• Journal of Trauma and Injury
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• v.26 no.3
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• pp.175-182
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• 2013

Purpose: Crushing injuries by car tires result from a combination of friction, shearing, and compression forces and the severity of injury is influenced by the acceleration. Because car-tire injuries of the lower leg in children are common these days but they have received little attention; thus, our purpose was to look closely into this problem. Methods: A retrospective analysis was conducted of data from children under 15 years old age who visited an emergency department because of a car-tire-related crushing injury to the lower leg in pedestrian traffic accident from January 2008 to September 2012. The patient's age, sex, site of injury, degree of injury, associated injuries, type of surgery, and complications were reviewed. Results: There were 39 children, the mean age was 8.0 years, and 71.8% were boys. The dorsal part of the leg was involved most frequently. According to the severity classification, 15 children were grade I, 6 were grade II, and 18 were grade III. Among 24 patients, 13 were treated with skin graft and 3 were treated using a sural flap. Twelve patients developed complications, such as hypertrophic scarring, contractures, and deformities with significant bone loss. Conclusion: Various degrees of skin or soft tissue defects were caused in children by car tires. In this study, patients were often also had tendon or bone damage. Proper and timely initial treatments are needed to reduce the incidence of infection, the number of operative procedures, and the hospital stay.

• Archives of Craniofacial Surgery
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• v.19 no.4
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• pp.270-274
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• 2018

Background: Nasal bone fractures occur frequently because the nasal bone is located at the forefront of the face. The goal of this study was to examine the cause, change in severity, change in incidence, and demographics of nasal bone fracture according to today's lifestyle. Methods: A total of 2,092 patients diagnosed as having nasal bone fractures at our department between 2002 and 2017 were included in this study. We retrospectively examined patients' medical records to extract information regarding age, sex, cause of injury, combined facial bone fractures, and related injuries such as skull base fracture, spinal cord injury, brain hemorrhage, and other bone fractures. Fracture severity was classified by nasal bone fracture type. Results: No statistically significant difference was found in annual number of patients treated for nasal bone fracture. The proportion of patients who underwent closed reduction was significantly decreased over time for those with nasal bone fractures caused by traffic accidents. However, it was not significantly changed for those with nasal bone fractures due to other causes. The number of patients with combined facial bone fractures increased over time. Incidences of severe nasal bone fracture also increased over time. Conclusion: The study suggested that there is a decrease in the frequency and increase in the severity of nasal bone fracture due to traffic accident. Many protective devices prevent nasal bone fractures caused by a small amount of external force; however, these devices are not effective against higher amounts of external force. This study highlights the importance of preoperative thorough evaluation to manage patients with nasal bone fractures due to traffic accident.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.58 no.3
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• pp.251-261
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• 2022

Tuna purse seine fishery (TPF) constitute more than 60% of distant water fishery production in Korea based on a statistic of 2018, and 28 ships from four different companies were under operation at the western and central Pacific Ocean. On this research, common risk factors during TPF were investigated via enumeration of five years Korean fisherman's insurance payment statement, followed by some counterplans to diminish the accident rate. The accident rate of TPF on the Pacific Ocean peaked by 43.0% in 2014 and constantly decreased to 23.0% until 2018, presenting an average of 33.6%. Meanwhile, the accident rate on the Indian Ocean reached the highest point 55.1% in 2014 and declined to 11.6% in 2016, having an average of 24.7%. The average accident rate of the Indian Ocean scored 8.9% lower than the rate of the Pacific Ocean, but no statistic significance was observed. Depending on the process of operation, 'casting or hauling of net' was the most frequent part that people received an injury (40.4%). When the accidents were classified by their types, 'falling down' was the most recurrent cause of the injuries (28.5%). At the point of severity, the worst injuries were induced by crush hazard. Considering aforementioned accident frequency and severity, all the factors on the accident type list were divided into three different groups including high risk, moderate risk, and common risk. This study is expected to contribute to the reduction of occupational accidents during the work of fishermen and establishment of a safety management system for distance water fishing vessels.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.22 no.5
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• pp.53-73
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• 2023

Although it is mandatory to wear a seat belt that can minimize human injury when traffic accident occurs, the number of traffic accident casualties not wearing seat belts still accounts for a significant proportion.The seat belt wearing detection system for all seats is a system that identifies whether all seat passengers wear a seat belt and encourages their usage, also it can be a useful technical countermeasure. Firstly, this study established the viability of system implementation by assessing the factors influencing the severity of injuries in traffic accidents through the development of an ordered probit model. Analysis results showed that the use of seat belts has statistically significant effects on the severity of traffic accidents, reducing the probability of death or serious injury by 0.054 times in the event of a traffic accident. Secondly, a meta-analysis was conducted based on prior research related to seat belts and injuries in traffic accidents to estimate the expected reduction in accident severity upon the implementation of the system.The analysis of the effect of accident severity reduction revealed that wearing seat belts would lead to a 63.3% decrease in fatal accidents, with the front seats showing a reduction of 75.7% and the rear seats showing a reduction of 58.1% in fatal accidents. Lastly, Using the results of the meta-analysis and traffic accident statistics, the expected decrease in the number of traffic accident casualties with the implementation of the system was derived to analyze the traffic safety effects of the proposed detection system. The analysis demonstrated that with an increase in the adoption rate of the system, the number of casualties in accidents where seat belts were not worn decreased. Specifically, at a system adoption rate of 60%, it is anticipated that the number of fatalities would decrease by more than three times compared to the current scenario. Based on the analysis results, operational strategies for the system were proposed to increase seat belt usage rates and reduce accident severity.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7329-7334
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• 2015

