• Journal of Trauma and Injury
• /
• 제28권4호
• /
• pp.248-255
• /
• 2015

Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma.

• Hip & pelvis
• /
• 제36권2호
• /
• pp.135-143
• /
• 2024

Purpose: Hip fractures are associated with increased mortality. The identification of risk factors of mortality could improve patient care. The aim of the study was to identify risk factors of mortality after surgery for a hip fracture and construct a mortality model. Materials and Methods: A cohort study was conducted on patients with hip fractures at two institutions. Five hundred and ninety-seven patients with hip fractures that were treated in the tertiary hospital, and another 147 patients that were treated in a secondary hospital. The perioperative data were collected from medical charts and interviews. Functional Assessment Measure score, Short Form-12 and mortality were recorded at 12 months. Patients and surgery variables that were associated with increased mortality were used to develop a mortality model. Results: Mortality for the whole cohort was 19.4% at one year. From the variables tested only age >80 years, American Society of Anesthesiologists category, time to surgery (>48 hours), Charlson comorbidity index, sex, use of anti-coagulants, and body mass index <25 kg/m² were associated with increased mortality and used to construct the mortality model. The area under the curve for the prediction model was 0.814. Functional outcome at one year was similar to preoperative status, even though their level of physical function dropped after the hip surgery and slowly recovered. Conclusion: The mortality prediction model that was developed in this study calculates the risk of death at one year for patients with hip fractures, is simple, and could detect high risk patients that need special management.

• 한국응급구조학회지
• /
• 제21권3호
• /
• pp.59-71
• /
• 2017

Purpose: The purpose of the study was to evaluate the ergonomic risk factors of 119 emergency medical technicians (EMT) with musculoskeletal disorders, performing emergency medical services (EMS) procedures in a firefighter combat challenge. Methods: The evaluated EMT procedures were cardiopulmonary resuscitation (CPR) & intubation, trauma patient assessment, and intravenous (IV) injection. Measurement of working posture was done during training. Results: In CPR & intubation, OWAS-score was 2 (mean 1.9, maximum 4), requiring correction action, while REBA-score was 11 (mean 7.28, maximum 11), requiring immediate improvement. In trauma patient assessment & IV injection, OWAS-score was 4 (mean 2.9, maximum 4), requiring immediate correction action, while the REBA score was 7 (mean 7.5, maximum 11), requiring improvement. Conclusion: Both OWAS score and REBA-score showed improvement of posture and high-risk of musculoskeletal disorders. Occupational health management in EMS procedures during combat challenge and effective injury prevention program in fire stations are warranted.

• 농촌의학ㆍ지역보건
• /
• 제16권1호
• /
• pp.40-47
• /
• 1991

Musculoskeletal disorders are a major cause of occupational disabilities. Approximately thirty percent state that the major reason for an inability to work is a musculoskeletal problem. A farm work is associated with increased stress and trauma to joints. Chronic overuse injuries are a result of stresses that exceed the body's adaptive or healing capabilities. They can occur in bone, tendons and muscle-tendon-bone junctions. The aim of the investigation was to the study the frequency of pain, ache, and discomfort in the musculoskeletal system among farmers, to find possible correlations between these symptoms and various working positions and different working actions. A questionnaire was answered by 138 farmers. Of those who answered the questionnaire 82% had pain and discomfort from back, shoulders, arms in orders, The result showed that musculoskeletal pain predominate in the farming seasons, and of those who had pain and discomfort 89% thought that farm works had a correlation with the pain and discomfort of musculoskeletal system. But only 17% of quationnaire were put to periodic medical examinations, and 50% of those who had pain and discomfort consulted a doctor. Education in effective pain treatment should therefore be intensifide to ascertain that farmers in rural areas have satisfactory knowledge of the musculoskeletal pain as a chronic overuse syndrome.

• 대한인간공학회지
• /
• 제32권3호
• /
• pp.273-278
• /
• 2013

Objective: This study aims to analyze and evaluate fatigue in upper trapezius muscles of adults when inputting text on a smart phone, thereby examining the risk of cumulative trauma disorders in the musculoskeletal system of the upper extremity. Method: Forty-five healthy adults were divided equally into three groups: a smartphone group, a notebook group, and a desktop group. A surface electromyogram was placed on the upper trapezius muscle of each participant, after which they inputted text for ten minutes within an ergonomic setting; their side posture was recorded on video and analyzed. Results: The spectral edge frequency values for the smartphone group, as recorded from the upper right trapezius muscles on the surface electromyogram, showed a significant decrease(p<.05). Regarding the RULA, all three groups had results indicating "action level 2". Conclusion: All three groups had results indicating "action level 2" according to the RULA, which means that additional research on the posture of the participants while performing tasks is necessary, and their posture needs to be corrected. In particular, the smartphone group has the highest levels of fatigue in the upper trapezius muscles, suggesting that the task of inputting text on a smartphone is a high risk for causing cumulative trauma disorders.

