• Title/Summary/Keyword: Traffic Injury Patients

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Comparison between Accurate Anatomical Reduction and Unsuccessful Reduction with a Remaining Gap after Open Reduction and Plate Fixation of Midshaft Clavicle Fracture

  • Kim, Joon Yub;Choe, Jung Soo;Chung, Seok Won
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.2-7
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    • 2016
  • Background: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). Methods: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. Results: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. Conclusions: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.

Clinical Evaluation of Traumatic Diaphragmatic Ruptures (외상성 횡격막 파열에 대한 임상적 고찰)

  • 조재민;김은기;이종국;박승일
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1257-1262
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    • 1996
  • From January 1989 to February 1996, 50 patients with a traumatic diaphragmatic rupture were treated at the Yonsei University Wonju College of Medicine. There were 40 male and 10 female patients. The ages ranged from 2 to 80 years, with peak incidence in third decades. Thirty-nine cases had blunt trauma (traffic accident 29, falls down 7, others 3), and 11 cases had penetrating injuries (stab injury 9, gun shot 1, broken glass 1). The most common symptoms were dyspnea (76%), chest pain (58%), and abdominal pain (52%). In blunt trauma, the rupture was located in the left in 30 cases, right in 9 cases and in penetrating trauma, the rupture was located in the left in 8 cases and in the right in 3 cases. Eighteen cases underwent thoracotomy alone, 29 cases underwent laparotomy only and 3 cases had combined thoracotomy and laparotomy. The postoperative mortality occurred in 6% (3 cases), and the cause of death were septic shock (1), intracranial hemorrhage (1), and respiratory failure (1).

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THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS (원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구)

  • Moon, Won-Kyu;Jung, Young-Soo;Lee, Eui-Wung;Kwon, Ho-Keun;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

Development and Clinical Evaluation of Wireless Gyro-mouse for the Upper Extremity Disabled to Use Computer (상지장애인의 컴퓨터 사용을 위한 무선 자이로마우스의 개발 및 임상평가)

  • Han Ha-Na;Song Eun-Beom;Kim Chul-Seung;Heo Ji-Un;Eom Gwang-Moon
    • Science of Emotion and Sensibility
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    • v.9 no.2
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    • pp.93-100
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    • 2006
  • This paper aims at the development and clinical evaluation of the wireless gyro-mouse system. The wireless gyro-mouse system is a computer interface with gyro-sensor and wireless communication, for the patients with upper-extremity disabled from the traffic accident or stroke to use the computer software i.e. internet browser. In the development, we focused on, firstly, to make the system wireless for the patients to manipulate the mouse easily even on the bed or wheelchair, secondly, to insert the gyro-sensor into a headband for easy don-and-doff and aesthetic appearance, thirdly, to devise a click switch in case of $C5{\sim}C6$ patients and a head nodding detection in case of C4 patients for sending click message to computer operating system. We performed evaluation experiment for patients with upper-extremities disabled from spinal cord injury. The results show that the displacement error of the cursor position against the target position during linear (vertical/horizontal) movement manipulation decreased with trial number. The click rate per minute also increased with trial number. This indicates the developed wireless gyro-mouse system would be more useful to the patients with repetitive use.

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Retrospective clinical study of mandible fractures

  • Jung, Hai-Won;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Jun;Lee, Jung-Woo;Lee, Hyun-Woo;Moon, Chang-Sig;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.21-26
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    • 2014
  • Objectives: The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of mandible fractures that were treated by the Department of Oral and Maxillofacial Surgery in Kyung Hee University Dental Hospital from January 2002 to December 2012. Materials and Methods: This was a descriptive and analytic retrospective study that evaluated 735 patients that were treated for mandible fracture. Results: This study included 1,172 fractures in 735 patients. The ratio of male to female patients was 5.45 : 1; the maximum value was in patients between 20 and 29 years (38.1%) and the minimum in patients over 70 years old. The monthly distribution of facial fractures peaked in the fall and was lower during winter. No specific correlation was identified based on the annual fracture distribution. Among the 735 fracture patients, 1.59 fracture lines were observed per patient. The most frequent site was the symphysis, which accounted for a total of 431 fractures, followed by the angle (348), condyle (279), and body (95). The symphysis with angle was the most common site identified in combination with fracture and accounted for 22.4%, followed by symphysis with condyle (19.8%). The angle was the most frequent site of single fractures (20.8%). The major cause of injury was accidental trauma (43.4%), which was followed by other causes such as violence (33.9%), sports-related accidents (10.5%), and traffic accidents (10.1%). Fracture incidents correlated with alcohol consumption were reported between 10.0%-26.9% annually. Conclusion: Although mandible fracture pattern is similar to the previous researches, there is some changes in the etiologic factors.

