• Title/Summary/Keyword: 늑골 골절

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MIDFACIAL DEGLOVING APPROACH IN MIDFACIAL BONE FRACTURE : THE REPORT OF CASES (Midfacial degloving approach를 이용한 중안면 골절 환자의 치험례)

  • Kim, Hyeon-Min;Jeong, Jong-Cheol;Song, Min-Seok;Jang, Jung-Hui;Kim, Nam-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.1
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    • pp.74-81
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    • 2005
  • In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.

Surgical Treatment of Aortic Valve Injury after Blunt Chest Trauma (흉부 둔상 후 생긴 대동맥판 폐쇄부전증의 외과적 치료)

  • Yoon, Soo-Young;Park, Sang-Soon;Na, Myung-Hoon;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.968-970
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    • 2000
  • 26세 남자가 길가다 버스에 치어, 다발성 늑골골절, 흉골골절, 우견갑골골절, 좌쇄골하동맥 폐색, 외상성 기관식도루로 입원 치료 중 이완기 심잡읍이 생겼다. 심초음파 검사에서 심한 대동맥판 폐쇄 부전과 증식물로 진단하였다. 심폐기 운영 하에 좌 우 관상 동맥 첨판에 10mm, 7mm 파열을 발견 5-0 Prolene 연속 봉합하여 좋은 수술 결과를 얻고 환자는 수술 14일에 퇴원하였다.

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Thoracic Trauma in Children (소아에서의 흉부외상)

  • 구본원;김성완
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.77-82
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    • 1997
  • Sixty children were admitted to he Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in )2% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45% ), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severi y Scale(MISS) score was measured in the multiple Injured group. MISS score correlated significantly with the length of stay In the intensive care unit. One child(1.7% ), involved in a traffic accident, died of sepsis.

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Evaluation of Relationship between Radiation Dose and Image Quality according to Source to Image Receptor Distance in Rib Series Radiography (늑골 방사선검사 시 X선관 초점-영상수신체간 거리에 따른 환자선량과 화질의 연관성 평가)

  • Joo, Young-Cheol;Jung, Young-Jin
    • Journal of radiological science and technology
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    • v.41 no.5
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    • pp.391-396
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    • 2018
  • The purpose of this study was to compare and analyze the patient dose according to the distance between the X-ray tube focus and the image receptor, and to propose a new method for quantitatively evaluating the image quality. Using this quantitative evaluation method, the optimal distance for increasing x-ray image quality with low radiation dose was estimated between source and image receptor in Rib series radiography. Phantom images were obtained by changing the distance between focus and image receptor (100 cm and 180 cm). The patient radiation dose was estimated using entrance surface dose and dose area product. In order to evaluate image quality objectively, a non - reference image evaluation method was employed with paper and salt noise and Gaussian filter. As a result of this study, when the SID was changed from 100 cm to 180 cm, the entrance surface dose decreased by 4 ~ 5 times and the dose area product decreased by 3 times. In addition, there is no significant difference in image quality between of SID 180 cm and SID 100 cm. In conclusion, it was demonstrated that performing the rib series radiography at SID 180 cm is an optimal method to reduce the exposure dose and improve the image quality.

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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Surgical Treatment of the Fracture of the Scapular Body (견갑골 체부 골절의 수술적 치료)

  • Rhyou, In-Hyeok;Suh, Bo-Gun;Chung, Chae-Ik;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.150-157
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    • 2008
  • Purpose: We wanted to evaluate the results of surgical treatment for fracture of the scapular body. Materials and methods: The subjects of this study were seven patients with fracture of the scapular body and all these patients were managed surgically. We considered the operative indications as being 100% translation of the lateral border, or $25^{\circ}$ of angular deformity of the glenoid, or 1cm medialization or the variant of the double disruption of the superior scapular suspensory complex. There were five males and two females, and their ages ranged between 40 and 58 years (mean age: 49) with average follow up of 11 months (6~24 months). Two patients sustained multiple fractures of the ribs and spines. The surgical results were evaluated according to the subjective satisfaction, the UCLA score and the Korean shoulder score. Results: The mean UCLA score was 29 (17~33) and the mean Korean shoulder score was 86 (63~94). The self assessment for subjective satisfaction was 7.7 (4~9). There were two complications; one case of screw pull-out without the loss of the fracture fixation and the other case with screw penetration of the glenoid cavity. Conclusion: Surgical treatment may be effective for the management of severely displaced fracture of the scapular body in order to prevent the impairment of the shoulder function caused by the altered glenohumeral and scapulothoracic kinematics.