This is to analyze of driver behavioral and the accident characteristics in rollover. The study period was January 2011 to May 2014 and the subject of study was 102 person who were drivers visited the emergency room. Research tool includes a damage information of the vehicle, accident mechanism, damage to the patient clinical information with the injury data from the ROAD Traffic Authority. For data analysis, SPSS 18.0 was used for t-test, ANOVA and Chi-square test. Injury Severity Score average score according to the vehicle type is 6.00 points in the smaller vehicle, at high vehicle 11.78 points, from the other vehicle that showed 14.70 points. Significant differences between the three groups did not show (P=.267). Men did not use a seat belt significantly compared to women(P=.007). Vehicle type and weather, this was no correlation with whether or not use the seat belt(P=.755, P=.793). But showed a tendency to smaller size vehicles drivers do not use a seat belt, the weather could see a little more inclined to use a seat belt rather than a sunny day. Finally, in rollover accidents as in other types of accident it was confirmed that the seat belt has a great influence on the damage.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.106-113
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• 2024

Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.68-74
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• 2010

Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

• Journal of Trauma and Injury
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• v.28 no.1
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• pp.15-20
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• 2015

Purpose: Vascular injuries caused by traffic, industrial accidents and by outside activities have increased in Korea. Especially, vascular injuries to the extremities can lead to limb loss and even mortality if they are not appropriately treated. The aim of the study was to evaluate the surgical outcomes of femoropopliteal vascular management after trauma. Methods: The medical records of 12 patients with femoropopliteal vascular injuries who were treated at Dankook University Hospital from 2011 to 2013 were reviewed. Iatrogenic vascular injuries were excluded. The clinical data including the causes of injury, associated injuries and surgical outcomes were analyzed retrospectively. Results: All patients were male, with a mean age of $46.8{\pm}16.3years$ (range: 26~69 years). The causes of vascular injuries were four traffic accidents, three industrial accidents, two iron plates, one outside activity, one glass injury and one knife injury. The average transit time between the place of the accident place and the emergency department was $3.0{\pm}2.1$ (0.5~12.5) hours, and the average preparation time for surgery was $8.0{\pm}6.7$ (1.7~23.3) hours. The anatomic injuries included the popliteal vessel in seven cases and the femoral vessel in five cases. The average Injury Severity Score (ISS) was $12.0{\pm}5.0$ (5~17), and the average Mangled Extremity Severity Score (MESS) was $5.7{\pm}2.1$ (2~9). The operation methods were four interposition grafts, three end-to-end anastomoses, two direct repairs and three patch angioplasties. One case required amputation of the injured extremity. Conclusion: Early recognition and revascularization of the injured vessel are mandatory to reduce limb loss and to obtain satisfactory outcomes. Therefore, careful/rapid evaluation of the vascular injuries and timely/successful surgical treatment are the keys to salvaging an injured limb.

• Journal of Auto-vehicle Safety Association
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• v.11 no.3
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• pp.7-12
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• 2019

AEB (Autonomous Emergency Braking system), a system in which vehicles automatically recognize forward objects or pedestrians and actively brake when forward collisions are expected, has been mandated by NHTSA (National Highway Traffic Safety Administration) and IIHS (Insurance Institute for Highway Safety) for all vehicles sell in the United States since 2022, and AEB research is also actively underway in korea. In this study, it can be confirmed that the passenger injury is reduced according to the AEB detection distance when it is assumed that the AEB is mounted in the actual event generated from KIDAS (Korea New Car Assessment Program) data through various analysis programs.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.146-150
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• 2016

Purpose: Traumatic aortic injuries are rare, but life threatening condition. They usually occur after high velocity impact on the chest or abdomen such as traffic accident or fall. We report the experiences of the traumatic aortic injuries at a single center. Methods: We retrospectively reviewed the medical records of nine patients with aortic injury resulting from the blunt trauma from Jan. 2010 to May. 2016. Results: The mean age was $51.1{\pm}20.8$ years old, and ten (90.9%) were men. The mechanisms of injury were traffic accidents in seven patients (motorcycle accidents; 3, car accidents; 4), and four in fall injury. Most common injured sites were thoracic aorta (9, 81.8%). Aortic injuries were repaired by endovascular approach in four patients, and by open graft surgery in four. Two patients were managed conservatively. Nine patients survived without any complications. Conclusion: We had experienced different approaches for management of aortic injuries after blunt trauma according to locations and severity of lesions.