• 제목/요약/키워드: Multiple injuries

검색결과 264건 처리시간 0.028초

견관절 외상성 전방 불안정성에 대한 Bio-knotless 봉합 나사못을 이용한 관절경적 Bankart 병변 봉합술 (예비 보고) (Arthroscopic Bankart Repair in Traumatic Anterior Shoulder Instability with Bio-knotless Anchor (Preliminary and Technical Report))

  • 염재광;성기혁;신용운
    • Clinics in Shoulder and Elbow
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    • 제9권1호
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    • pp.105-110
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    • 2006
  • Purpose: This study reports the clinical results of the arthroscopic Bankart repair in traumatic anterior instability of the shoulder with bio-knotless anchor. Materials and Methods: 21 cases of 21 patients (20 male and 1 female) were included in this study. The average age was 24.8 years old and the period from the first injury to operation was average 37.2 months. All cases had Bankart lesion and 12 cases had Hill-Sachs' lesion. The SLAP lesion was associated in 6 cases. Preoperative Rowe score was average 29.1. Arthroscopic Bankart repair with bio-knotless anchor were performed in all cases; 3 anchors at 3, 4, 5 O'clock position of the glenoid were used in 11 cases and 2 anchors at 4, 5 O'clock position were used in 10 cases. All the associated SLAP lesions were repaired arthroscopically with bio-knotless anchor. Thermal capsular shrinkage at the anterior and inferior shoulder capsule after the Bankart repair was performed in 3 cases. The average follow up period was 20.2 months. Results: The Rowe score improved to 92.8, excellent in 17 cases and good in 4 cases, at last follow up period and 20 cases had full range of motion of the shoulder. 1 case had mild limited range of motion of the shoulder (150 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation) without any problem in normal activity. The arthroscopic revision surgery of the shoulder was performed in 1 case because of multiple traumatic injuries of the shoulder with pain postoperatively. Conclusion: Arthroscopic Bankart repair with bio-knotless anchor in traumatic anterior shoulder instability is one of the good methods because of the good clinical results.

L1 요추 압박골절에 대한 진단방사선학 및 보존적 치료 (Diagnostic Radiology and Conservative Management of L1 Lumbar Spine with Compression Fracture)

  • 김재웅
    • 한국식품영양학회지
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    • 제11권2호
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    • pp.165-170
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    • 1998
  • 교통사고로 인한 척추골절 환자 S75에서 손상부위에 따른 진단방사선학 및 보존적 치료 소견을 임상 문헌과 함께 고찰해 본 결과 다음과 같은 결론을 얻었다. 1. 흉요추 좌측방 단순필름에서 L1 요추에 설상변형 정도가 약 10%인 쐐기형 압박골절이 확인되었다. 2. L1 요추의 CT촬영 결과 추체부 전면에 궁형의 불규칙한 골 절편을 관찰할 수 있었으며, T12∼L1는 구조상 손상빈도가 높은 부위로 밝혀졌으며, Denis의 골절형태는 중간주와 후방주가 잘 보존된 전방주의 다발성 압박골절로 분류되었고, Cobb의 척추 만각증은 없었으며, Frankel의 신경손상 분류형태는 E형이었다. 3. 정형외과적 치료방법은 비수술 요법의 보존적 치료를 원칙으로 하였고, 수분·전해질, 영양 및 혈장제 대용으로 공급하는 수액과 함께 브스테로이드성 항염진통제, 근육 이완제를 투여하면서 철저한 침상안정을 유도하였다. 4. 수상후 3주째는 폴리에틸렌 back corset를 착용하고 조기재활을 시도하였으며, 수상 8주 후에도 경도의 불편감이 남아 있었으나, 추시 관찰한 결과 일정기간이 지나면서 점차 척추는 안정성을 찾게 되었다.

