• Journal of Trauma and Injury
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• v.32 no.1
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• pp.26-31
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• 2019

Purpose: Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ${\geq}5,000$) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1-3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters. Methods: We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ${\geq}1,000U/L$ and ${\geq}5,000U/L$, respectively. The diagnosis of AKI was based on RIFLE criteria. Results: The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L. Conclusions: Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.

• Journal of Biomedical Engineering Research
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• v.43 no.4
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• pp.241-250
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• 2022

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (G_E) and 27 healthy adults for the control group (G_C) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in G_E; 20.24 deg in G_C) and elbow (5.25 deg in G_E; 2.57 deg in G_C) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of G_E was already narrowed by about 60% compared to the G_C from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.7-13
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• 2008

Popliteal artery injury in blunt trauma of knee joint is not common but poses high rate of amputation due to anatomical characteristics or delayed diagnosis and treatment. The aim of the present study is to review the authors' experiences with this condition and identify factors contributing to disability. We reviewed 7 cases of popliteal artery injury in trauma around knee. Injury mechanism, type of vessel damage, associated injuries, mangled extremity severity scores (MESS), ischemic time and additional treatments were analyzed. Tibial fracture, distal femoral fracture and serious soft tissue defect were combined. Mean MESS was 9.9 point and mean time of revascularization was 7.1 hours. Transfemoral amputation was performed in 2 cases due to vascular insufficiency and devastating infection, and 4 patients were able to walk without any support at the last follow up. Age, the severity of soft tissue injury, ischemic time and MESS are thought to be related to prognosis, and young patients with short ischemic time show best results, but authors experienced one exceptional case. We have to consider multiple factors related to the prognosis in popliteal artery injury with fractures around knee, and careful decision is needed regarding to early amputation.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.25-30
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• 2004

Objective: Recently, inline skates are populary increasing and have become major recreational activities. This study was performed to determine the effective prevention means on various extremity injury by investigating injury severity occording to acute injury and overuse injury. Results: Acute inline skating injury was experienced mostly among the age between 6$\~$14 years old children after school around nearby their home without using no appropriate safety device gear. The wrist injury was mostly happened. We think that overuse injury is related to boot itself, boot fitting and improper skating techniques. Conclusion: So afterall, appropriate safety equipment wearing in inline skating at the safe place after learning about the skating skills can reduce the acute inline skating extremity injuries. Choosing a pair of good fitting boots, performing the exact pushing techniques and take good rests in the middle of skating frequently can reduce the overuse injury.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.78-84
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• 2008

Purpose: Recently, the incidence of blast injury has been on the increase worldwide. The purpose of this study was to evaluate and analyze blast injuries in South Korea. Methods: This was a retrospective multi-center study of blast injuries in three tertiary military centers. The medical records of patients with blast injuries from January 2003 to December 2007 were reviewed. The injury severity was evaluated according to the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma Score and the Injury Severity Score (TRISS). Results: This study revealed epidemiological data of blast injury in the three tertiary military hospital. A total of 94 cases of blast injury had occurred. Various body regions were involved. The most frequently injured site was the upper extremity (52.1%). The mechanisms for the blast injuries were primary (41.5%), secondary (74.5%), tertiary (7.4%), and quaternary (29.8%). The mean injury-to-hospital arrival time was $3.2{\pm}1.7hour$. The rate of admission was 88.3%, and the rate of ICU admission was 32.5%. Thirty-six (36) cases required an emergency operation. Most were performed by an Orthopedist (55.6%), an Ophthalmologist (19.4%), or a general surgeon (13.9%). The mortality rate from blast injury was 4.3%. Conclusion: This was the first paper to present data on the type of injury, the site of injury, the cause of death, and the mortality from blast injury in South Korea. Chest injury, brain injury, tertiary injury mechanisms, $ISS{\geq_-}16$, and a Maximal Abbreviated Injury Scale Score $(ABI){\geq_-}4$ were significantly associated with death.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.308-311
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• 2013

Congenital arteriovenous malformation is rare disease. Endovascular treatment is one of the important modality in the treatment of arteriovenous malformation. We report a successful treatment case of arteriovenous malformation with endovascular treatment.

