• Journal of Trauma and Injury
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• v.37 no.1
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• pp.48-59
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• 2024

Purpose: Research on rib fracture management has exponentially increased. Predicting fracture patterns based on the mechanism of injury (MOI) and other possible correlations may improve resource allocation and injury prevention strategies. The Chest Injury International Database (CIID) is the largest prospective repository of the operative and nonoperative management of patients with severe chest wall trauma. The purpose of this study was to determine whether the MOI is associated with the resulting rib fracture patterns. We hypothesized that specific MOIs would be associated with distinct rib fracture patterns. Methods: The CIID was queried to analyze fracture patterns based on the MOI. Patients were stratified by MOI: falls, motor vehicle collisions (MVCs), motorcycle collisions (MCCs), automobile-pedestrian collisions, and bicycle collisions. Fracture locations, associated injuries, and patient-specific variables were recorded. Heat maps were created to display the fracture incidence by rib location. Results: The study cohort consisted of 1,121 patients with a median RibScore of 2 (range, 0-3) and 9,353 fractures. The average age was 57±20 years, and 64% of patients were male. By MOI, the number of patients and fractures were as follows: falls (474 patients, 3,360 fractures), MVCs (353 patients, 3,268 fractures), MCCs (165 patients, 1,505 fractures), automobile-pedestrian collisions (70 patients, 713 fractures), and bicycle collisions (59 patients, 507 fractures). The most commonly injured rib was the sixth rib, and the most common fracture location was lateral. Statistically significant differences in the location and patterns of fractures were identified comparing each MOI, except for MCCs versus bicycle collisions. Conclusions: Different mechanisms of injury result in distinct rib fracture patterns. These different patterns should be considered in the workup and management of patients with thoracic injuries. Given these significant differences, future studies should account for both fracture location and the MOI to better define what populations benefit from surgical versus nonoperative management.

• International Journal of Concrete Structures and Materials
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• v.9 no.4
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• pp.475-486
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• 2015

Mode II fracture toughness ($K_{IIc}$) of fiber reinforced concrete (FRC) has been widely investigated under various patterns of test specimen geometries. Most of these studies were focused on single type fiber reinforced concrete. There is a lack in such studies for hybrid fiber reinforced concrete. In the current study, an experimental investigation of evaluating mode II fracture toughness ($K_{IIc}$) of hybrid fiber embedded in high strength concrete matrix has been reported. Three different types of fibers; namely steel (S), glass (G), and polypropylene (PP) fibers were mixed together in four hybridization patterns (S/G), (S/PP), (G/PP), (S/G/PP) with constant cumulative volume fraction ($V_f$) of 1.5 %. The concrete matrix properties were kept the same for all hybrid FRC patterns. In an attempt to estimate a fairly accepted value of fracture toughness $K_{IIc}$, four testing geometries and loading types are employed in this investigation. Three different ratios of notch depth to specimen width (a/w) 0.3, 0.4, and 0.5 were implemented in this study. Mode II fracture toughness of concrete $K_{IIc}$ was found to decrease with the increment of a/w ratio for all concretes and test geometries. Mode II fracture toughness $K_{IIc}$ was sensitive to the hybridization patterns of fiber. The (S/PP) hybridization pattern showed higher values than all other patterns, while the (S/G/PP) showed insignificant enhancement on mode II fracture toughness ($K_{IIc}$). The four point shear test set up reflected the lowest values of mode II fracture toughness $K_{IIc}$ of concrete. The non damage defect concept proved that, double edge notch prism test setup is the most reliable test to measure pure mode II of concrete.

