• 제목/요약/키워드: Crush injuries

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Management of a traumatic anorectal full-thickness laceration: a case report

  • Fortuna, Laura;Bottari, Andrea;Somigli, Riccardo;Giannessi, Sandro
    • Journal of Trauma and Injury
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    • v.35 no.3
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    • pp.215-218
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    • 2022
  • The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.

Sports Injury of the Elbow (주관절의 스포츠 손상)

  • Sin, Hyeon-Dae
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.1
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    • pp.8-14
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    • 2008
  • Elbow joint injuries during exercise mostly occur by repeated stress to the joint than direct trauma. A pitcher who uses his arm above his head is most likely to be injured. So learning the right way to exercise and gaining the strength by maturating the body are essential for diminishing the chance of injury. On lateral ulnar tendon injury, which is most commonly injured area on elbow joint, pitchers generally complain of pain in arm movement above head and reduction of velocity, accuracy, and number of pitching. When there is pain on upper arm in harsh using, the stress fracture must be thought and epicondylar physis fracture of medial arm can occur by repeated abduction stress and contraction of flexors on forearm on children with immature skeleton. Osteochondritis dissecans of capitullum occur in young athletes who use there upper limb continuously lifting weights and gym work. And stress of abduction-extension includes damage of soft tissue and bone components, post medial crush syndrome, lateral ulnar ligament injury, extensor-abductor injury, stress of radius- capitullum are in this category.

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Introduction to an Evaluation Method for Crashworthiness of Korean Tilting Train Express (한국형 고속틸팅열차의 충돌안전도 평가기법 소개)

  • Jung H.S.;Kwon T.S.;Koo J.S.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.318-321
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    • 2005
  • Crashworthy design of a train is a systematic approach to ensure the safety of passengers and crews in railway transportation for the prescribed accident scenarios. This approach needs new structural arrangements and designs to absorb higher levels of impact energy in a controlled manner and interior designs to minimize passenger injuries. In this paper, an evaluation method for crashworthiness of Korean tilting train express is introduced. Crush characteristics for each part of tilting train express are evaluated numerically through 3-dimensional shell element analysis with LS-DYNA. Based on a head-on collision and a level crossing collision scenarios, the crash behaviors of tilting train express are evaluated numerically using full-rake collision simulations.

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Effects of Dioscoreae Rhizoma (SanYak) on Peripheral Neuropathy and its Safety

  • Kim, Min-Jung;Sung, Hyunkyung;Hong, Kwon-Eui
    • Journal of Pharmacopuncture
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    • v.16 no.3
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    • pp.7-10
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    • 2013
  • Objectives: This study aimed to evaluate the evidence available in the literature for the safety and efficacy of Dioscoreae Rhizoma (DR) for the treatment of peripheral neuropathy. Methods: Literature searches were performed in MEDLINE and three Korean medical databases up to April 2013. All studies evaluating the effects on peripheral neuropathy or the safety of DR monopreparations were considered. Results: Three studies - DR extract per os (po) on diabetic neuropathy in mice, DR extract injection on the peripheral sciatic nerve after crush injury in rats and DR extract injection to patients with peripheral facial paralysis proved that DR treatments were effective for the treatment of nerve injuries. Conclusions: In conclusion, we found the DR has a strong positive potential for the treatment of peripheral neuropathy, but studies addressing direct factors related to the nerve still remain insufficient.

Tracheobronchial Rupture following Blunt Chest Trauma -1 case report- (외상성 기관지 파열 -1례 보고-)

  • 김용한
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.588-593
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    • 1990
  • The rupture of tracheobronchial tree caused by non penetrating blunt trauma is being increased in incidence though it is still rarely occurred on now Because this type of injury is uncommon, a high index of suspicion should be maintained in all crush injuries involving the chest. Early diagnosis and primary repair not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced a case of tracheobronchial rupture caused by non penetrating blunt chest trauma without rib fracture. The patient was a 16 year old male who was a high school student. He was compressed on anterior chest by hand ball goal post being failed down on the morning of admission day. After this accident, he was suffered from progressively developing dyspnea and subcutaneous emphysema on face, neck and anterior chest. The diagnosis, tracheal rupture, was made by chest CT and bronchoscopy. After right thoracotomy, the ruptured site was directly closed by using interrupted suture. Post-operative course was uneventful. Thus we report this case of traumatic tracheal rupture with review of literature.

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Effects of High-Intensity Interval Training on Motor Skills Recovery in Sciatic Nerve Crush-Induced Rats

  • Kim, Ki-Hyun;Shin, Hyung-Soo;Jung, Nam-Jin;Hwangbo, Gak
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.1
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    • pp.43-54
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    • 2020
  • PURPOSE: This study examined the effects of mild-intensity exercise (MIE) and high-intensity interval exercise (HIIE) on the recovery of the motor function over time in sciatic nerve crush injury rats. METHODS: The MIE group ran on a treadmill at a speed of 8.3 m/min to perform low-intensity training with maximum oxygen uptakes ranging from 40 to 50%. The HIIE group ran on the treadmill at a speed of 25 m/min to perform high-intensity training with a maximum oxygen uptake of 80%. The interval training was performed based on a 1:1 work-to-rest ratio. The effects of each form of exercise on the rats' walking abilities following their recovery from the peripheral nerve injuries were evaluated based on the results of behavior tests performed at one and 14 days. RESULTS: According to the test results, the MIE group showed significant improvements in the rats' ankle angle in the initial stance phase, and in the ankle and knee angles in the toe-off phase (p<.05). The HIIE group exhibited significant improvements in the ankle and knee angles in the initial stance phase, SFI(p<.05). CONCLUSION: The state of such patients can be improved by applying the results of this study in that MIE and HIIE on a treadmill can contribute to the recovery of the peripheral nerve and motor skill. In particular, MIE is used as a walking functional training in the toe-off stance phase, while HIIE is suitable in the initial stance stage.