• Journal of Biomedical Engineering Research
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• v.31 no.1
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• pp.33-39
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• 2010

During running, the human body experiences repeated impact force between the foot and the ground. The impact force is highly associated with injury of the lower extremity, comfort and running performance. Therefore, shoemakers have developed shoes with various midsole properties to prevent the injury of lower extremity, improve the comfort and enhance the running performance. The purpose of this study is to investigate influence of midsole hardness on shock absorption along the human body during running. Thirty two expert runners consented to participate in the study and ran at a constant speed with three different pairs of shoes with soft, medium and hard midsole respectively. Using accelerometers we measured the shock absorption from shoe heel to cervical vertebral column. In conclusion, at the shoe heel, shock was the greatest with the hard midsole. However because most shock was absorbed between shoe heel and the knee, notable influence of midsole was not detected upper knee. At shoe heel, regardless of midsole hardness, the shock of younger female was the greatest. The authors expect to apply this result for providing a guideline for utilizing proper midsole hardness for manufacturing age and gender-specific shoe.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.144-151
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• 2005

Purpose: Disaster as traffic accident, industrial disaster, high voltage electrical bum and flame burn of extremity have a destructive effect because of the involvement of deep structure. Generally, such injury may result in decreased function or loss of limb. In this study the successful use of the combined scapular/parascapular flap as microsurgical transfer to cover extensive defect of electrical and flame bum is reported. Material and Method: Between January 2000 and June 2001, the combined scapular and parascapular flap was used for the coverage of soft tissue defect for 7 patients were admitted to our department with high voltage electrical bum and flame burn. The recipient site were the wrist joint in 2 cases, the forearm in 1 case, the ankle joint in 1 case, the foot dorsum in 1 case, the heel in 1 case. Result: Flap survival was complete in all patients. The result of flap coverage for these deep wound was successful. Conclusion: The advantages of scapular/parascapular combined flap were coverage of the large defect, easy shaping of the flap to fit the required three dimensional configuration around the joint, non hair bearing skin of uniform thickness, minimal donor site morbidity.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.139-143
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• 2018

Rhabdomyolysis is a syndrome caused by injury to skeletal muscles and involves leakage of large quantities of potentially toxic intracellular contents into the plasma. It is known that rhabdomyolysis results in peripheral nerve injury, however, reports of bilateral sciatic neuropathy following rhabdomyolysis are rare. We report a case involving a 42-year-old female patient with no past medical history, who presented with sudden bilateral calf pain, redness, and burning sensation with weakness of both lower extremities after sleeping on an electric heating pad following alcohol drinking. Lower extremity magnetic resonance angiography (MRA) revealed multifocal edema with enhancement of bilateral lower extremity muscles. Clinical and electrodiagnostic tests were consistent with the diagnosis of bilateral sciatic neuropathy following rhabdomyolysis. This is a rare case of bilateral sciatic neuropathy following rhabdomyolysis.

• Korean Journal of Applied Biomechanics
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• v.25 no.1
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• pp.49-56
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• 2015

Objectives : The purpose of this study was to present quantitative data and basic references to decrease the accident risk of soccer instructors. Methods : To obtain data, we conducted an investigation on how H/Q ratio affects the dynamic stability of the lower extremity at the time of drop landing. The study targeted 13 soccer players from C University who have not had any injuries or wounds in the lower extremity joints and in any other parts of their bodies over the last 6 months. By using CMIS (USA), the players were divided into two groups according to H/Q ratios higher and lower than 69%, respectively. The subjects in each group were instructed to perform a drop landing. Results : The H/Q ratio did not affect the maximal flexion angle of the knee joints at the time of drop landing. In addition the dominant group with a relatively high H/Q ratio was observed to have increased time to reduce shock and to efficiently absorb the ground reaction force during drop landing. Also, the dominant group with a relatively high H/Q ratio utilized the strong performances of the antagonistic muscles around the hamstrings and the controlled rotatory powers of the thighs that were applied to the tibias supported by the ground. Finally, H/Q ratio, load factors, and mean and maximum EMG were significantly negatively related, whereas GRFx showed a positive relationship. In fact, these factors all affected the impact of the load from the H/Q ratio to the knee joints. Conclusion : From these findings it can be concluded that unbalanced H/Q ratio can be considered as a predictor of knee joint injury at the time of drop landing.