• Journal of Trauma and Injury
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• 제25권2호
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• pp.63-66
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• 2012

Resection of the bowel is necessary for the repair of a ventral hernia after recovery from trauma in some cases. In such instances, polyester or polypropylene meshcannot be used due to the possibility of infection; we had to use biological mesh instead. We report a case in which a traumatic hernia was repaired with Permacol (Covidien, Norwalk, CT, USA). A 42-year-old male patient had been injured by a factory machine seven months prior to admission. At that time, he had abdominal wall injury and small bowel perforation. His abdominal wall had been a defect after operation. A CT scan of the abdomen showed that the left abdominal wall, which is lateral to left rectus abdominis muscle had only one muscle layer, an external oblique muscle, and that a previous abdominal incision had a defect along the entire incision. During the exploration, 10 cm of small bowel was removed due to firm adhesion to the previous surgical scar. Permacol mesh was applied and fixed with transfascial fixations and tacks by using the intraperitoneal onlay mesh technique. There were no complications after the surgery and the patient was discharged without any problems.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1028-1031
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• 1997

무명동맥은 길이가 짧고 흉곽에 의해 잘 보호되기 때문에 흉부둔상에 의한 무명동맥의 손상은 매우 드물다. 본 증례는 흉부둔상을 수상한 37세의 남자에서 발생한 무명동맥 파열로 흉부W와 대동맥 조영술로 진단되었다. 정중흉골절개를 통한 응급 수술을 시행한 바 무명동맥의 근위부에 길이와 폭이 각각 3 cm의 가성동맥류를 형성하고 있었고 혈관 내피의 완전파열을 관찰할 수 있었다 무명동맥의 근위부를 대동맥궁 쪽에서 폐쇄시키고 손상된 부위를 절제한 후 10 m Gore-tex를 이용하여 대동맥-무명동맥 우회술을 실시하였다. 수술후 환자는 20일째에 신경학적 합병증없이 퇴원하였고 양측상지의 혈압도 동일하게 측정되었다.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.729-734
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• 2008

Purpose: The evaluation and management of a completely transected tendon of the hand is relatively clear. In most cases, the integrity is assessed by physical examination(eg, broken normal cascade, motion loss) but occasionally, It happens in troubles. because of pain, limited patient cooperation(eg, child, unconscious patient), and other associated injuries(eg, fractures, foreign bodies). Methods: From september 2006 to August 2007, 28 patients were evaluated with real time ultrasonography preoperatively and postoperatively. Twenty eight patients with injured tendon were evaluated using an HDI 5000 Sono CT(Philips Medical Systems, Bothell, WA) machine with a high resolution, 7.5MHz hockey stick linear probe. Dynamic evaluation was performed in real time. Results: Surgery was performed after the ultrasonographic evaluation. Sonographic diagnosis and intraoperative findings were correlated. Ultrasonographic findings show tendon discontinuity, gaps, and fluid collection. Conclusion: We conclude that ultrasonography is helpful in evaluating and managing acute tendon injury. Especially, in cases of completely lacerated tendon, ultrasonography can identify the location of the proximal tendon stump and partial lacerated tendon, ultrasonographic diagnostic tool can decrease misdiagnosis.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.228-234
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• 2020

Background A patient's overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected. Methods Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin. Results The bacterial study had 29 positive results. Based on these results and the patient's status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds. Conclusions This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.147-153
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• 1998

Biceps tendon dislocation combined with rupture of subscapularis tendon is not a common lesion and there has been few case reported in Korea. We experienced one fifty Six years old male patient who shows typical features on physical examination and roentgenographic finding. He was injured by direct trauma on his right shoulder in adducted and external rotated position. He showed positive findings on passive external rotation test and lift-off test. On MR!, the subscpaularis tendon was totally ruptured and the biceps tendon was dislocated to anteromedial aspect of the glenoid labrum, which was typical finding. On the arthroscopic examination, the subscapularis tendon was totally ruptured from its humeral attachment and the biceps tendon was not seen in its normal anatomical position and it was dislocated antermedially to the glenoid labrum. We repaired the subscapularis tendon to humerus by use of suture anchor and the biceps tendon was relocated to its normal anatomical position in the intertubercular groove. On the post operative 6 months follow up, the patient shows improvements in his subjective symptoms and active range of motion.

