• Journal of Trauma and Injury
• /
• v.34 no.2
• /
• pp.98-104
• /
• 2021

Purpose: Severe pelvic fractures are associated with genitourinary injuries, but the relationship between pelvic trauma and concomitant urethral injuries has yet to be elucidated. This study evaluated the incidence, mechanism, site, and extent of urethral injuries in male patients with pelvic fractures. Methods: A retrospective cohort study was performed involving patients with urethral injuries accompanying pelvic fractures who visited Pusan National University Hospital from January 1, 2014 to December 31, 2019. Demographics, mechanisms of injury, clinical features of the urethral injuries, concomitant bladder injuries, methods of management, and the configuration of the pelvic fractures were analyzed. Results: The final study population included 24 patients. The overall incidence of urethral injury with pelvic fracture was 2.6%, with the most common mechanism of urethral injury being traffic accidents (62.5%). Complete urethral disruption (16/24, 66.7%) was more common than partial urethral injuries (8/24, 33.3%), and unstable pelvic fractures were the most common type of pelvic fracture observed (70.8%). There was no definitive relationship between the extent of urethral injury and pelvic ring stability. Conclusions: The present study provides a 6-year retrospective review characterizing the incidence, mechanism, and clinical features of urethral injury-associated pelvic fractures. This study suggests that the possibility of urethral injury must be considered, especially in unstable pelvic fracture patients, and that treatment should be chosen based on the clinical findings.

• Journal of Korean Foot and Ankle Society
• /
• v.5 no.2
• /
• pp.112-119
• /
• 2001

Purpose: The purpose of this study is to analyze the clinical prognostic factors which may affect the postoperative clinical results of the unstable ankle fractures. Materials and Methods: This study is based on 62 unstable ankle fractures treated by open reduction and internal fixation from May 1994 to June 2000, with a minimum follow-up period of 12 months(range: 13 months-7 years 3 months). The 62 patients were average 39.1 years old with male: female ratio of 41:21. Based on Lauge-Hansen classification, the supination-external rotation type was the most common with 36 (58.1%) cases. The clinical results was assessed by American Orthopaedic Foot and Ankle Society(AOFAS) functional scale. The sex, age, body weight, trauma-operation interval, operation time, cause of injury, fracture type were statistically analyzed as the possible postoperative clinical prognostic factors. Results: Postoperative AOFAS functional scale was average 82.1 points with 22(35.5 %) cases excellent, 12(19.4%) good. 16(25.8%) fair and 12(19.4%) cases poor results. The age and the operation time were found to be statistically significant factors affecting the prognosis(p<0.001). The sex, weight, trauma-operation interval factors did not significantly affect the clinical results. The pronation-external rotation type showed better clinical tendency among the fracture types, but without the statistical significance. Conclusion: The surgically treated unstable ankle fractures in patients whose age was above 41 years old or operation time exceeding 90 minutes showed significantly poor clinical results.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.1
• /
• pp.58-65
• /
• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

• Clinics in Shoulder and Elbow
• /
• v.12 no.1
• /
• pp.1-6
• /
• 2009

Purpose: To evaluate and report the clinical and radiological outcomes of open reduction and internal fixation with a mini-T plate for unstable distal clavicle fractures. Materials and Methods: From December 2004 to July 2007, fifteen patients who had a fracture of the distal clavicle (Neer type II fracture) were treated with an open reduction and internal fixation using a mini-T plate. They were followed up for a minimum of one year and the clinical and radiological results were analyzed. Results: The average time to fracture union was 3.1(3~4) months. There were no complications, such as deep infection or fixation loss. The mean ASES score was 97 points (85~100points) at the last follow up period, and 14 patients had a full range of motion of the shoulder. Conclusion: Open reduction and internal fixation with a mini-T plate for unstable distal clavicle fracture is a good surgical method with good clinical and radiological results.

