• Title/Summary/Keyword: rib fracture

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Clinical analysis of the chest trauma - 823 cases - (흉부손상의 임상적 고찰)

  • 노태훈
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.715-722
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    • 1987
  • A clinical analysis was performed on 823 cases of the chest trauma experienced at department of thoracic & cardiovascular surgery, Kyung Hee University Hospital during the past 8 years from Jan, 1978 to Aug. 1986. 1. the ratio of male to female patient of the chest trauma was 3:1 in male predominance. 2. The common age groups were 3rd, 4th and 5th decades. 3. The most common causes of the chest trauma was traffic accidents [79.8%] were injured due to non-penetrating injuries and the remainders [166/823, 20.2%] were injured due to penetrating injuries 4. The frequently injured site of the chest trauma was left side of the chest [46%], and the right side was 42% 5. The most common injury from non-penetrating trauma was rib fracture [77.5%], and the incidence rate of flail chest was 59% of all cases of rib fractures. 6. The incidence rate of hemopneumothorax was 42.9% in non-penetrating traumas, and 84.3% in penetrating traumas. 7. The most common method of surgical treatment was closed tube thoracostomy [37.3%], and open thoracotomy was performed in 71 cases [8.6%]. 8. the overall mortality was 2.2%, and common causes of death were cerebral damage, respiratory insufficiency, and hypovolemic shock.

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Cardiac Valve Replacement: A Report of 145 Cases (인공심장판막에 의한 심장질환수술에 관한 연구)

  • 이영균
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.501-515
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    • 1978
  • The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

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Chest Trauma (흉부 외상)

  • 김송명
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.488-500
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    • 1978
  • The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

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Large Focal Extrapleural Hematoma of Chest Wall: A Case Report

  • Lee, Hohyoung;Han, Sung Ho;Lee, Min Koo;Kwon, Oh Sang;Kim, Kyoung Hwan;Kim, Jung Suk;Chon, Soon-Ho;Shinn, Sung Ho
    • Journal of Trauma and Injury
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    • v.32 no.2
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    • pp.115-117
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    • 2019
  • Although hemothorax and pneumothorax are common complications seen in rib fractures, focal extrapleural hematoma is quite rare. We report a 63-year-old female patient that developed large focal extrapleural hematoma after falling off a second floor veranda. The patient had sustained 3, 4, 5th costal cartilage rib fractures and a sternum fracture. She had developed suspected empyema with loculations with small amount of hemothorax. She underwent a planned early decortication/adhesiolysis by video assisted thoracoscopic surgery at the 12th post-trauma day due to failed drainage. Unexpectedly, she had no adhesions or any significant retained hematoma mimicking a mass, but was found with the focal extrapleural chest wall hematoma. She was discharged on postoperative 46th day for other reasons and is doing fine today.

Modelling the coupled fracture propagation and fluid flow in jointed rock mass using FRACOD

  • Zhang, Shichuan;Shen, Baotang;Zhang, Xinguo;Li, Yangyang;Sun, Wenbin;Zhao, Jinhai
    • Geomechanics and Engineering
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    • v.22 no.6
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    • pp.529-540
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    • 2020
  • Water inrush is a major hazard for mining and excavation in deep coal seams or rock masses. It can be attributed to the coalescence of rock fractures in rock mass due to the interaction of fractures, hydraulic flow and stress field. One of the key technical challenges is to understand the course and mechanism of fluid flows in rock joint networks and fracture propagation and hence to take measures to prevent the formation of water inrush channels caused by possible rock fracturing. Several case observations of fluid flowing in rock joint networks and coupled fracture propagation in underground coal roadways are shown in this paper. A number of numerical simulations were done using the recently developed flow coupling function in FRACOD which simulates explicitly the fracture initiation and propagation process. The study has demonstrated that the shortest path between the inlet and outlet in joint networks will become a larger fluid flow channel and those fractures nearest to the water source and the working faces become the main channel of water inrush. The fractures deeper into the rib are mostly caused by shearing, and slipping fractures coalesce with the joint, which connects the water source and eventually forming a water inrush channel.

A Study Radiograph Techniques for Diagnosis of Axillary Fracture Ribs in X-ray (X-ray 갈비뼈 촬영에서 겨드랑이쪽의 골절된 갈비뼈 진단을 위한 촬영법 연구)

  • Ahn, Byung-Ju;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.13 no.7
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    • pp.979-986
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    • 2019
  • The purpose of this study devised a method for the examination of the images of the first and second rib fractures of the axillary using Rib Rando Phantom. The position of the phantom and the angle of the X-ray tube were changed to vertical, head 5° and foot 5°. The Radiological Technologists subjectively evaluated the acquired images and the evaluation data were analyzed by SPSS 3.0 ver. The signal to noise ratio(SNR) was calculated using the ImageJ Program. As a result, the cronbach alpha value was significantly higher at 0.789. The SNR was highest at 6.038 when the X-ray tube was tilted 5° toward the head in the front of the ribs and highest at 7.860 when the X-ray tube was tilted 5° toward the foot. Radiographic Techniques proposed axillary ribs this study are as follows. The anterior rib scan is examined by elevating the fractured area and changing the X-ray tube angle by 5° towards the head. The posterior ribs scan is examined by attaching the fractured area and changing to the X-ray tube angle by 5° towards the foot. It is considered that such an inspection method can obtain a sharp image.