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가로손가락손바닥활을 이용한 다발성 벗겨짐 손상 손가락 재접합술 - 증례보고 - (Case Report of Avulsion Amputation of Multiple Digits: Use of Rerouting the Transverse Digital Palmar Arch)

  • 김재인;최환준;김준혁;탁민성;김용배
    • Archives of Reconstructive Microsurgery
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    • 제18권2호
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    • pp.79-83
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    • 2009
  • Purpose: Avulsion injuries of digits have been presented for a long time as complex management problems. Despite of microsurgical advances, it is difficult to achieve good functional results and their management remains somewhat controversial. However, in a finger there are three transverse digital palmar arches. The middle and distal transverse digital palmar arches are consistently large(almost 1 mm) and may be used for arterial vessel repairs either proximally or distally, depending on the length and direction needed. 39-year-old man presented with avulsion amputation of the ulnar three digits, was operated using only arterial anastomosis with rerouting the transverse digital palmar arches. Methods: Replantation was performed using the artery-only technique. Because the digital arteries had been damaged, we did that the transverse digital palmar arches were transposed in an inverted Y to I configuration and were lengthened with rerouting them for the purpose of direct anastomosis of the digital artery. Venous drainage was provided by an external bleeding method with partial nail excision and external heparin irrigation. Results: The authors conclude that complete avulsion amputations with only soft tissue at the distal to insertion of the flexor digitorum superficialis tendon were salvageable with acceptable functional results. All three fingers survived. Conclusion: With technical advancements, the transverse digital palmar arches play an important role for finger amputation. Three digital palmar arches give us additional treatment option for the finger amputation. In this case, replantation with only-arterial anastomosis was successful and we obtained good aesthetic and functional outcome.

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Musculoskeletal Pain Status of Local Farmers in Tigray, Ethiopia: A Cross-Sectional Survey

  • Jeon, Min-jae;Jeon, Hye-seon
    • 한국전문물리치료학회지
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    • 제24권2호
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    • pp.76-91
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    • 2017
  • Background: Agricultural work is physically demanding and is associated with a high frequency of musculoskeletal disorders. It is challenging to comprehensively understand the present status of work-related diseases and injuries among farmers in underdeveloped countries. Objects: This study aimed to elucidate the current status of work-related musculoskeletal disorders in local farmers in Tigray, Ethiopia, and identify the agricultural factors associated work-related musculoskeletal pain (AFWMP) and healthy living and healthy behavior factors associated work-related musculoskeletal pain (HFWMP). Methods: The Institute for Poverty Alleviation and International Development at Yonsei University conducted a survey of 126 households in Tigray, Ethiopia in 2014. A total of 116 individuals (73 men, 43 women) representing each household answered the questionnaires. Results: 1) Work-related musculoskeletal pain (WMSP) most commonly occurred when performing heavy lifting and most frequently occurred in the lower back. 2) Age, self-perceived labor intensity, and months of farming work were significantly higher in the pain group than those in the non-pain group. 3) Overall work-related musculoskeletal pain intensity (WPI) showed positive and negative correlations with years of farming experience and self-perceived health status, respectively. 4) In binary logistic regression, the occurrence of WMSP showed significant associations with self-perceived labor intensity. 5) On multiple linear regression analysis, age, months of farming work, and self-perceived health status had a significant impact on overall WPI. Conclusion: The WMSP of farmers in Tigray, Ethiopia was related to the characteristics of farm working and health status. Furthermore, HFWMP and AFWMP were the chief factors affecting the occurrence of WMSP in farmers in Tigray. Therefore, both HFWMP and AFWMP should be considered for clinical health assessments of farmers with WMSP in underdeveloped African countries.

소아에서 발생한 복부 둔상의 임상적 고찰 (Clinical Analysis of Blunt Abdominal Trauma in Childhood)

  • 김영욱;정연준;정성후;김재천
    • Advances in pediatric surgery
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    • 제16권2호
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    • pp.177-189
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    • 2010
  • Traumatic injury is one of the leading causes of morbidity and mortality in children. This is a clinical review of pediatric blunt abdominal trauma. A retrospective analysis of the 112 children with blunt abdominal trauma aged 15 years or less treated at the Department of Pediatric Surgery, Chonbuk National University Hospital was performed. The analysis included age, sex, injury mechanism, number and site of the injured organ, management and outcomes. The average age of occurrence was 7.6 years, and the peak age was between 6 and 8 years. There was a male preponderance with a male to female ratio of 2.3:1. The most common cause of blunt abdominal trauma was traffic accidents (61.6 %), principally involving pedestrians (79.7 %). The accident prone times were between 8:00 AM and 8:00 PM, the weekends (40.2 %), and the winter respectively. Thirthy-five patients (31.2 %) had multiple intra-abdominal organ injuries and the most common injured organ was the liver. Seventy-four cases (66.1 %) were managed non-operatively and eleven cases (9.8 %) expired. Of the patients who were treated surgically or were to be operated on one patient died before surgery, the remainder died during or after surgery. Risk factors such as number of injured organ, systolic and diastolic blood pressure, and trauma scores by Glasgow coma scale (GCS), Pediatric trauma score (PTS), revised trauma score (RTS), injury severe score (ISS), TRISS were significantly correlated with mortality rate.

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소아 복부 외상에 관한 임상적 고찰 (Blunt Abdominal Trauma in Children)

  • 김동현;서상혁;이난주;전용순
    • Advances in pediatric surgery
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    • 제13권2호
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    • pp.119-126
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    • 2007
  • Trauma is one of the leading causes of death in children. Abdominal trauma is about 10 % of all pediatric trauma. This study describes the sex and age distribution, injury mechanism, site of intraabdominal injury, management and mortality of children aged 16 years or less who suffered abdominal trauma. The hospital records of 63 patients treated for abdominal injury between March 1997 and February 2007 at the department of surgery, Inje University Pusan Paik Hospital, were analyzed retrospectively. The peak age of incidence was between 2 and 10 years (78%) and this report showed male predominance(2.7:1). The most common mechanism of blunt abdominal trauma was pedestrian traffic accident (49%). The most common injured organ was liver. More than Grade IV injury of liver and spleen comprised of 4(12%) and 5(24%), respectively. Fourteen cases (22%) had multiple organ injuries. Forty nine cases (78%) were managed nonoperatively. Three patients (4.8%) died, who had Grade IV liver injury, Grade IV spleen injury, and liver and spleen injury with combined inferior vena cava injury, respectively. All of the three mortality cases had operative management. In conclusion, the liver or spleen injury which was more than Grade 4 might lead to mortality in spite of operation, although many cases could be improved by nonoperative management.

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소아환자에 있어서 외상방지를 위한 마우스가드의 치험례 (MOUTHGUARD FOR PREVENTING ORAL INJURIES IN CHILDREN)

  • 김경희;김종수;유승훈
    • 대한소아치과학회지
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    • 제32권3호
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    • pp.537-542
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    • 2005
  • 구강악안면 영역의 외상은 치아파절, 탈구, 골절, 연조직 손상을 일으킬 수 있으며, 뇌진탕의 원인이 되기도 한다. 미국과 일본에서는 contact sports 일부에서 마우스가드의 장착이 의무화되어 있으나, 현재 한국에서는 운동 시 마우스가드의 장착을 거의 볼 수 없는 실정이다. 마우스가드는 크게 ready-made type과 custom-made type으로 나눌 수 있다. Ready made type의 마우스가드에는 형태가 일정하고 조정이 곤란한 stock mouthguard와 다소 조정이 가능한 mouth formed mouthguard가 있다. Custommade type의 마우스가드는 적합성이 뛰어나며 정확한 교합, 하악위를 재현할 수 있다는 장점이 있다. 마우스가드는 입술과 구강연조직을 치아로부터 보호하고, 치아에 가해지는 충격을 분산시켜 파절이나 탈구가능성을 줄여준다. 또한, 악골의 골절과 변위를 방지하고 충격을 흡수한다. 성장기 아동의 경우 치아손상의 30% 정도가 스포츠나 레포츠에 의한 것이라는 보고가 있으며, 이 경우 치아나 잇몸은 물론 성장 중인 치조골에 악영향을 주게 된다. 이 때 외상처치는 어려우며, 그 예후 또한 불명확하다. 따라서 성장기 아동의 마우스가드 장착은 외상 예방차원에서 중요하다. 이에 저자는 단국대학교 치과병원에 내원한 환아에게 ERKODENT$^{(R)}$사의 ERKOFORM-RVE를 이용한 흡입성형 마우스가드(vacuum type mouthguard)를 적용한 임상경험을 보고하는 바이다.

