• 제목/요약/키워드: internal injuries

검색결과 227건 처리시간 0.03초

Analysis of Sternal Fixation Results According to Plate Type in Sternal Fracture

  • Byun, Chun Sung;Park, Il Hwan;Hwang, Wan Jin;Lee, Yeiwon;Cho, Hyun Min
    • Journal of Chest Surgery
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    • 제49권5호
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    • pp.361-365
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    • 2016
  • Background: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. Methods: We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. Results: Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. Conclusion: Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.

Management of a traumatic anorectal full-thickness laceration: a case report

  • Fortuna, Laura;Bottari, Andrea;Somigli, Riccardo;Giannessi, Sandro
    • Journal of Trauma and Injury
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    • 제35권3호
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    • pp.215-218
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    • 2022
  • The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

항생제 치료 중 드레싱과 황기 약침액 도포를 병행하여 호전된 뇌출혈 환자 욕창 1례 (Case Report of Pressure Injury in Intracerebral Hemorrhage Patients Improved by Combining Radix Astragali Pharmacoacupuncture Solution during Antibiotic Treatment)

  • 김근영;이다빈;전선욱;이한결;조기호;문상관;정우상;권승원
    • 대한한방내과학회지
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    • 제44권2호
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    • pp.167-177
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    • 2023
  • Background: Pressure injuries are localized areas of damage to the skin and/or underlying tissue, usually over a bony prominence due to pressure. Cerebrovascular disease increases the risk of pressure injuries due to the immobility caused by physical paralysis. The general approach to managing a patient with pressure injuries should include pain relief, the treatment of the infection, optimizing nutritional intake, proper positioning, and contamination prevention. Nonetheless, the duration of treatment for pressure injuries varies from person to person. Case report: An 80-year-old female intracerebral hemorrhage patient developed a pressure injury. To improve the injury faster, a Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. The pressure injury's width, length, and depth was assessed using a ruler, and the exudate amount and tissue types were assessed. The treatment was performed for 35 days. The rate at which the size of the pressure sore lessened increased since the Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. In addition, the tissue type of the pressure injury improved, and the exudates decreased. There was no significant difference in the Pressure Ulcer Scale for Healing Tool 3.0, since the Radix Astragali pharmacoacupuncture solution was applied to the pressure injury. Conclusion: This clinical case study suggests that the Radix Astragali pharmacoacupuncture solution might be effective in speeding up the healing of pressure injuries.

전기자동차의 유럽 측면 충돌 특성 기초 연구(II) (A Basic Study of the European Side Impact Characteristics of Electric Vehicle(II))

  • 조용범;신효철
    • 한국자동차공학회논문집
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    • 제10권1호
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    • pp.143-152
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    • 2002
  • European side impact analysis of an electric vehicle was done using the robust design method. In order to minimize VC as well as rib deflection, the injury response table which consists of rib deflection and VC response table has been introduced. The sensitivities and interactions are almost the same when it was compared with those of rib deflection and VC response table. Using internal energy of the factors, the starting time of dummy rib deflection and the contact average velocity, the internal energy and time-velocity response table were introduced. It is shown that the results of the new response tables have the similar characteristics to those of the Injury response table. It is suggested that the internal energy and time-velocity response table should be utilized to minimize injuries.

췌장 효소 상승을 동반한 급성 신손상 환자의 복통 치험 1례 (A Case Report of Abdominal Pain with Acute Kidney Injury and Elevated Pancreatic Enzymes)

  • 김도현;공경환
    • 대한한방내과학회지
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    • 제44권5호
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    • pp.1017-1024
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    • 2023
  • Objectives: The aim of this study is to report the effectiveness and safety of herbal medicine treatment for abdominal pain with acute kidney injury. Methods: A 80-year-old female patient presented with abdominal pain. Blood test results showed increased blood urea nitrogen, serum creatinine, amylase, and lipase. The patient was treated with acupuncture and herbal medicine, specifically Hyangsayukgunja-tang-gahwangryeon for 4 days and Gagam-gunbi-tang for 11 days. Gastrointestinal symptoms were assessed using the Numerical Rating Scale, Gastrointestinal Symptom Rating Scale, and abdominal examination. Results: Gastrointestinal symptoms improved after taking Korean herbal medicine. Additionally, blood urea nitrogen, serum creatinine, amylase, and lipase levels showed improvement compared to values before treatment. Conclusions: Korean medicine treatment can improve clinical symptoms without damaging the kidneys of patients with acute kidney injuries.