• 대한한방내과학회지
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• 제25권4호
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• pp.401-409
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• 2004

Aphasia is a dysfunction in recognition and communication, Most instances of aphasia are caused by cerebral disease, especially when a dominant hemisphere is injured. It brings about serious problem in treatment and in directing a therapeutic course for return to social community. A stroke patient who was adimitted Dongguk Bundang Oriental hospital was treated. This subject was diagnosed with Broca Aphasia and Flaccid Tongue(舌?) induced by Yang-deficiency of Kidney(腎陽虛). She was adiministered Jiwhangeumja(地黃飮子) and Scalp acupuncture, and the degree of her aphsia was measured with the Western Aphasia Battery. After three weeks, The patient improved in speaking and general depressed condition.

• Archives of Plastic Surgery
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• 제37권6호
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• pp.779-782
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• 2010

Purpose: As the evaluation of the preoperative sensibility in the orbitozygomatic complex fracture, used by most surgeons, depends on the patient's subjective judgements, it is difficult to make generalization and to use it as an objective evaluation method. We used the blink reflex study to objectively evaluate injury to the infraorbital nerve. Methods: From December 2008 to November 2009, a total of 16 patients underwent the patient's subjective report on sensory symptoms and the blink reflex study preoperatively. Among patients having orbitozygomatic complex fracture of type III or more according to Henderson's classification and simultaneously suspected as being injured along the infraorbital nerve pathway, patients who had difficulty in checking preoperative sensibility and said 'normal sensibility' were selected as candidates. Results: Fifteen patients showed abnormal R1 on the fracture side. These results suggested that most of patients had injury to the infraorbital nerve. Conclusion: Contrary to the existing tests, the blink reflex study is a useful diagnostic tool in reflecting injury to the infraorbital nerve objectively.

• Clinical Pain
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• 제19권1호
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• pp.28-31
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• 2020

The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5~6 to 0~1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.298-303
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• 2023

Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

• 대한정형외과스포츠의학회지
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• 제7권1호
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• pp.33-36
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• 2008

목적: 축구에 의해 발생한 전방 십자인대 파열 환자에서 손상의 기전을 알아보고자 하였다. 대상 및 방법: 축구 도중에 발생한 전방 십자인대 파열이 된 환자 92명 중 손상 기전을 정확히 기억하는 환자 50명을 대상으로 하였다. 평균 연령은 27세로, 남자 47명, 여자 3명 이였다. 아마추어 및 프로 축구 선수는 15명이었고, 35명은 비선수였다. 수상 기전은 전화나 의무기록으로 조사하였다. 결과: 수상 기전은 접촉성 손상이 17명, 비접촉성 손상이 33명 이었고, 41명의 환자가 손상 당시 발이 지면에 접촉을 하였고, 9명은 지면에 접촉하지 않았다. 접촉성 손상에서 17명 중 9명에서 슬관절에 외반력, 5명에서 내반력이 가해졌고, 11명의 환자가 손상 당시 발이 지면에 접촉을 하였고, 6명은 발이 지면에 접촉하지 않았다. 발이 지면에 접촉된 상태에서 대퇴부의 회전에 의한 손상은 3명이었고, 과신전 손상은 1 명이었고, 감속 손상은 없었다. 비접촉성 손상에서 33명 중 30명의 환자가 손상 당시 발이 지면에 접촉을 하였고, 3명은 발이 지면에 접촉하지 않았다. 30명 중 대퇴부의 회전에 의한 손상은 16명이 있었고, 6명에서 슬관절에 외반력, 5명에서 내반력이 가해졌고, 과신전 손상은 5 명이었고, 감속 손상은 2명 이었다. 발이 지면에 접촉하지 않은 3명의 환자들은 킥을 할 때 손상을 받았다. 결론: 축구 선수에서 전방 십자인대 파열은 대부분(66%) 비접촉성이 원인이며, 발이 지면에 접촉되면서 상체가 회전되면서 발생했다. 접촉성인 경우 대부분(53%) 외측에서의 태클에 의한 외반력이 원인이었다.