• Journal of Korean Foot and Ankle Society
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• v.21 no.3
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• pp.108-112
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• 2017

The midtarsal joint is composed of the talonavicular and calcaneocuboid joints. It is also known as the Chopart joint. Midtarsal joint fracture and dislocation are relatively rare and frequently missed or misdiagnosed. A proper understanding about the anatomy of the midtarsal joint is an essential part in comprehending the mechanism of injury and rationale for treatment. Anatomical reduction of midtarsal joint with correction of the column in length and shape are important; however, it is technically challenging and may require open procedure. Herein, we described a case of initial open reduction and internal fixation for midtarsal joint fracture and dislocation with a brief literature review.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.248-251
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• 2019

Traumatic intrapulmonary glass foreign bodies that are missed on an initial examination can migrate and lead to severe complications. Here, we present a rare case of a traumatic intrapulmonary glass foreign body surgically removed by a direct pulmonary incision, which preserved the pulmonary parenchyma and avoided severe complications caused by migration.

• Journal of Trauma and Injury
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• v.30 no.1
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• pp.16-20
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• 2017

A 48-year-old man came to the emergency department with altered consciousness and hemoperitoneum following a pedestrian traffic accident. He underwent immediate emergency laparotomy, and on the second day, he required craniectomy because of increase of intracranial hemorrhage. A chest radiograph taken 7 days after admission, showed elevation of the right hemi-diaphragm, and follow-up chest CT showed a right-sided rupture of the diaphragm, which was surgically repaired. Rupture of the diaphragm can be easily overlooked and the diagnosis delayed, especially in unstable patients with multiple trauma or altered level of consciousness, as in the case reported here.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.419-421
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• 2021

Fracture of prosthetic valve leaflets in the absence of traumatic injury is very rare. Leaflet fracture can cause acute pulmonary edema and cardiogenic shock and is potentially life-threatening, requiring emergency surgery. Thus, a leaflet fracture must be diagnosed quickly and accurately. We present the case of a 46-year-old man with CarboMedics prosthetic aortic and mitral valve replacements implanted 24 years previously. The patient presented at our emergency department with abrupt dyspnea and fever. We diagnosed severe mitral valve regurgitation with anterior leaflet fracture. The patient underwent venoarterial extracorporeal membrane oxygenation and delayed mitral valve replacement. The foreign body was removed step by step because the diagnosis was missed. Two pieces of broken leaflets were found in the left common iliac artery and left external iliac artery. The patient was treated successfully and remains asymptomatic 1 year following surgery.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.407-410
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• 2006

Carotid artery-internal jugular vein arteriovenous fistula is very rare, but it should be suspected in case of vascular injury by neck trauma because the diagnosis may be missed due to anatomical complexity of neck, We report a 57-year old male who had the carotid artery-jugular vein arteriovenous fistula caused by gunshot injury in the neck 44 years ago.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.89-98
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• 2013

Purpose: The assessment of trauma patients in the prehospital setting is difficult, but appropriate field triage is critical to the prognosis of trauma patients. We sought to evaluate the triage given by the emergency medical technicians (EMTs) using the trauma score to patients injured in motor vehicle collisions (MVCs). Methods: From June 2012 to July 2012, questionnaires were distributed to EMTs, who had transported injured patients to the study hospital. Scene records, photos of the damaged vehicle, and ambulance run sheets were used to provide physiologic, physical, and mechanistic information about the MVC. To evaluate the appropriateness of the injury assessment by EMTs, we compared their impressions with the hospital's final diagnosis within a 3 level triage system comprising both the maximum abbreviated injury scale (MAIS) and the injury severity score (ISS). Kappa (k) was calculated to evaluate the agreement between the triage by EMTs and the triage based on hospital's final diagnosis. Results: A total of 91 patients were analyzed by 31 EMTs. The percentage of males was 57.1%, the mean age was 44.5, and the mean MAIS and ISS were 2.7 and 16.6 respectively. While EMTs correctly diagnosed patient injuries to the extremities in 35.7%, and to the neck in 32.1%, pelvic injuries were missed in 80.0%. The agreement between the triage by the EMTs and the triage based on the hospital's final diagnosis was 62.6%(k=0.366) by the MAIS and 50.5%(k=0.234) by the ISS. The kappa value was higher in EMT-I than in EMT-II. Conclusion: In MVC, the assessment of injured patients by EMT-I was more appropriate, and the 3-level triage method based on the MAIS could contribute to a more accurate triage. Prospective studies to search for appropriate methods of field triage are required for programming practical education for EMTs.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.103-107
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• 2006

Simultaneous acute rupture of the anterior cruciate ligament (ACL) and the patellar tendon is a very unusual injury. That is difficult to diagnose in initial evaluation of knee injury, because the patellar tendon rupture is often missed. We report a 26 year-old male patient who was treated with ACL reconstruction using achilles allograft and direct patellar tendon repair with achilles allograft augmentation. The patient had the stable knee and full range of motion. It's clinical results were excellent(Lysholm score 93, Tegner activity score 6).

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.122-125
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• 2007

Avulsion of the ischial tuberosity is an acute injury caused by sudden contraction of the hamstrings, typically occurs in early adolescence, whereas ischial apophysitis has a more insidious onset during times of increased activity and its diagnosis is often missed. Authors present a rare case of having neglected avulsion fracture of the the ischial tuberosity in one side and ischial apophysitis in the other side with characteristic radiological features in a 16-year-old male who was an active Tae-Kwon-Do player.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.294-298
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• 2021

Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.217-222
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• 2012

Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.