• 대한정형외과학회지
• /
• 제56권3호
• /
• pp.234-244
• /
• 2021

목적: 현재까지 군에서 발생하는 총기 및 폭발물 손상은 그 중요성에 비해 연구된 것이 제한적이었다. 이를 극복하기 위해 최근 4년간 총기 및 폭발물에 의해 수상한 군인 환자의 근골격계 손상에 대한 특징을 확인하고자 하였다. 대상 및 방법: 2015년 1월부터 2019년 7월까지 총기 및 폭발물에 의해 근골격계 손상을 당한 군인 환자를 대상으로 하였다. 의무 기록과 의료영상저장전송시스템 영상자료를 분석하고, 전화 면담을 통해 short musculoskeletal function assessment (SMFS)를 이용한 기능평가를 후향적으로 시행하였다. 기능평가에 대한 통계 분석으로 무기종류에 따른 분석은 t-test를, 다른 요인에 따른 분석은 ANOVA 분석을 실시하였다. 결과: 총기 및 폭발물에 의한 손상으로 치료받은 총 61명의 환자 중 30명(49.2%)이 근골격계 손상으로 정형외과적 치료를 시행받았다. 평균 수상 나이는 26.4세(21-52세)였다. 간부와 병사의 수는 비슷하였다. 총기 손상이 11명, 폭발물 손상이 19명이었다. 30명 중 수도병원에서 16명(53.3%)이, 민간병원에서 10명(33.3%)이 치료받았다. 12명에게 복수부위 손상이 있었고, 골절이 동반된 16명(53.3%)의 환자 중 절반 이상인 7명의 환자가 다발성 골절이었다. 수부와 하퇴부가 가장 흔한 수상 부위였다. 2명을 제외하고는 모두 개방창이 있었으며, 연부조직 재건술이 필요한 환자는 14명(46.7%)이었다. SMFS 기능평가에는 15명이 응답하였다. 계급에 따른 분석 결과, Borther Index에서 간부의 결과가 통계적으로 유의하게 낮은 것으로 분석되었다(p=0.05). 치료 병원에 따른 분석 결과, Dysfunction Index와 Bother Index 모두 수도병원에서 치료 받은 인원의 점수가 통계적으로 유의하게 낮은 것으로 분석되었다. (p=0.0008, p=0.0149) 결론: 국내 무기에 의해 수상한 군인 환자에 대해 분석한 첫 연구이다. 무기 손상 환자의 치료에 있어 orthopedic burden이 높음을 확인하였으며, 장기적으로 이런 환자들에 대한 치료평가 및 군 외상 시스템 발전을 위해 총기 및 폭발물에 의한 손상 환자를 포함한 군 외상환자 레지스트리 구축이 필요하겠다.

• Journal of Acupuncture Research
• /
• 제24권6호
• /
• pp.187-193
• /
• 2007

Objectives : The objectives of this study were to investigate the relationship between electrical detection of ear acupuncture points and musculoskeletal pain. Methods : 18 adults who have musculoskeletal pain without trauma factorsparticipated in this study. They answered the questionnaire and their ear acupuncture points were examined with electrical detectors. We analyzed the relationship between electrical detection of ear acupuncture points and musculoskeletal pain with concordance rate and validity. Results : Total concordance rates of the head region was 68.00%(questionnaire) 32.08%(investigation), that of vertebral region was 67.86%, 59.38%, that of both upper limbs was 86.67%, 39.69%, and that of both lower limbs was 50.00%, 23.46%. The true positive rate was 0.704, the true negative rate was 0.492, the false positive rate was 0.508, and the false negative rate was 0.296 in the validity test. In the head, two concordance rates of the temporal and occipital regions were relatively higher than those of the parietal and frontal regions. In the vertebral region, two concordance rates of the cervical and lumbar regions were relatively higher than those of the thoracic and sacrum regions. In the upper limb, two concordance rates of the shoulder and shoulder joints were relatively higher than those of the others. In the lower limb, concordance rates of investigation were relatively low at all areas. The right lower limb was relatively higher than the left in concordance rates of the questionnaire. Conclusions : The results suggest that electrical detection of ear acupuncture points can be used in the diagnosis and treatment of musculoskeletal pain.

• 한국안전학회지
• /
• 제14권4호
• /
• pp.192-198
• /
• 1999

Work-related musculoskeletal disorders constitute a major source of employee disability and lost wages. Cumulative Trauma Disorders(CTD) refers to a category of physical conditions which result from chronic musculoskeletal injury. Assessment of CTD risk in industry at early stage allows for early control, a safe environment, and a healthier workforce. In this study, the physical load of the shipping work in the cold storage warehouse were especially investigated. Employees were working with almost unnatural posture in a very restricted work space. The questionnaire and biomechanical analysis were used to evaluate the physical load. Results from analyses showed that they were sufficiently exposed to CTD due to repetition and unnatural posture. Based on the analysis, ways for improving working conditions are proposed. The analysis and proposals in this paper will serve as a basic tool for designing/redesigning working environment such as improvement of tools and equipments, design of times for work/rest cycle.

• The Korean Journal of Pain
• /
• 제29권4호
• /
• pp.274-276
• /
• 2016

Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles.

• 산업경영시스템학회지
• /
• 제22권52호
• /
• pp.323-335
• /
• 1999

Spinal injuries are common these days and are increasing due to the increasing sports activities, auto-related accidents, and occupational incidences. Most of spinal injuries of strain and sprain are associated with trauma and resulted in loss of optimal musculoskeletal system in spinal column area. Some of these injuries requires surgical treatments. Fortunately, some people with spinal disorder are achieving outstanding results with the chiropractic care which utilizes muscle stimulation and strengthening, traction therapy, and spinal adjustments. These treatments using chiropractic table can ease pain by restoring alignment, improving mobility, and relieving pain and stiffness in neck and spinal areas. The purpose of this study was thus to gather the comprehensive information about spinal injuries, to define the specific dimensions, and to recommend functions of chiropractic table specially suited for Korean. This study was an integrated approach in applying the concepts of biomechanical correction of the musculoskeletal system. Also, this study was to utilize a knowledge of physics, ergonomics, and rehabilitation to the development of spine cure medicine.