• Journal of Chest Surgery
• /
• v.36 no.3
• /
• pp.211-214
• /
• 2003

Sternal fracture is relatively common in chest trauma. Mediastinal hematoma secondary to sternal fracture is not in common, and it has minor symptoms such as mild dyspnea and chest tightness, which usually resolve spontaneously. We experienced two cases of extrapericardial tamponade by hematoma caused by sternal fractures. Two patients were diagnosed by chest CT scan and sent to the operating room within 2 hours after arriving at emergency room because of unstable vital signs. Cardiovascular signs were relieved immediatly after the operation. We report these cases with a brief review of the literature.

• Hip & pelvis
• /
• v.30 no.4
• /
• pp.241-253
• /
• 2018

Purpose: This study was conducted to compare cemented and cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures via meta-analysis and systematic review of relevant studies. Materials and Methods: Systematic review and meta-analysis were performed on 31 available clinical studies; 19 of these studies used cemented stems, 12 used cementless stems, one used both types of stems, and two studies involved a comparative analysis of both stem types. Results: There were statistically significant differences in rates of leg length discrepancy (LLD) greater than 1 cm between the cemented (event rate, 0.089) and cementless groups (event rate, 0.015 and 0.047; P=0.03). Conclusion: Cemented bipolar hemiarthroplasty and cementless bipolar hemiarthroplasty performed on elderly patients with unstable intertrochanteric fracture revealed similar mortality and complication rates; however, the rate of LLD greater than 1 cm was significantly higher in the cemented group compared with the cementless group.

• Journal of Trauma and Injury
• /
• v.36 no.3
• /
• pp.298-303
• /
• 2023

Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

• Proceeding of KASS Symposium
• /
• 2005.05a
• /
• pp.89-98
• /
• 2005

Membrane structures, a kind of lightweight soft structural system, are used for spatial structures. The material property of the membrane has strong axial stiffness, but little bending stiffness. Therefore membrane structures arc unstable structures initially. These soft structures need to be introduced initial stresses first because of its initial unstable state, and it happens large deformation phenomenon. To find the structural shape after large deformation caused by initial stiffness introduced, we need the shape analysis considering geometric nonlinearity in structural design procedure. In this study, we investigate into the stress concentration at crack of membrane structures. Therefore, using the nonlinear analysis program that NASS (Nonlinear Analysis for Spatial Structures) perform nonlinear analysis, and stress distribution for creak length investigate for using linear elastic fracture mechanics.

• Journal of Trauma and Injury
• /
• v.36 no.3
• /
• pp.261-264
• /
• 2023

Pancreatic trauma occurs in 0.2% of patients with blunt trauma and 5% of severe abdominal injuries, which are associated with high mortality rates (up to 60%). Traumatic pancreatoduodenectomy (PD) has significant morbidity and appreciable mortality owing to complicating factors, associated injuries, and shock. The initial reconstruction in patients with severe pancreatic injuries aggravates their status by causing hypothermia, coagulopathy, and acidosis, which increase the risk for early mortality. A staging operation in which PD follows damage control surgery is a good option for hemodynamically unstable patients. We report the case of a patient who was treated by staging PD for an injured pancreatic head.

• Journal of the Korea institute for structural maintenance and inspection
• /
• v.17 no.4
• /
• pp.30-37
• /
• 2013

A soft rock fracture zone is an important element for rock slope or earth retaining, however stability studies of earth retaining wall have been lack. Therefore, this study is analyzed for a behavior of earth retaining wall with condition of fracture zone or no fracture zone and then a numerical analysis (Finite Element Method) was performed considering interaction with field monitoring data between ground and structures. As a result, applied horizontal displacement on retaining wall is correspond between result of numerical analysis and field monitoring data and displacement point stress distribution with fracture zone condition analyzed to be stable side but no fracture zone condition is expressed to be unstable side. The results of this study is purpose for applying safety construction as a top priority at field when designing for future.