• Journal of Trauma and Injury
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• 제29권2호
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• pp.56-59
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• 2016

Patients with pelvic bone fractures with gastrointestinal perforations are reported in 4.4% of the cases and in very rare cases jejunum (0.15) is involved. However, intestinal perforations are often undiagnosed on the first examination before peritonitis is evident. We are presenting a report where a patient with anteroposterior compression injury, who was expected to undergo an internal fixation procedure, did not show any jejunum perforations on abdominal CT or other physical exams but was found on abdominal CT 1 week after right before surgery, therefore excision and anastomosis surgery, pelvic open reduction and internal fixation was simultaneously done with favorable results. In our case, we present a 61 year old male patient with liver trauma, adhesion at the abdominal cavity, with a past history of gallbladder excision, but without abdominal pain, fever, or infection symptoms. Therefore, this was a case that was difficult to initially diagnose the patient with jejunum perforation and peritonitis. The diagnosis was further supported during laparotomy when peritonitis around the area of intestinal perforation was observed. Generally, it is understood that pelvic bone fracture surgery is not immediately done on patients with peritonitis. However, this kind of patient who had peritonitis with intestinal adhesion and other complications could undergo surgery immediately as infection or other related symptoms did not coexist and the patient was rather stable, and as a result the treatment was successful.

• 대한골관절종양학회지
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• 제13권2호
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• pp.113-118
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• 2007

골반 골에 생기는 종양은 복잡한 해부학적 구조와 체부 깊숙이 위치하는 특성으로 인하여, 상당히 커진 후에야 발견되는 경우가 많아서 진단이 늦어지고, 수술이 어려워지는 경우가 많이 있다. 특히 비구 주위에 발생한 종양은 종양의 제거 후에 고관절의 기능을 유지 할 수 있는 재건술의 방법이 극히 제한되어 있고, 수술도 어려우며, 재건술의 예후 또한 예측하기 어렵다. 저자는 신장암이 골반 골 비구 주위로 단독 전이 된 환자의 광범위 종양절제 후 저온 가열 처리한 자가골 과 인공고관절로 재건 한 증례를 보고한다.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.139-145
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• 2016

Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

• 대한골절학회지
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• 제30권4호
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• pp.186-191
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• 2017

목적: 이번 연구의 목적은 고령 인구의 골반 부전 골절에 대한 방사선적, 역학적 특징과 임상 경과를 알아보는 것이다. 대상 및 방법: 2010년 3월부터 2017년 5월까지 골반 부전 골절 환자를 대상으로 후향적 조사를 시행하였다. 환자의 인구학적 정보, 골밀도, 골표지자를 조사하였다. 단순 방사선 촬영과 컴퓨터 단층촬영을 비교하였다. 임상 경과 평가를 위해 이환된 합병증과 골절 6개월 이후 보행 능력을 비교하였다. 결과: 연구 대상 총 42명의 평균 나이는 76.5세였고, 1명을 제외하고는 모두 여성이었다. 초진 병원이 타 병원인 5예 중 골절 진단을 받지 못한 경우가 3예였다. 단순 방사선 사진에서 발견된 골절 외 컴퓨터 단층촬영에서 추가로 골절이 발견된 경우가 81.0%였다. 모두에서 보존적 치료를 시행하였다. 골절 후 보행 시작까지 걸린 시기는 평균 2.8주였으며 42명 중 1예를 제외한 전체 예(97.6%)에서 수상 전 보행 상태로 회복이 가능하였다. 결론: 골반 부전 골절을 진단하는 경우 단순 방사선 사진으로는 제한점이 있는 것을 확인하였다. 골반 부전 골절은 보존적 치료로 좋은 결과를 얻을 수 있었으며, 치명적인 합병증이 비교적 적게 발생하였다.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.161-166
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• 2016

Purpose: Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography. Methods: This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author's trauma center between January 01, 2013 and April 30, 2015. Results: Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%). Conclusion: The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications.

• 한방재활의학과학회지
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• 제28권2호
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• pp.135-148
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• 2018

The objective of this study is to investigate conservative treatment of pelvic fracture, and report that Korean rehabilitation treatment is effective for pelvic fracture. We reported a case about pelvic fracture treated with Korean rehabilitation treatment. We searched 10 domestic electronic databases to find reports on conservative treatment of pelvic fracture. We selected and analyzed 12 studies. In this case, pain, range of motion, and Oswestry Disability Index of patient were improved by Korean rehabilitation treatment. In analysis, traction, pelvic sling, hip spica cast, pelvic belt, medication are used in western medical treatment. Acupuncture, herbal medicine, cupping, moxibustion, physical therapy, manual therapy are used in Korean medical treatment. Most of conservative treatments are effective for pain, bone union, osteoporosis, dysfunction. In this study, we expect further study of Korean rehabilitation treatment program for pelvic fracture to compensate existing conservative treatment.