Aortic Arch Rupture due to Compression Injury of the Thorax - A case report - (흉부 압박손상에 의한 대동맥궁 파열 - 1예 보고 -)

  • Lee, Gun;Lim, Chang-Young;Lee, Hyeon-Jae
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.100-103
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    • 2009
  • Traumatic rupture of the thoracic aorta is the second most common cause of death from motor vehicle accidents after head injury. About 85% of these patients do not survive to reach the hospital. The most common mechanism for this is deceleration injury, as occurs in a high speed motor vehicle accident. The aortic isthmus is the site of disruption for about 95% of all blunt thoracic aortic injuries. Another mechanism is crush injury which causes compression of the aorta between the displaced sternal body or manubrium and the thoracic vertebral column. These forces tear the inner layer of the aortic wall at an unusual location. We report here on a case of aortic arch dissection where the injury clearly occurred due to a crush injury and not because of deceleration. The surgical repair was delayed for 10 days after administering intensive medical therapy. The ascending aorta and aortic arch were replaced with an artificial graft with the patient under circulatory arrest and cerebral protection.

Second Toe Plantar Free Flap for Volar Tissue Defects of the Fingers

  • Cho, Yong Jin;Roh, Si Young;Kim, Jin Soo;Lee, Dong Chul;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.226-231
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    • 2013
  • Background The reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps. Methods A single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases) followed by amputations (3 cases) and a single case of burn injury. Half of the indications (6 cases) were for soft-tissue defects with the other half for scar contracture. Results All of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series. Conclusions Flexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.

Analysis of safety risk factors of fishermen on the Korean tuna purse seiner (우리나라 다랑어선망어선의 어선원 안전 위험요소 분석)

  • KIM, O-Tae;JO, Hyun-Su;CHANG, Ho-Young;LEE, Yoo-Won
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.58 no.3
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    • pp.251-261
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    • 2022
  • Tuna purse seine fishery (TPF) constitute more than 60% of distant water fishery production in Korea based on a statistic of 2018, and 28 ships from four different companies were under operation at the western and central Pacific Ocean. On this research, common risk factors during TPF were investigated via enumeration of five years Korean fisherman's insurance payment statement, followed by some counterplans to diminish the accident rate. The accident rate of TPF on the Pacific Ocean peaked by 43.0% in 2014 and constantly decreased to 23.0% until 2018, presenting an average of 33.6%. Meanwhile, the accident rate on the Indian Ocean reached the highest point 55.1% in 2014 and declined to 11.6% in 2016, having an average of 24.7%. The average accident rate of the Indian Ocean scored 8.9% lower than the rate of the Pacific Ocean, but no statistic significance was observed. Depending on the process of operation, 'casting or hauling of net' was the most frequent part that people received an injury (40.4%). When the accidents were classified by their types, 'falling down' was the most recurrent cause of the injuries (28.5%). At the point of severity, the worst injuries were induced by crush hazard. Considering aforementioned accident frequency and severity, all the factors on the accident type list were divided into three different groups including high risk, moderate risk, and common risk. This study is expected to contribute to the reduction of occupational accidents during the work of fishermen and establishment of a safety management system for distance water fishing vessels.

Clinical Features of Tibialis Anterior Tendon Rupture (전경골건 파열의 임상 양상)

  • Sang-Eun Park;Huyn-Sik Jun;Jae-Jung Jeong
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.2
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    • pp.55-57
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    • 2023
  • Purpose: Tibialis anterior tendon rupture is uncommon and usually caused by laceration. Rupture with an open window is often considered simple laceration, and thus diagnosis is often overlooked or delayed. The purpose of this study was to analyze the clinical features of tibialis anterior tendon rupture. Materials and Methods: Twenty-two patients treated for tibialis anterior tendon rupture from March 2015 to December 2019 were examined. Age, sex, rupture etiology, rupture location, and diagnostic and treatment delays were investigated. Results: Mean patient age was 45.7 years, and there were 14 males and 8 females. In 18 cases, rupture was caused by laceration and in 4 by spontaneous rupture. Of the 18 cases caused by laceration, 8 were lawnmower related, 8 were glass injuries, and 2 were caused by crush or degloving injuries, respectively. Three of the 4 spontaneous rupture cases and 4 of the 18 caused by laceration were overlooked. Conclusion: Tibialis anterior tendon rupture is rare and is easily overlooked. Close physical examination is essential to arrive at a correct initial diagnosis in patients with acute or chronic rupture, and greater care is needed in cases of glass injury.