Purpose: Bone contusion is usually treated with conservative therapy for 3 months. Bone contusion around knee and hip joints has been extensively reported on, but there are scant reports on this condition in foot and ankle joints. This study evaluated the nature, characteristics and location of bone contusion around foot and ankle joints to enlighten clinicians on how to better treat this disease entity. Materials and Methods: We classified bone contusion of the 76 patients into three types (102 sites; 47 ankle sprains, 18 traffic accidents, 11 falls) according to the Costa-Paz system with employing magnetic resonance imaging (MRI), and the study then analyzed the common sites and areas of occurrence according to the mechanism of injury and duration of pain after first conducting conservative therapy. Results: Of the 76 patients (102 sites) on the MRI, 43 case (42.2%) for talus, 19 cases for distal tibia, and 12 cases for calcaneus were involved. The classification, according to the Costa-Paz system, was Type I, 51 cases; Type II, 32 cases; and Type III, 19 cases. The duration of pain after conservative treatment was 12.15±2.17 weeks for Type I, 14.5±2.15 weeks for Type II, and 21.0±3.8 weeks for Type III. Conclusion: The most common location of post-traumatic bone contusion around both the foot and ankle is the talus, distal tibia, and calcaneus. The most common type of injury noted on MRI is a diffuse signal with change of the medullary component (Type I), In cases of bone contusion extending to a subjacent articular surface or disruption or depression of the normal contour of the cortical surface (Types II, III), the patients' pain appears to last longer. Thus, it is necessary to consider a longer period of conservative treatment in cases of Types II and III bone contusion because the patients' pain may last longer than 3 months.
Kim, NamHoon;Jeon, Dong-Hwi;Lee, Jung Min;Oh, MinSeok
Journal of Korean Medicine Rehabilitation
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v.31
no.2
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pp.57-67
/
2021
Objectives To observe the pain reduction effect of Korean medical treatment combined with supine JS cervical therapy on neck pain and headache caused by whiplash injury. Methods The medical records of 30 patients suffering from neck pain and headache caused by traffic accidents from August 1, 2020 to October 30, 2020 were studied. 15 patients receiving supine JS cervical therapy combined with Korean medical treatment were assigned to group A and another 15 patients receiving Korean medical treatment but without Chuna therapy were assigned to group B. The following patient data were analyzed retrospectively - age, sex, and number of admission days, neck pain and headache visual analogue scale (VAS), and neck disability index (NDI). Statistical analysis was conducted using IBM SPSS 25.0. for Windows. A p-value≤0.05 was considered to be statistically significant. Results Both neck pain and headache VAS score in group A and B showed a statistically significant decrease. The changes in neck pain and headache VAS score in group A was statistically significant higher compared to those of group B. NDI in group A showed a statistically significant decrease, but NDI in group B did not decreased statistically significant. Conclusions Korean medicine treatment effectively reduces neck pain and headache. Especially, the pain reduction effect is better in patients receiving Korean medicine treatment combined with supine JS cervical therapy than in those receiving Korean medicine treatment without supine JS cervical therapy.
Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.
Kim, Young-Yuk;Jeong, Yeon-Jun;Jung, Sung-Hoo;Kim, Jae-Chun
Advances in pediatric surgery
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v.16
no.2
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pp.177-189
/
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.
This study's purpose is to report the effectiveness of Korean medicine treatment to posterior cruciate ligament tear patients due to traffic accident. 2 patients were treated with Korean medicine by acupuncture, pharmacopuncture and herbal medication. We assessed the knee pain and functional improvement by using numeric rating scale (NRS), Western Ontario and McMaster Universities arthritis (WOMAC) index and EuroQol-5 dimension (EQ-5D) index. After treatment, NRS decreased from 6 to 2 in case 1 and from 5 to 3 in case 2. EQ-5D index chaged from 0.465 to 0.72 in case 1 and from 0.719 to -0.171 in case 2. WOMAC index decreased from 82 to 13 in case 1 and from 55 to 54 in case 2. NRS improved in both cases, but WOMAC index and EQ-5D index improved in only one case. Korean medicine treatment could be helpful for posterior cruciate ligament tear traffic accident patients. However, further clinical studies are needed to clarify the effectiveness to the patients with old age, degeneration and accompanying injury.