• Journal of Chest Surgery
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• 제44권3호
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• pp.250-252
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• 2011

A sixty-year-old man was admitted due to chest pain. He had a history of pelvic bone fracture fixation with Kirschner wire about 20 years earlier. On examination, we detected a Kirschner wire that had migrated into the right ventricle. Without cardiopulmonary bypass, we removed the migrating Kirschner wire via median sternotomy. The patient recovered without complications and was discharged on the 5th postoperative day.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권2호
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• pp.88-94
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• 1990

Because of it's accessibility and the quantity of bone available, the ilium is a common donor site for autogenous cancellous, cortical, and corticocancellous grafts to the facial skeleton. Especially, the anterior iliac crest has been the traditional source of pelvic bone for autogenous bone grafting in the maxillofacial skeleton. Recently the need for large amounts of bone in some reconstructive procedures of the facial skeleton has led to the evaluation of posterior ilium. The posterior approach to the ilium is superior to the anterior approach when large quantities of cancellous bone are required for facial reconstruction. The posterior approach has the advantages of more available bone, fewer complications, less postoperative pain, less disturbance in ambulation, and a possible reduction in the length of hospitalization. As the posterior approach affords an almost unlimited amount of bone for autogenous grafting in the maxillofacial region, we feel its use is indicated when very large amounts of bone are required.

• 한국임상수의학회지
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• 제31권6호
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• pp.527-530
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• 2014

7살 중성화된 수컷 한국집 고양이가 6개월동안 지속된 변비를 주증으로 본원에 내원하였다. 직장검사에서 골반강의 우측 외측부분의 좁아짐을 보였고, 방사선검사에서는 골반골절의 부정유합으로 인한 골반강의 협착을 확인할 수 있었다. 골반강 직경 비율은 0.68이었다. 직장검사와 방사선검사를 기반으로 골반강 협착으로 인한 변비로 진단하였다. 그래서 골반결합을 절골하여 골반강 확장술을 시행하였고 이를 용이하게 하기 위하여 장골 절골술도 함께 시행하였다. 확장된 골반강을 유지하기 위하여 골반결합 사이에 폴리메칠메타크릴레이트를 성형하여 구조물로 삽입하였다. 절골 한 장골은 뼈판과 나사를 이용하여 다시 고정시켜주었다. 방사선 검사에서 술 후 골반강 직경 비율은 0.91로 증가했음을 알 수 있었다. 술 후 처치로는 항생제, 진통소염제, 락툴로오스경구제 투여와 함께 수액요법을 시행하였다. 환자는 골반강 확장술 후 일주일부터 정상적인 배변을 보였고, 그 이후 6개월동안 재발은 없었다. 이 증례를 바탕으로 골반강 확장술은 골반골절의 부정유합으로 인한 골반강 협착에 따라 발생한 변비에서 유용한 치료법으로 사료된다.

• 대한물리치료과학회지
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• 제2권3호
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• pp.609-622
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• 1995

The purpose of this study was l)to compare a pelvic tilt angle between sound side and affected side in hemiplegic patients, 2)to determine the difference of weight bearing and weight shifting between sound and affected lower extremity according to the pelvic tilt angle. The subject for the study were 40 hemiplegic patients(mean age of 55.6 years)without orthopedic disability on pelvic bone. The data were analyzed by t-test, one way ANOVA, Multiple comparison and Range. The results of this study were as follows : 1. There was a significant difference in the pelvic tilt angle between sound side and affected side in hemiplegic patients(p<0.05). 2. There was a significant difference in the weight bearing value between sound and affected side in hemiplegic patients according to the posterior pelvic tilt angle(F = 12.43, df = 3/36, p<0.001). Therefore, the lesser the posterior pelvic tilt angle, the higher the weight bearing value on the affected side. 3. The lesser the posterior pelvic tilt angle, the higher the weight shifting value on the affected side. 4. There was a significant difference in weight bearing value between sound and affected side according to the grade spasticity(F = 3.61, df = 4/35, p<0.05). Therefore, the higher the grade spasticity, the lower the weight bearing value on affected side.