• 제어로봇시스템학회:학술대회논문집
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• 2005.06a
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• pp.2451-2454
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• 2005

In recent years, the importance of the characterization of fall for a fracture prevention system keeps increasing since fracture from a fall can lead to serious health problems. Fall is one of the major sources which increase morbidity in elderly people. In terms of the cost and the influence to the quality of life, the most serious injury with hip fractures is caused by falls. The traditional methods in characterizing fall patterns have been mainly by the epidemiological surveys. With surveys, the exact data of fall patterns can not been acquired. In this paper, we measured and analyzed with the parameters related to fall pattern such as velocities and accelerations during the motion of falls using 3D motion capture program. We acquired the parameters of the fall pattern of intentional and unexpected fall. The result showed that the variation of velocity and acceleration during fall was very important in characterizing fall pattern, which of vital importance for the development of a fracture prevention system and for the safety of the elderly.

• Proceedings of the KOSOMBE Conference
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• v.1990 no.11
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• pp.64-67
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• 1990

Bending strength, bending elastic modulus ,and fracture toughness of different types of dental composite resins were deter mined. The relationship between bending strength, fracture toughness and filler volume fraction of dental composite resin was understood. In Acoustic Emission(AE) behavior during fracture toughness test, characteristic generation patterns of each type were understood. The fracture toughness values, AE generation patterns, and the nature of fracture surface were analyzed to understand fracture behavior of dental composite resin.

• Journal of Trauma and Injury
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• v.23 no.1
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• pp.38-42
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• 2010

Purpose: The clinical utility of brain computed tomography (CT) in detecting temporal bone fracture is not well established. We performed this study to determine the utility of brain computed tomography (CT) in detecting fractures of the temporal bones in correlation with fracture patterns. We used high resolution computed tomography (HRCT) as the gold standard for diagnosing temporal bone fracture and its pattern. Methods: From January 2007 to December 2009, patients who underwent both brain CT and HRCT within 10 days of head trauma were investigated. Among them, 58 cases of temporal bone fracture confirmed by HRCT were finally included. Fracture patterns (transverse or non-transverse, otic capsule sparing or otic capsule violating) were determined by HRCT. Brain CT findings in correlation with fracture patterns were analyzed. Results: Among 58 confirmed cases of temporal bone fracture by HRCT, 14 cases (24.1%) were not detected by brain CT. Brain CT showed a significantly lower ability to detect temporal bone fracture with transverse component than without transverse component (p=0.020). Moreover, brain CT showed lower ability to detect otic capsule violating pattern than otic capsule sparing pattern (p=0.015). Among the 14 cases of temporal bone fracture that were not detected by brain CT, 4 cases lacked any objective physical findings (facial palsy, hemotympanum, external auditory canal bleeding) suggesting fractures of the temporal bones. Conclusion: Brain CT showed poor ability to detect temporal bone fracture with transverse component and otic capsule violating pattern, which is associated with a poorer clinical outcome than otic capsule sparing pattern. Routine use of HRCT to identify temporal bone fracture is warranted, even in cases without evidence of temporal bone fracture on brain CT scans or any objective physical findings suggestive of temporal bone fracture.

• Journal of The Geomorphological Association of Korea
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• v.19 no.2
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• pp.145-159
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• 2012

Fracture patterns observed in the phyllosilicate-bearing layers of the Mawrth Vallis region are analyzed using High Resolution Imaging Science Experiment image data in order to understand the causes of polygonal fracturing. HiRISE data show that the different mineralogies have distinct surface textures and morphologies. The majority of the nontronite-bearing rocks typically appear to have been heavily eroded and are fractured into irregular shaped blocks with variable size, whereas most of the montmorillonite-bearing rocks have polygons which are relatively consistent in size and shape. The majority of the fracture patterns observed in the nontronite-bearing outcrops are interpreted to be a result of unloading stresses. While the polygonal fractures developed in the montmorillonite-bearing layers appear to be a product of desiccation.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.304-310
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• 2022