A RECENT 5-YEAR RETROSPECTIVE STUDY ON NASAL BONE FRACTURE (비골 골절에 대한 최근 5년간의 후향적 연구)

  • Oh, Hee-Kyun;Park, Young-Jun;Kim, Hyun-Syeob;Ryu, Jae-Young;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.230-236
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    • 2008
  • Purpose: This study was performed to investigate the incidence, types of fracture, treatment, associated fracture and complications in patients with nasal bone fracture. Materials and methods: Clinical examination, patient's records and radiographic images were evaluated in 230 cases of nasal bone fractures who were treated at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital for recent 5 years; from January 2002 to December 2006. Results: 1. The age of patient was ranged from 4 to 77 years (mean age=36.6 years); Males was 75.7% (n=174), and females 24.3% (n=56). 2. The cause of the nasal bone fracture in this study was a fall or slip down (28.8%, n=66), sports accident (26.0%, n=60), fighting (21.3%, n=49), traffic accident (9.6%, n=22), industrial trauma (7.8%, n=18), and the others (6.6%, n=15). 3. For the patterns of fracture, simple fracture without displacement occured in 10.4% (n=24). Simple fracture with displacement without septal bone fracture was found in 49.5% (n=114). Simple fracture with displacement in company with septal bone fracture showed in 32.6% (n=75). Commiuted fracture with severe depression was presented in 7.4% (n=17). 4. The reduction the displaced nasal bone was carried out in 2 to 10 days (mean 6.8 days) after the injury. 5. Nasal bone fracture associated with Le Fort I fracture (6.5%, n=6.5), Le Fort II fracture (7.4%, n=17), Le Fort III fracture (1.3%, n=3), NOE fracture (13.9%, n=32), ZMC fracture (17.4%, 40), maxillary bone fracture (8.3%, n=19), orbital blow-out fracture (15.7%, n=36), frontal bone fracture (1.3%, n=3) and alveolar bone fracture (10.9%, n=25). 6. The major type of treatment method was closed reduction in 90% (n=207), open reduction in 3% (n=7), and observation in 7% (n=16). 7. There were some complications such as ecchymosis, hyposmia, hypo esthesia and residual nasal deformity which are compatible. Open rhino-plasty was conducted for 3 patients who had residual nasal deformity. Conclusions: These results suggest that most of nasal bone fractures are occurred physically active aged groups(age 10-49 years) and could be treated successfully with closed reduction at 7 days after the injury.

A CLINICAL STUDY OF FRONTAL BONE FRACTURE (전두부 골절 환자의 임상적 연구)

  • Min, Sung-Ki;Han, Dae-Hee;Chang, Kwan-Sik;Oh, Sung-Hwan;Lee, Dong-Kun;Jo, Yong-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.56-62
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    • 2000
  • Fracture of frontal bone is infrequent, but may have serious complications because of their proximity to the brain, eyes and noses. Fractures of the frontal area range from 5% to 15% of all facial bone fracture and include supraorbital rim and frontal sinus. As frontal bone fractures most frequently occur in the multiply injured patient, a thorough clinical and radiological examination of the patient is required before diagnosis and treatment plans are established. Sometimes coorperative treatment with other department is required. It is specially considered that incision for access to frontal region and surgical methods for open reduction, cranialization, cannulization, sinus obliteration. After surgical or conservative treatment, it may have complication. Complication of frontal bone injury vary in severity and may occur at several years after the incidents. The major types of complications are those that occur directly at the time of injury, infection and chronic problems. This is clinical study on 31 patients with frontal bone fracture, at department of oral and maxillofacial surgery in dental hospital of Wonkwang university during past ten years. The results were as follows; 1. The sex ratio of all patients is 29 (94%) male to 2 (6%) female, the average age is 33 and the prominent groups are 2nd, 3rd decade age. 2. The causative factors are mostly traffic accident 22 cases (70%) and fall dawn, industrial accidents, so on. 3. The 17 cases has shown alert mental status, but neurologic problems is in 14 (45%) cases in initial accessment. 4. Associated facial bone fractures are prominent in the maxilla (42%) and panfacial fracture (39%). 5. Involved general problems are in department of neurologic surgery problems (65%), orthopaedic problems (23%) and ophthalmologic problems (19%) in order. 6. Open reduction has done in 15 cases and 16 cases with conservative management. 7. Postoperative complications are chronic headache (42%), esthetic problems (39%) and ophthalmologic problems (35%)in order.