Lee, Yu Jin;Lee, Sung Joon;Cheong, Moon Joo;Lim, Jung Hwa;Jo, Hee Geun;Kim, Bo Min;Chung, Sun-Yong;Kwak, Hui-Yong;Park, Bo Ra;Park, Tae-Yong;Shin, Byung-Cheul;Kang, Hyung Won
Journal of Oriental Neuropsychiatry
/
v.32
no.1
/
pp.1-11
/
2021
Objectives: To investigate the prevalence of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in patients with traffic injuries. In addition, PTSD patients was classified using 'pattern identification for jing ji and zheng chong'. Methods: Questionnaires such as the primary care PTSD screen for DSM-5(PC-PTSD-5), Korean version of PTSD checklist-5 (PCL-5-K), and the instrument of pattern identification for jing ji and zheng chong were conducted on 195 patients within 3 days to 1 year after traffic accidents. Patients were recruited from six medical institutions. Collected data were used to determine the prevalence of acute stress disorder and post-traumatic stress disorder. Results: On PC-PTSD-5, the prevalence was 39.1% for ASD and 50% for PTSD. On PCL-5-K, the prevalence was 20.4% for ASD and 29.3% for PTSD. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. As a result of pattern identification for jing ji and zheng chong, 'weakness of heart and gall bladder type' accounted for the highest proportions in both ASD and PTSD groups. Conclusions: In this study, the prevalence was 39.1% for ASD and 50% for PTSD by PC-PTSD-5. Satisfying both PC-PTSD-5 and PCL-5-K, the prevalence was 18.2% for ASD and 25.8% for PTSD. Further large-scale prospective studies are needed to analyze the prevalence of ASD and PTSD, the rate of progression from ASD to PTSD, and the type of pattern identification.
Overall study was carried out for the patients visiting Department of Oral & Maxillofacial Surgery through Emergency Room in Chonnam University Hospital, from Jan. 1, 1992 to Dec. 31, 1996. Result obtained were as follows ; Male predilection was shown, the male to female ratio being 2.5 to 1. The frequently developing age group were the first 3rd and 4th decade and under the age of 9 was followed. The number of patients for emergency was peak in September and October to 11%. About the causes for emergency, traffic accident was the most, and fall down injury and assault were followed. About the injury lists, facial laceration was preceded and the next facial bone fracture and the tooth injury followed. In the facial bone fracture, fracture in the mandible only was the most, and zygomaticomaxillary complex fracture, and mandible-maxilla complex fracture were followed. when the case of the mandible fracture, symphysis, condyle, angle were marked in succession. 57% was predomunatly ranged in the timea of 18 : 00 to 03 : 00 for the emergency. From injury onset to visiting emergency room, the range of 8 hours to 12 hours was predominant. Above results suggest that urgent patients of oral and maxillofacial area were relatively so high that division of oral and maxillofacial surgery should be established immediately.
With today's social and cultural personal interactions, greater leisure time and participation in sports activities, and growing traffic volume, the risk of physical trauma has increased markedly. This is a clinical and retrospective study of patients exposed to oral and maxillofacial trauma. We clinically observed 72 patients with trauma in the Department of Oral and Maxillofacial Surgery, Kyunghee University Dental Hospital, from June 2006 through November 2007. The following data was obtained: 1. The male:female ratio of patients having experienced physical trauma was 6.2:1, with most patients in their twenties. 2. Traffic accident (37.5%) was the most common cause of trauma. 3. The highest incidence of fracture occurred to the zygomatic arch(22.1%) among mid-facial fractures and angle(37.5%), symphysis(35.4%) in mandible fractures. 4. Open reduction (88.9%) was the most frequently used form of treatment. Closed reduction was performed on the remaining 11.1% of cases. 5. Teeth and alveolar bone damage occurred in 23.6% of all cases. 6. Other injuries that were related to mid-face fracture occurred in 27.8% of all cases. 7. Post-operative complications occurred in 31.9% of cases, and the highest complication was the nerve injury.
Kim, Dae Kon;Hong, Ki Jeong;Noh, Hyun;Hong, Won Pyo;Kim, Yu Jin;Shin, Sang Do;Park, Ju Ok
Journal of Trauma and Injury
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v.27
no.4
/
pp.126-132
/
2014
Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.42
no.4
/
pp.174-181
/
2016
Objectives: This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. Materials and Methods: The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Results: Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were $35.0{\pm}11.8$ years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P <0.001). Conclusion: The most common etiology of maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients.
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