Pathological Observation on the Swine Carcass (돈지육에 대한 병리학적 관찰)

  • Jeon Sung Hwan;Lee Cha Soo
    • Journal of the korean veterinary medical association
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    • v.30 no.7
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    • pp.424-437
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    • 1994
  • The pathological observation was carried out on the swine carcasses, which were slaughtered from the abattoir in Pusan and purchased by a meat processing company, for a year. The results obtained were as follows ; The examined carcasses were 13,083 pigs a

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Cardiac Arrest during Thoracic Epidural Blockade in the Patient with Multiple Rib Fractures -A case report- (다발성 늑골골절 환자에서 흉부 경막외 차단중 발생한 심정지 -증례 보고-)

  • Bae, Sei-Kwan;Lee, Young-Bok;Yoon, Kyung-Bong;Im, Kong-Been
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.138-141
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    • 1997
  • Rib fracture due to intense pain, may restrict patients from inadequate coughing. These conditions may produce varying degrees of complications such as atelectasis, pneumonia and arterial hypoxemia. Thoracic epidural analgesia has been used to treat pain associated multiple rib fractures because of its marked improvement in vital capacity and dynamic lung compliance. However, there are complications related to thoracic epidural analgesia which may include damage to spinal cord, perforation of dura, respiratory depression, decrease heart rate and arterial blood pressure. We experienced such a case of cardiac arrest during thoracic epidural analgesia while treating a patient for multiple rib fractures.

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Cardiac Rupture Combined with Massive Right Hemothorax by Blunt Chest Trauma -A report of two cases- (흉부둔상환자에서 중증우측혈흉을 동반한 심장파열 -치험 2례-)

  • 정은규;이병욱;윤용한;백완기;김광호;류송현;김혜숙;김정택
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.173-175
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    • 2001
  • 흉부둔상에 의한 심장파열은 50% 이상의 치사율을 갖는 질환으로 응급실에 도착하기 전에 사망하는 경우가 대부분이다. 일반적으로 전형적인 심장압전을 동반하기 때문에 이학적 소견이나 심장초음파 또는 흉부전산화 단층촬영으로 진단이 가능하다. 그러나 저자의 경우와 같이 심장압전의 징후가 없이 중증 우측혈흉만 있는 경우 심장파열을 진단하는 것은 어렵다. 만약 고속의 자동차사고로 인한 흉부둔상을 받은 환자에서 늑골골절이 없이 우측에 중증의 혈흉이 있어 응급개흉술을 받아야 한다면 심장파열의 가능성을 염두에두고 수술을 계획하는 것이 필요하다고 생각한다. 본 인하대학교 흉부외과학 교실에서는 흉부둔상에 의한 중증우측 혈흉과 심낭파열을 동반한 심장파열 2례를 심패바이패스와 자가수혈 장치를 이용하여 효과적으로 치료하였기에 보고하는 바이다.

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Case Report of a Simple Rib Fracture Caused by Coughing (기침으로 초래된 단순 늑골골절 1례)

  • Choi, Woo-Ik
    • Journal of Trauma and Injury
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    • v.27 no.1
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    • pp.9-12
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    • 2014
  • Violent or severe persistent coughing is rarely associated with rib fracture. We report a rare case of a cough-induced rib fracture in a patient without any traumatic history or any other underlying disease. A 32-year-old female presented to the emergency department complaining of having had right-sided pleuritic chest pain for 5 days. She had a background of an 8-week coughing illness. A posteroanterior view of the chest radiograph showed no definite fractured line. Chest computed tomography revealed a subtle break cortical line of the 7th rib in the right-sided chest wall. Early identification of a cough-induced fracture of the rib by using computed tomography may avoid unnecessary further work-ups including laboratory examination and may lead to appropriate discharge instructions including rest and reassurance. The clinical presentations and radiologic findings of rib fractures caused by coughing are presented along with a review of the literature.