracture in a Novice Golfer: A Case Report

  • Seongho Woo;Kwangohk Jun;Hyoshin Eo;KooWon Mo;Sunyoung Joo;Donghwi Park;Chung Reen Kim
    • The Journal of Korean Physical Therapy
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    • 제35권6호
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    • pp.163-166
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    • 2023
  • A 30-year-old male novice golfer was diagnosed with a clay-shoveler's fracture. During golf practice, he experienced persistent posterior neck and upper back pain for a month. Cervical radiographs and computed tomography revealed a series of sequential spinous process fractures from C7 to T3. The patient was prescribed analgesic medication and fitted with a cervical brace alongside extracorporeal shockwave therapy (ESWT) directed explicitly toward the upper back region, subsequently leading to a notable reduction in pain. Therefore, ESWT could be considered an additional method for pain management in patients with clay-shoveler's fractures.

Combined Orbital Fractures: Surgical Strategy of Sequential Repair

  • Hur, Su Won;Kim, Sung Eun;Chung, Kyu Jin;Lee, Jun Ho;Kim, Tae Gon;Kim, Yong-Ha
    • Archives of Plastic Surgery
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    • 제42권4호
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    • pp.424-430
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    • 2015
  • Background Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. Methods We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. Results In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. Conclusions We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon.