• 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.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.103-112
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• 2019

Objectives The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - thoracic paravertebral space (TPVS), and also compare to the patients with non-guided pharmacoacupuncture. Methods We studied medical records of 6 patients hospitalized with rib fractures were analyzed retrospectively at department of Korean Medicine Rehabilitation from March 1, 2019 to May 31, 2019, The 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance with Korean Medicine treatment (such as herbal medicine, acupuncture, moxabustion, etc) and the other 3 patients had performed the treatment of Soyeom pharmacopuncture therapy on TPVS through non-guided. We used numeric rating scale to assess improvements in pain and the five-point likert scale was used to assess treatment satisfaction. Statistical analysis was carried out using the IBM SPSS Statistics 24 program. Results The purpose of this study is to investigate pain reduction and treatment satisfaction of patients with rib fracrture treated with Soyeom pharmacopuncture therapy under ultrasonic guided - TPVS, and also compare to the patients with non-guided pharmacoacupuncture. Conclusions After analyzing 6 studies, we could imply that the treatment of Soyeom pharmacopuncture therapy on TPVS under ultrasonic guidance could be more effective on pain reduction and improvement of treatment satisfaction with rib fracture compared to those who were treated with non-guided pharmacoacupuncture.

• Archives of Reconstructive Microsurgery
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• v.15 no.2
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• pp.58-64
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• 2006

Purpose: Management of soft-tissue defect after open tibial fractures includes immediate and repeated debridement, skeletal stabilization, and early soft-tissue coverage with muscle flaps. The purpose of this study was to evaluate the outcome of the free rectus abdominis muscle flap (RA flap) for treatment of open fractures of the tibia and to discuss its advantages compared with the latissimus dorsi muscle flap (LD flap) in poly trauma patients. Materials and Methods: We performed a retrospective review of 5 patients who had a severe (Gustilo IIIb or IIIc) open fracture of the tibia treated with RA flap from May 2003 to March 2006. All were men, and the mean age was 46.6 years (range, $28{\sim}68$). Three patients had combined injuries such as pelvic bone fractures, multiple rib fractures with hemothorax, and contralateral tibial fracture. All patients received RA flap within 7 days after trauma except two with established chronic osteomyelitis. Results: All flaps survived, and there was no marginal flap necrosis. During the follow-up period, there was no evidence of persistent or recurrent osteomyelitis. The size of RA flap ranged from $8{\sim}20\;cm$ in length and $6{\sim}10\;cm$ in width. The average time required for RA flap elevation was 32 minutes, which is shorter than LD flap. Flap elevation could be done in supine position which is essential in poly trauma patients. Conclusion: Although a wide variety of options are available, RA flap is regarded as an optimal method for coverage of soft-tissue defect of the open tibial fracture in poly trauma patients. LD flap is reserved for large sized soft-tissue defect which cannot be covered by RA flap.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.237-242
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• 1973

Two cases of traumatic diaphragmatic hernia are reported, who were operated on in this department during the last 12 months` period. The first case, a 34 year old male, fell from 6 meters` height while he was working on electric pole. He sustained rib fractures, left 8th, 9th and 10th rib, left diaphragmatic rupture and ileal perforation. In the pleural cavity, there were stomach, omentum, left lobe of liver, transverse colon and ileum, which were reduced into the peritoneal cavity, and the diaphragmatic aperture was closed through anterolateral thoracotomy. After closure of the thoracic incision, median abdominal incision was made and closed the ileal perforation by primary suture. The second case was a 19 year old tyre repairman, who felt abrupt severe abdominal pain during lifting a heavy lyre. A barium study revealed a marked displacement of the stomach into the left pleural cavity. Immediately, thoracotomy was performed and closed the ruptured diaphragm after reduction of the herniated stomach, omentum, transverse colon, spleen and small intestine. The size of the diaphragmatic aperture were measured 17cm. in first case and 12cm. in the other respectively. Both cases discharged after uneventful recovery.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.352-359
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• 1985

A clinical evaluation was performed on 811 cases of chest trauma who were admitted and treated at the department of thoracic & cardiovascular surgery, Catholic Medical College, during the past 19 years from Jan. 1966 to Dec. 1984. 1. The overall incidence rate of male to female was 3:1. 2. The common age groups were 4th, 5th, and 3rd decades. 3. The most common cause of chest trauma was stab in penetrating wound and traffic accidents in non penetrating wound. 4. The most common injury from non penetrating chest trauma was rib fracture [81.3%], and the incidence rate of flail chest was 14.5% of all cases of rib fractures. 5. The incidence rate of hemo-pneumothorax was 50.4% in non penetrating wounds, and 55.2% in penetrating wounds. 6. The most common method of surgical treatment was CTD [33.5%], and open thoracotomy was performed in 67 cases [8.3%]. 7, The overall mortality was 3.3% [27 cases], and common causes of the death were shock and respiratory insufficiency.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.243-247
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• 2019

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1-4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors' knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.114-123
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• 2024

Purpose: Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods: Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma. Results: In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5-15] vs. 15 [14-15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively) Conclusions: Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.83-86
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• 1981

Eight cases by power tiller accidents experienced for 3 years from Jan. 1978 to Dec. 1980 were studied clinically. The results are as follows: 1. The most of the patients were thirties to fifties, and the incidence rate of male to female 7:1. 2. The common injuries were hemopneumothorax and multiple rib fractures [respectively and the other associated injuries were hepatic and delayed splenic ruptures, and fractures of the another sites. 3. The accident forms were overturning [50.0%], falling down from the power tiller [37.5%], and collision against the power tiller [12.5%]. 4. All of the drivers and 75% of the passengers in the patients were drunken states at the accident time. 5. The common methods of treatment were closed thoracostomy [62.5%], conservative treatment [37.5%], and exploratory laparotomy [25.0%].

• Journal of Chest Surgery
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• v.20 no.2
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• pp.427-431
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• 1987

A case is presented of a steering wheel Injury to the chest which developed right atrial free wall rupture and cardiac tamponade without rib fractures or hemo-pneumothorax. A 30 year old man who sustained, blunt chest trauma by steering wheel injury to his chest developed right atrial rupture and cardiac tamponade. Pericardiocentesis was performed and cardiac tamponade was confirmed. After a median sternotomy, large right atrial free wall laceration [about 8cm] was noted. He was placed on cardiopulmonary bypass. The laceration wound of right atrium was closed with a 2 rows of continuous suture. Recovery was uneventful. The patient has returned to his previous level of activity.

• 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.