Clinical Analysis of the Chest Trauma (흉부 손상의 임상적 고찰)

  • 이재덕;이계선
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.79-85
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    • 1996
  • A clinical evaluation was performed on 305 cases of chest trauma experienced at the department of the Thoracic and Cardiovascular Surgery, Dae Jeon Eul Ji Hospital, during the period from March 1991 to November 1994. Age distribution was from 4 to 85 years, the mosts common age groups were 4-th, 5th and 6th decades. The ratio of male to female was 229:76(3:1), the ratio showed male predominance, the most common cause of trauma was traffic accidents in nonpenetrating trauma and stab wounds in penetrating trauma. Hemothorax, pneumothorax, and hemopneumothorax were observed in 159 cases (52.1 %) of total cases, Rib fracture was observed in 236 cases (77.4%) of total cases, location distribution was right : left : Both (102 : 142 : 45), with left predominant, rib fracture commonly involved from the 3th to 8th rib. Lag period from accident to admission was 155 cases (50.8%) under 6hr The principles of therapy for early complications of chest trauma were rapid r expansion of the lungs by thoracentesis 5 cases(1.6%) and closed thoracostomy 1-42 cases(46.6%), but open thoracotomy had to be done on 17 cases (5.6%) because of massive bleeding 13 cases or ruptured diaphragm, foreign body. Conservative nonoperative treatment was 140 cases (45.9%). Overall mortality rate was Bcases (2.6%) and common causes of the death were respiratory insufficiency and shock.

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Skeletal Manifestations of Hydatid Disease in Serbia: Demographic Distribution, Site Involvement, Radiological Findings, and Complications

  • Bracanovic, Djurdja;Djuric, Marija;Sopta, Jelena;Djonic, Danijela;Lujic, Nenad
    • Parasites, Hosts and Diseases
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    • v.51 no.4
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    • pp.453-459
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    • 2013
  • Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was $40.9{\pm}18.8$ years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.

Quantitative analysis of three dimensional volumetric images in Chest CT (흉부 CT 검사에서 3차원 체적 영상의 정량적 분석)

  • Jang, Hyun-Cheol;Cho, Jae-Hwan;Park, Cheol-Soo
    • Journal of the Korean Society of Radiology
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    • v.5 no.5
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    • pp.255-260
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    • 2011
  • We wanted to evaluate the usefulness of three-dimensional reconstructive images using computed tomography for rib fracture patients. The reconstruction used in clinical multi planar reformation(MPR), volume rendering technique(VRT), and image data using quantitative methods and qualitative methods were compared. Much more, the artifact shadow was minimized to reconstruct with 3D volumetric image by using an law data in the analysis of the reconstructive image and chest CT scan of the evaluation result fractures of the thoracic patient. And we could know that the fractures of the thoracic determination and three dimension volume image reconstruction time were reduced.

A New Method of Approach for Percutaneous Thoracic Vertebroplasty in Vertebral Compression Fracture -Case report- (흉추 압박골절환자를 위한 경피적 척추성형술의 새로운 접근법 -증례 보고-)

  • Shin, Keun-Man
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.237-241
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    • 2000
  • Vertebral compression fractures commonly afflict the elderly. Some patients suffer from severe mechanical pain in spite of treatments with strong analgesics and bracing. Vertebroplasty, which was originally used for vertebral hemangioma, is effective for patients who do not respond to these more conservative treatments. However, the procedure has some risk. Leaks of bone cement into perineural tissues can be a serious complication. In contrast to the lumbar vertebrae, the outer margin of the pedicle of the thoracic vertebrae is almost in line with the outer margin of the body. This, combined with the thinner pedicle of the thoracic vertebrae, makes proper needle placement difficult. The posterolateral approach is preferred to the transpedicular approach in order to avoid the danger of destroying the inner cortex of the pedicle. But there can be a problems with the standard posterolateral approach. The rib can be broken, the pleura can be punctured. A new and safer approach is possible. Before penetrating the bone, the needle is positioned at the upper margin of the transverse process, 5 mm away from the pedicle. To achieve this positioning, the needle must puncture the skin 1~1.5 cm laterally and 3~5 mm cranially to the target point on the bone. This approach was used for 10 patients and we achieved good results with no serious complication.

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