• Title/Summary/Keyword: Neck trauma

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의료보험 심사 업무의 작업자세(Work Postures) 특성과 누적외상성질환(CTDs) 발생에 관한 연구 (Relationships between Work Postures and Upper Extremity Cumulative Trauma Disorders in Medical Insurance Bill Reviewers)

  • 이윤근;임상혁
    • 한국산업보건학회지
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    • 제8권1호
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    • pp.36-49
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    • 1998
  • The purpose of this study is to investigate the relationship between the work postures and upper extremity cumulative trauma disorders(CTDs) in female medical insurance bill reviewers(n=448). This study included diagnosis for CTDs, anthropometry and job analysis (workstations and posture). The characteristics of subject were 33.6 years of average age and 8.7 years of average work duration. The results were as fallows. Ergonomic conditions of workstation were unsuitable compared with anthropometry result. The height of work surface(79.5 cm) and chair(43.0 cm)were high. work space was small, and legs space under the table was limited. Work postures were awkward compared with recommended neutral postures. Neck flexion($21.0-36.0^{\circ}$), elbow elevation, shoulder abduction ($46.0-47.0^{\circ}$). wrist radial and ulnar deviation, forearm supination and pronation, and wrist repeated motion(12.7-21.5 freq./min) were analyzed as hazardous risk factors by job analysis. The prevalence of CTDs was 32.8 % by medical diagnosis. The prevalence rate of CTDs in hazardous work posture group was significantly greater than safe work posture group both neck-shoulder (relative prevalence = 5.2, p<0.001) and wrist-hand (relative prevalence = 2.5, p<0.05).

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총상에 의한 경부 관통상 -치험 1례- (Penetrating Neck Trauma by Gunshot Injury: 1 Case Report)

  • 홍윤주
    • 한국응급구조학회지
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    • 제9권1호
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    • pp.95-99
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    • 2005
  • Penetrating neck trauma by gunshot injury involving tracheobronchial tree is rare in Korea. Extensive tissue damage by cavitation, tissue fragmentation and shock wave transmission of high-velocity projectile along with associated organ injury renders high rate of mortality and morbidity. A 28 year old man in military service with gunshot wound in left cervical area presented initial symptoms of severe dyspnea and subcutaneous emphysema. Computed tomography of chest and cervical region as well as bronchoscopic evaluation was performed to confirm highly suspected injury to cervical trachea. Surgical exposure was established through a low collar incision; the damaged segment of 3.5 cm length including 2-4th tracheal rings was resected out and end-to-end anastomosis was performed. Bleeding from lacerated anterior jugular vein was controlled by ligation of both ends and a K2 bulllet was found upon inner border of body of first rib, medial to right carotid sheath and removed out. Cervical esophagus, carotid artery, internal jugular vein and recurrent laryngeal nerve were spared. Extubation was done on the first postoperative day and postoperative course until discharge on nineth postoperative day remained uneventful.

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외상성 기도 손상의 임상적 고찰 (Clinical Aanalysis of Airway Trauma)

  • 조현민;김영진;류한영;황정주
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.7-11
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    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

Part 3. Clinical Practice Guideline for Airway Management and Emergency Thoracotomy for Trauma Patients from the Korean Society of Traumatology

  • Park, Chan Yong;Kim, O Hyun;Chang, Sung Wook;Choi, Kang Kook;Lee, Kyung Hak;Kim, Seong Yup;Kim, Maru;Lee, Gil Jae
    • Journal of Trauma and Injury
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    • 제33권3호
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    • pp.195-203
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    • 2020
  • The following key questions and recommendations are presented herein: when is airway intubation initiated in severe trauma? Airway intubation must be initiated in severe trauma patients with a GCS of 8 or lower (1B). Should rapid sequence intubation (RSI) be performed in trauma patients? RSI should be performed in trauma patients to secure the airway unless it is determined that securing the airway will be problematic (1B). What should be used as an induction drug for airway intubation? Ketamine or etomidate can be used as a sedative induction drug when RSI is being performed in a trauma patient (2B). If cervical spine damage is suspected, how is cervical protection achieved during airway intubation? When intubating a patient with a cervical spine injury, the extraction collar can be temporarily removed while the neck is fixed and protected manually (1C). What alternative method should be used if securing the airway fails more than three times? If three or more attempts to intubate the airway fail, other methods should be considered to secure the airway (1B). Should trauma patients maintain normal ventilation after intubation? It is recommended that trauma patients who have undergone airway intubation maintain normal ventilation rather than hyperventilation or hypoventilation (1C). When should resuscitative thoracotomy be considered for trauma patients? Resuscitative thoracotomy is recommended for trauma patients with penetrating injuries undergoing cardiac arrest or shock in the emergency room (1B).

Subclinical Cervical Osteochondroma Presenting as Brown-Sequard Syndrome after Trivial Neck Trauma

  • Lee, Jin-Young;Im, Soo-Bin;Park, Kwan-Woong;Shin, Dong-Seong
    • Journal of Korean Neurosurgical Society
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    • 제51권4호
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    • pp.233-236
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    • 2012
  • Osteochondroma is a rare condition in the spine that may be indolent due to its slow growth. The authors present a case of 32-year-old man with subclinical osteochondroma in the cervical spine presenting as Brown-Sequard syndrome after trivial neck trauma. After resection of the tumor through hemilaminectomy, his symptoms were improved with mild residual sequelae.

Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report

  • Paramaswamy, Rathna
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권3호
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    • pp.183-187
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    • 2018
  • Complex cervical spine fractures are a serious complications of maxillofacial trauma and associated with high mortality and neurological morbidity. Strict vigilance in preventing further insult to the cervical spine is a crucial step in managing patients who are at risk for neurologic compromise. We report a rare case of a right transverse process of atlas fracture with right-sided vertebral artery injury that was associated with a comminuted fracture of the body and angle of the mandible, which restricted mouth opening. Airway management was performed by an awake fiber-optic nasotracheal intubation, where neck movement was avoided with a cervical collar. Vertebral artery injuries may have disastrous consequences, such as basilar territory infarction and death, and should be suspected in patients with head and neck trauma. After mandibular plating, the patient was on cervical collar immobilization for 12 weeks and anti-coagulant therapy.

A case report of "minor" trauma leading to a major disability: whiplash-associated dysphagia, dysphonia, and dysgeusia

  • Schattner, Ami;Glick, Yair
    • Journal of Trauma and Injury
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    • 제35권2호
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    • pp.115-117
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    • 2022
  • "Whiplash"-type injuries are commonly encountered and often cause neck pain, neck stiffness, and headaches. However, these injuries can have rare and poorly recognized complications, such as the development of a prevertebral hematoma leading to acute respiratory failure in the emergency department, followed by severe, life-threatening dysphagia and recurrent aspirations. In the patient described herein, a whiplash injury was accompanied by vocal cord paralysis and dysphonia (vagus nerve), dysgeusia (glossopharyngeal nerve, vagus nerve), and upper esophageal spasm (cricopharyngeal muscle, vagus nerve). It is unlikely that this was a complication of cervical fusion surgery. Instead, a combined stretch-induced lower cranial nerve injury, possibly on the exit of these nerves through the jugular foramen, seems to be a likely, but underappreciated mechanism occurring in rare instances of whiplash injuries.

Unusual Bilateral Impalement Injury with Rusted Iron Bars on Face and Neck

  • Suh, Hyun Suk;Pak, Ji Hyun;Hong, Seung-Eun;Kang, So Ra
    • 대한두개안면성형외과학회지
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    • 제16권3호
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    • pp.147-150
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    • 2015
  • Impalement injury is the subset of penetrating trauma, defined as fixed, elongated objects penetrate and remain in the human body cavity or region by relatively low velocity. We report an unusual case of facial and neck impalement where two dirty rusted iron bars penetrated forehead bilaterally and exited neck and ear respectively without causing major organ injuries. After thorough radiologic and physical evaluation, the patient got medical and surgical treatment. The patient was discharged without complication after four day of delayed wound closure. There have been no complications and sequelaes related with trauma, wound infection and scar contracture at 3-year follow-up. According to affected organs and pattern of impalement, individualized and multidisciplinary surgical approach should be considered. Following these guidelines as in this case, it was possible to achieve excellent clinical outcome in impalement injury.

노령 환자에서 발견된 후두개 이형성증 1예 (A Case of Dysplastic Epiglottis in Elderly Patient)

  • 임성환;김승우
    • 대한두경부종양학회지
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    • 제33권2호
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    • pp.71-73
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    • 2017
  • Dysplastic epiglottis is extremely rare congenital malformation, which usually occurs in association with other laryngeal anomalies. Hypoplasia is the most common type in epiglottic malfomations. Other abnormalities include rudimentary, aplasia and bifid etc. Mostly, they are found in infancy and early childhood, and diagnosis at adulthood is extremely rare. A 69-year-old man with chronic cough and globus sense visited our clinic. Laryngoscopic findings revealed a unique form of epiglottis. He had no history of laryngeal trauma, tumors, head and neck surgery, and radiation. There was no another anomaly in the laryngo-pharynx. Because of a mass-like lesion at the apex of epiglottis, we performed the laryngeal microsurgery. The pathology revealed as granulation tissue. We report a rare and unique case of dysplastic epiglottis in elderly patient with a brief literature review.

턱뼈가지의 골절로 인한 내상악동맥의 가성동맥류 1례 (Traumatic Internal Maxillary Artery Pseudoaneurysm Caused by Fracture of the Mandible Ramus: A Case Report)

  • 한창덕;김영효;김규성;최호석
    • Journal of Trauma and Injury
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    • 제25권1호
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    • pp.32-35
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    • 2012
  • Traumatic pseudoaneurysms in the head and neck region are very rare. Particularyly, pseudoaneurysms of the internal maxillary artery are known to be very rare. The authors report a 20-year old male who was diagnosed as having a pseudoaneurysm of the internal maxillary artery. The cause was assumed to be a mandible ramus fracture. When he visited our emergency room, we did not consider a pseudoaneurysm because of his other life-threatening conditions. Fortunately, he re-visited our hosipital before the aneurysm ruptured. He was diagnosed with angiography and was treated by using embolization with glue. The rupture of the pseudoaneurysm could have caused a life-threatening hemorrhage.