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The Effects of Radix aconiti on the Contraction of Rat's Spinal Cord Injury (부자(附子)의 경구투여(經口投與)가 RAT의 척수손상(脊髓損傷)에 미치는 영향(影響) 및 비교(比較))

  • Lee Geon-Mok;Kim Kyung-Sik;Lee Kang-Chang
    • Journal of Acupuncture Research
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    • v.15 no.2
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    • pp.105-116
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    • 1998
  • Purpose In this study, We observed the recovery process in the ability to move in the hind limbs of the rats whose spinal cord injuries were treated by Radix acouniti(RA). The purpose of this study is to see the effects of Radix acouniti(RA) water extract on the contraction of rat's spinal cord injury. Procedure First, the rats were subjected to hemisectional spinal cord injuries by a scalpel blade. Those rats, then, were divided into three groups: Sham operated rats group and the experimental group, which received the Radix acouniti(RA) water extract, and the control group, which had no treatment. Their recovery in the ability to walk was observed by the Open Field Test (OFT) for 14 days after the injuries. Method The OFT was applied at four points: the hip, knee, ankle joint, and the tail. Each joint was given a movement rating of from 0 to 3, depending on the amount of movement. A movement rating of 0 designates no movement, a 1 designates slight movement, a 2 designates increased movement, and a 3 designates active movement. Slight movement is defined as a joint displaying less than or equal to 30% of that joint range, increased movement is displaying less than or equal to 60% of that joint's range, and active movement is greater than or equal to 90% of that joint's range. Tail movement is also graded on a scale of 0 to 3. A rating of 0 indicates that the tail is down 100% of the time, one of 1 indicates that the tail is down more than 10%, one of 2 shows that the tail is down less than 50% but more than 10% of the time, and one of 3 shows that the tail is down less than 10% of the time. All four ratings were added together and then averaged to arrive at a single score. Results The sham group which did not go through spinal cord injuries showed near normal results on all 3 joints and tail from right after the operation, which one would expect. The RA oral application group showed more effective recovery of movememt function than the control group around 4 days after the spinal cord injuries. However, after 14 days, both groups displayed almost the same degree of movement recovery. The results of this study are summarized as follows: 1. After 14days the spinal cord injuries, movement was recovered in sham operated group, control group, and experimented group in the hip, the knee, the tail and then the ankle of rats, in that order. 2. Around 7 days after the spinal cord injuries, the experimental group proved the effectiveness of the therapy in terms of movement recovery. 3. The level of ALT, ALP, AST in RA treated group was slightly increased. 4. The level of BUN and creatinine in RA treated group was slightly increased. The above results indicate that RA therapy at an early stage can bring about better movement recovery in patients with spinal cord injuries from traffic accidents or industrial disasters. But there is apparent side effect of RA on clinical, therefore the study on this should be continued.

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Clinical Analysis of Patients with Multiple Organ Injuries Who Required Open thoracotomy (개흉술이 필요했던 다발성 외상환자에 대한 임상적 고찰)

  • 이성광;정성운;김병준
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.804-810
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    • 1998
  • Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).

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Spur-like Lesion on the Lateral Tibial Condyle - A Sign of Chronic ACL tear - (경골 외과의 골극 유사 병변 - 만성 전방 십자 인대 파열의 징후 -)

  • Cho Sung-Do;Ko Sang-Hun;Hwang Su-Yeon;Yang Jung-Hun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.201-205
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    • 2003
  • Purpose : Authors experienced cases of chronic ACL tear with spur-like lesion on the tibial condyle which is different from the lateral capsular sign and degenerative change and evaluated the significance of 'spur-like lesion' in relations with chronic ACL injury. Material and Method : We have 5 patients with spur-like lesion on the lateral tibial condyle in simple radiogram. The location, shape and size of the lesion were studied using radiogram and MRI. Cause of injury, associated injury and chronicity of the ACL tear were analyzed. All 5 patients were male, and mean age was 33.8 $(17\~46)$ years. Result : The spur-like lesion was located from 3.8 mm(avg.) below the articular surface of the lateral tibial condyle to the apex of the fibular head and protruded laterally or inferolaterally from just posterior to the Gerdy's tubercle with a round or sharp-end triangular shape. Average length was 6 mm and average width ortho base was 9.2 mm. The cause of injury were sports jnjury 4 cases and traffic accident in one. The chronicity of the ACL tear was average 10.7(8 months$\~$23 years) years and medial meniscus tear was shown in all cases and lateral meniscus tear in three. Conclusion : We suggest that a patient who has a history of trauma with spur-like lesion on the lateral tibial condyle of the knee is expected to have chronic ACL tear.

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