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척수손상 후 세포이식에 의한 운동기능의 회복증진 (Improvement of Functional Recovery by Cell Transplantation after Spinal Cord Injury)

  • 이배환;이경희;성제경;황세진;김계성
    • 감성과학
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    • 제7권2호
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    • pp.179-186
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    • 2004
  • 중추신경계는 일단 손상이 되면 손상된 세포의 재생, 손상된 수초의 회복, 신경계의 정상적인 연결 등의 제한성 때문에 그 회복이 매우 힘들다. 이러한 중추신경계의 중요한 손상으로는 다발성 경화증, 뇌졸중, 척수손상, 외상, 축삭의 탈수초화 등이 있다. 이전 연구들은 많은 발생빈도를 보이고 있는 척수손상에서 실질적인 척수의 기능적인 회복을 위해 손상된 척수신경의 재생과 축삭의 재수초화가 중요한 요인이라고 전하고 있다. 최근에는 이러한 척수손상에 대한 치료적 접근으로서 세포이식 기술이 하나의 해결책을 열어주고 있다. 따라서 본 논문에서는 척수손상의 특성을 살펴보고, 척수손상에 의한 기능장애에 대해 세포이식이 기능의 회복을 증진시킬 수 있다는 증거를 논의하고자 한다.

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Surgical Roles for Spinal Involvement of Hematological Malignancies

  • Kim, Sang-Il;Kim, Young-Hoon;Ha, Kee-Yong;Lee, Jae-Won;Lee, Jin-Woo
    • Journal of Korean Neurosurgical Society
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    • 제60권5호
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    • pp.534-539
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    • 2017
  • Objective : Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. Methods : From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results. Results : The most common diagnosis of hematological malignancy was multiple myeloma (96 patients, 49.7%), followed by chronic myeloid leukemia (30, 15.2%), acute myeloid leukemia (22, 11.2%), and lymphoma (15, 7.56%). The major presenting symptoms were mechanical axial pain (132, 67.7%) resulting from pathologic fractures, and followed by radiating pain (49, 25.1%). Progressive neurologic deficits were noted in 15 patients (7.7%), which revealed as cord compression by epidural mass or compressive myelopathy combined with pathologic fractures. Reconstructive surgery for neurologic compromise was done in 16 patients. Even though surgical intervention was useful for early paralysis (Frankel grade D or E), neurologic recovery was not satisfactory for the progressed paralysis (Frankel grade A or B). Conclusion : Hematological malignancies may cause various spinal problems related to disease progression or consequences of treatments. Conservative and palliative treatments are mainstay for these lesions. However, timely surgical interventions should be considered for the cases of pathologic fractures with progressive neurologic compromise.

새 신체활동기준의 동향과 함의 (Features and implication of new physical activity guidelines)

  • 고광욱
    • 보건교육건강증진학회지
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    • 제35권5호
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    • pp.17-24
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    • 2018
  • Objectives: After many national physical activity guidelines have established, recent changes are deep and rapid. So the major features and implication to reverse worsening Korean physical activity indicator is desprate but related knowledge and informations are few. So review of recent features and implications of new physical activity guidelines have made. Methods: National physical activity guidelines of advanced countries were searched through snowballing methods. Major features were described according to the nation. Implication were drew through discussion for Korean realitiy. Results: New Australian physical activity and sedentary behaviour guideline explicitly included sedentary behaviour. The age in the guideline expanded to early years. Canada also presented 24-hour movement guidelines to early years. The second generation of the physical activity guidelines reflects the extensive amount of new knowledge. New aspects include discussions of additional health benefits related to brain health, additional cancer sites, and fall-related injuries; immediate and longer term benefits for how people feel, function, and sleep; further benefits among older adults and people with additional chronic conditions; risks of sedentary behavior and their relationship with physical activity; elimination of the requirement for physical activity benefits to occur in bouts of at least 10 minutes; and tested strategies that can be used to get the population more active. Conclusions: The most important message from the new guidelines is that the greatest health benefits accrue by moving from no, to even small amounts of, physical activity. Multiple studies demonstrate that the steepest reduction in disease risk occurs at the lowest levels of physical activity. People need to understand that even small amounts of physical activity are beneficial and that reductions in the risk of disease and disability occur by simply getting moving. So various evidence based proven strstegies are needed in Korea including workforce training.