Background: The Boileau classification distinguishes three surgical neck fracture patterns: types A, B, and C. However, the reproducibility of this classification on plain radiographs is unclear. Therefore, we questioned what the interobserver agreement and accuracy of displaced surgical neck fracture patterns is categorized according to the modified Boileau classification. Does the reliability to recognize these fracture patterns differ between orthopedic residents and attending surgeons? Methods: This interobserver study consisted of a randomly retrieved series of 30 plain radiographs representing clinical practice in a level 1 and a level 2 trauma center. Radiographs were included from patients (≥18 years) who sustained an isolated displaced surgical neck fracture if they were taken ≤1 week after initial injury. A ground truth was established by consensus among three senior orthopedic surgeons. All images were assessed by 17 orthopedic residents and 17 attending orthopedic trauma surgeons. Results: Agreement for the modified Boileau classification was fair (κ=0.37; 95% confidence interval [CI], 0.36-0.38) with an accuracy of 62% (95% CI, 57%-66%). Comparison of interobserver variability between residents and attending surgeons revealed a significant but clinically irrelevant difference in favor of attending surgeons (0.34 vs. 0.39, respectively, Δκ=0.05, 95% CI, 0.02-0.07). Conclusions: The modified Boileau classification yields a low interobserver agreement with an unsatisfactory accuracy in a panel of orthopedic residents and attending surgeons. This supports the hypothesis that surgical neck fractures are challenging to categorize and that this classification should not be used to determine prognosis if only plain radiographs are available.

• Archives of Craniofacial Surgery
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• v.23 no.5
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• pp.205-210
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• 2022

Background: Nasal bone fractures are the most common type of facial bone fracture, but are under-studied in adults above 65 years of age. Therefore, we investigated the epidemiology and patterns of nasal bone fractures among older adults in comparison to different age groups. Methods: This retrospective study included 2,321 nasal bone fracture patients who underwent surgery at our hospital from January 2010 to December 2017. The patients were classified by age as preschoolers, school-age children, young and middle-aged adults, and the elderly. We performed pairwise comparisons between elderly patients and each other age group in terms of sex, cause of injury, and fracture type. Results: The 2,321 nasal bone fracture patients included 76 elderly patients (50 men [65.8%] and 26 women [34.2%]). In these patients, the two most common injury causes were falling or slipping down (n= 39; 51.3%) and road traffic accidents (n= 19; 25.0%). According to the Stranc and Robertson classification, the most common force vector was lateral, and plane 2 fractures with lateral forces predominated. Conclusion: The elderly showed similar patterns of nasal bone fractures to those observed in young and middle-aged adults, but significant differences from preschoolers (in the injury vector and plane of fracture) and from school-age children (in the sex ratio and plane of fracture). However, elderly patients presented significantly different epidemiological characteristics compared to the other three groups. Therefore, it is necessary to improve the quality of life of the elderly and prepare for the upcoming super-aged society by taking steps to reduce the incidence and severity of fractures. Possible options for doing so include strengthening individual-level safety factors and expanding the social safety net for the elderly.

• Archives of Craniofacial Surgery
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• v.21 no.5
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• pp.294-300
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• 2020

Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

• Journal of Korea Foundry Society
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• v.7 no.2
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• pp.114-121
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• 1987

In order to determine the plane strain fracture toughness of Al-Si-Cu-Mg alloy castings, solution heat treatments have been conducted at $530^{\circ}C$ for 8hr and aged for 10hr at $145^{\circ}C$, $160^{\circ}C$ and $175^{\circ}C$. Effects of aging treatment and of Si contents on the fracture toughness have been investigated by a three point loaded bend test, using the artificial notch. The results obtained are as follows; 1) The fracture toughness is appreciably affected by the aging treatment temperature and Si contents. The specimen aged for 10hr at $145^{\circ}C$ has the highest fracture toughness. 2) Increasing Si contents from 5% to 9% results in decrease of fracture toughness. 3) Increasing the aging temperature and Si contents, C.O.D. value was decreased. The specimen aged for 10hr at $145^{\circ}C$ has the highest C.O.D. value. 4) Dimple patterns were observed in the specimens of containing under 7% Si, while mixed cleavage-dimple patterns in those of over 8% Si.