• Title/Summary/Keyword: 다발성 손상

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Multiple Sequential Physeal Injuries with Vitamin D Deficiency (비타민 D 결핍이 동반된 다발성 연속적 골단판 손상)

  • Kim, Byoung-Kook;Kim, Yong-Gun;Lee, Ho-Jae;Choi, Dae-Sung;Dan, Jinmyoung
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.552-557
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    • 2018
  • Vitamin D plays a major role in bone metabolism, and its deficiency has an impact on fracture risk and healing. Low vitamin D levels are a cause of poor bone mineralization and have been associated with a significantly higher risk of physeal injury in children. This paper presents a case of a 13-year-old boy with a vitamin D deficiency, who sustained multiple sequential epiphyseal injuries at various areas. This report suggests that vitamin D deficiency is not only a significant cause of the clinical disease itself, but also an important factor affecting the successful recovery of injuries.

CASE REPORTS OF MULTIPLE FACIAL BONE FRACTURE TREATED BY THE USE OF MINIPLATE OSTEOSYNTHESIS (MINIPLATE를 이용한 다발성 안면골 골절의 치험례)

  • Lee, Dong-Keun;Yim, Chang-Joon;Yang, Hee-Chang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.47-52
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    • 1989
  • There were increased number of maxillofacial trauma in recent years accompanied by the change in the type and the severity of the injury thus it was necessary to set up new therapeutic concepts. Among many fixation methods, miniplate osteosynthesis, compression osteosynthesis, wire osteosynthesis and so forth were considered. In this paper we are reporting case of the multiple facial bone fracture, which mainly treated with miniplate osteosynthesis and the additionally used craniofacial suspension wire and transpaltal wire. It was concluded that miniplate osteosynthesis was useful in multiple facial bone fractures.

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Comparative Analysis of Double Bundle and Single Bundle ACL Reconstruction with Tibialis Anterior Allograft (동종건을 이용한 단일다발 및 이중다발 전방십자인대 재건술의 비교 분석)

  • Kim, Deok-Weon;Lee, Kang;Kim, Young-Woo;Yang, Sang-Jin;Seo, Jeong-Gook;Kim, Jin-Goo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.198-204
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    • 2008
  • Purpose: The purpose of this study is to analyze the merits and demerits of double bundle reconstruction and achieve improvements hereafter, by comparing the results of double bundle and single bundle reconstruction using tibialis anterior allograft. Materials and Methods: Twenty seven patients were divided to undergo either double bundle(n=14) or single bundle(n=13) reconstruction with tibialis anterior allograft tendon. The evaluation methods were AP laxity with KT-2000 arthrometer, isokinetic knee strength measurements, pivot-shift test, IKDC subjective score, Lysholm knee score, Tegner activity score, radiographic evaluations with postoperative MRI, and second look arthroscopy. Results: Lysholm knee score and Tegner activity score were significantly better in double bundle reconstruction. In pivot-shift test, single bundle reconstruction was evaluated as grade 0 in 10 of the knees, grade 1 in 1, and grade 2 in 2. Double bundle reconstruction was evaluated as grade 0 in 13, and grade 2 in 1. In second look arthroscopy, single bundle was evaluated as excellent in 6 of the knees, fair in 7, anteromedial bundle of double bundle reconstruction was excellent in 13 and fair in 1, and posterolateral bundle was excellent in 4, fair in 9, and poor in 1. There were no significant differences in other evaluations. Conclusion: Favorable outcome may be expected with double bundle reconstruction of ACL. However there are still need for improvement in terms of reconstruction technique and rehabilitation protocol to reduce PL bundle injury.

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The Prognostic Factors of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열에서 예후에 영향을 미치는 인자)

  • Cho, Sukki;Lee, Eung-Bae;Seok, Yang-Ki
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.47-52
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    • 2010
  • Background: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. Material and Method: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. Result: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. Conclusion: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.

THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES (치료법을 달리한 상악골절후 부정유합 2예)

  • Yoo, Jae-Ha;Lee, Won-Yoo;Rew, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.117-127
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    • 1991
  • When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

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ORAL HEMORRHAGE CONTROL AS TREATMENT PRIORITY IN A MENTALLY RETARDED PATIENT WITH MULTIPLE TRAUMA (다발성 손상을 가진 정신지체 환자에서 치료 우선순위로 구강출혈의 조절)

  • Oh, Ji-Hyeon;Kim, Ji-Hun;Yoo, Jae-Ha
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.20-26
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    • 2016
  • Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries. The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment. In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.

Transtibial Double Bundle PCL Reconstruction using TransFix Tibial Fixation - Technical Note - (TransFix 경골부 고정을 이용한 경 경골 두 다발 후방십자인대 재건술 - 수술 술기 -)

  • Lee, Yong-Seuk;Jung, Young-Bok;Ahn, Jin-Hwan;Kang, Bun-Jung;Shin, Yun-Chang;Kong, Chae-Gwan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.203-208
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    • 2006
  • Purpose: Previous transtibial double bundle posterior cruciate ligament (PCL) reconstruction methods have several problems in graft length and tibial fixation. We introduce new surgical method that is less restrictive by graft length and is more stable with single tibial fixation. Operative technique: After diagnostic arthroscopy, we prepare the graft, ream the tibial tunnel and perform the procedure for TransFix tibial fixation. Femoral 2 tunnel is made and graft is passed via anteromedial (AM) portal. Tibial fixation is done and femoral 2 graft is fixed sequentially at each knee position. Conclusion: TtransFix tibial single fixation method in double bundle PCL reconstruction provides more stable fixation, more free graft selection and prevents graft damage by passing the graft via AM portal.

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Diagnostic Radiology and Conservative Management of L1 Lumbar Spine with Compression Fracture (L1 요추 압박골절에 대한 진단방사선학 및 보존적 치료)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.11 no.2
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    • pp.165-170
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    • 1998
  • Diagnostic radiology and conservative management for S75 patient with L1 lumbar fracture by traffic accidents were discussed with references, and then the obtained results were as follows ; 1. Wedging compression fractures with 10% deformity was confirmed at anterior vertebral body of L1 lumbar spine through lateral plain X-ray film. 2. Irregular bony fractures were observed at anterior vertebral body of L1 lumbar spine by CT scans, anatomically T12-L1 sites showed highly frequency of injuries, Denis's fracture type was classified as multiple compression fracture at anterior column without abnormal middle and posterior column, also no Cobb's angle, and then Frankel's neurological classification was E grade. 3. Orthopaedic treatments were performed with conservative methods. With rest on the bed, anti-in-flammatory medication, electrolyte and nutritional solution, the pain diminished. 4. After 3 weeks, rehabilitation was worked with putting on polyethylene back corset, although pains remained slightly until after 8 weeks, thereafter the spine showed gradually stability.

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Thoracoscopic Surgery for Diaphragmatic Rupture -One case report - (흉강경 수술을 이용한 횡격막 파얼의 치유 -1예 보고-)

  • 류지윤;장우익;김욱성;김수영;이성순;김연수
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.813-816
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    • 2004
  • The conformation of traumatic diaphragmatic rupture is frequently difficult, even if radiologic evaluation has been performed. A 37-year old man with multiple trauma was suspicious with diaphragmatic rupture. The diaphragmatic rupture could not be confirmed with chest CT. We decided thoracoscopic operation for diagnosis. Diaphragm was ruptured about 8 cm length involving entering site of phrenic none into diaphragm and diaphragmatic paralysis was combined. We made 5 cm sized working window additionally. Ruptured diaphragm was repaired by continuous suture and plication of diaphragm was performed. Postoperative result was good at chest radiogram after three monthes.

The Polyneuropathy in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자들의 다발성 말초신경병변에 대한 연구)

  • Baek, Jong-Cheul;Myung, Jae-Il;Kang, Heon-Seok;Kim, Yeong-Rock;Youm, Houng-Roul;Ryeu, Hyung-Seun;Lee, Soong;Kim, Wan;Noh, Jean-Yee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.806-814
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    • 1997
  • The incidence, type and distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneuropathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy(13 patients, 30%) more commonly occurs than clinical polyneuropathy(9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.

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