악안면 손상후 발생된 경동맥해면동루에 대한 증례보고 (CAROTID-CAVERNOUS SINUS FISTULA (C.C.F.) OCCURRED AFTER ORAL AND MAXILLOFACIAL INJURIES.)

  • 박용근;여환호;김광진
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.226-230
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    • 1989
  • As carotid-cavernous fistula is the major complication that can be occurred uncommonly after maxillofacial injuries, it is abnormal arteriovenous communication between cavernous sinus and internal carotid artery. Such an arteriovenous communication is most often the result of injuries, but need not be associated with bony fracture. It usually begins soon after an injury, but it may be delayed for as long as several months. It begins undramatically with eye pain, headache and slow protrusion of eye ball. A bruit may be heard above the eye with stethoscope. Close examination will reveal dilatation of superficial veins of the eyelid and forehead and periorbital edema. There will be complete or partial ophthalmoplesia of the affected eye. Compression of the common carotid artery on the ipsilateral side will reduce or obliterate the bruit. The lesion in the cavernous sinus is them demonstrable by angiography.

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Left External Iliac and Common Femoral Artery Occlusion Following Blunt Abdominal Trauma without Associated Bone Injury

  • Byun, Chun Sung;Park, Il Hwan;Do, Hye-Jin;Bae, Keum Seok;Oh, Joong Hwan
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.214-216
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    • 2015
  • Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.

흉·요추 불안정성 척추 손상 환자에서 전방 감압술과 전방기기 및 Surgical Titanium Mesh를 이용한 내고정술 (장기적 추적 검사 결과) (Anterior Decompression and Internal Fixation with Anterior Instrument and Surgical Titanium Mesh in Thoracolumbar Unstable Spine Injuries (Long-term Follow-up Results))

  • 박환민;이승명;조하영;신호;정성헌;송진규;장석정
    • Journal of Korean Neurosurgical Society
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    • 제29권1호
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    • pp.58-65
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    • 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.

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졸음운전과 교통사고 (Drowsy Driving and Traffic Accidents)

  • 이상학
    • 수면정신생리
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    • 제10권2호
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    • pp.84-87
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    • 2003
  • Drowsy driving is a major cause of automobile crashes and can lead to more serious injuries than other causes of traffic accidents. Factors increasing the risk of drowsy driving and related crashes include sleep loss, late night driving, untreated or unrecognized sleep disorders, use of sedating medications and consumption of alcohol. Young people, especially young males, shift workers, and people with untreated sleep apnea syndrome and narcolepsy are well known as the population groups at highest risk. To prevent drowsy driving and its consequences, getting adequate and quality sleep is both easier and much more successful than any remedial measure. Other helpful behaviors include avoidance of alcoholic beverages and limiting late night driving. Taking a short nap or consuming caffeine can make a short-term difference in driving alertness. In addition, information should be actively provided to the public about the importance of sleep disorders and their consequences. To reduce injuries and death caused by drowsy driving, it is a prerequisite to increase public awareness that drowsy driving can cause serious automobile crashes and has morbidity and mortality rates as high as those of drunk driving.

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조선시대(朝鮮時代) 인조(仁祖)의 질병(疾病)에 관한 고찰(考察) (Examination of the Diseases of Chosun Dynasty's InJo)

  • 김훈
    • 한국의사학회지
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    • 제18권2호
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    • pp.15-37
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    • 2005
  • In this paper, the overall contents of InJo's disease centering on the records from Chosun Dynasty's Official Records were examined. As a result, it was elucidated that the fundamental cause had lied in internal injuries of the Spleen and Stomach. The reason behind the constant change from fever to chills that agonized InJo the most lied not so much in external hazards as much in the injuries of the Spleen and Stomach. The treatment for InJo focused more on acupuncture methods than herbal medicine, which is thought to be characteristic of mid-Chosun Dynasty starting from the times of prior king SunJo or GwangHaeGun.

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