• Journal of Trauma and Injury
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• 제29권4호
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• pp.146-150
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• 2016

Purpose: Traumatic aortic injuries are rare, but life threatening condition. They usually occur after high velocity impact on the chest or abdomen such as traffic accident or fall. We report the experiences of the traumatic aortic injuries at a single center. Methods: We retrospectively reviewed the medical records of nine patients with aortic injury resulting from the blunt trauma from Jan. 2010 to May. 2016. Results: The mean age was $51.1{\pm}20.8$ years old, and ten (90.9%) were men. The mechanisms of injury were traffic accidents in seven patients (motorcycle accidents; 3, car accidents; 4), and four in fall injury. Most common injured sites were thoracic aorta (9, 81.8%). Aortic injuries were repaired by endovascular approach in four patients, and by open graft surgery in four. Two patients were managed conservatively. Nine patients survived without any complications. Conclusion: We had experienced different approaches for management of aortic injuries after blunt trauma according to locations and severity of lesions.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.219-221
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• 2015

Subclavian injuries in blunt trauma are reported in less than 1% of all arterial injuries or chest related injuries. We report a female 68 yr-old patient whom has visited our emergency center due to a motorcycle traffic accident with complaints of right chest wall and shoulder pain. Her injury severity score was 22 and she was found with a comminuted clavicle fracture and subclavian artery injury. She developed delayed symptoms of pallor, pain and motor weakness with loss of pulse in her right arm. Attempts at intervention failed and thus, she underwent emergency artificial graft bypass from her subclavian artery to her brachial artery. Her postoperative course was uneventful and she is happy with the results. Although rare, a high index of suspicion for the injury must be noted and the inevitable surgical option must always be considered.

• Journal of Acupuncture Research
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• 제35권1호
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• pp.1-3
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• 2018

This case report demonstrates the beneficial effects of cupping therapy (CT) in a 35-year-old man who is diagnosed with a fracture of the radial shaft due to a motorcycle accident. One year after the treatment started, pseudoarthrosis developed in the radius and an autogenous iliac bone graft was performed. However, extension dysfunction in the wrist became evident. After another 6 months of physical therapy and rehabilitation, no improvements were observed. Therefore, CT and adjunctive electrostimulation were performed, after 30 days of treatment, marked recovery of muscle function and full wrist extension were observed, as determined by electromyography and a grade 5/5 on the Medical Research Council power of wrist extension scale. The results in this case study suggest that CT in conjunction with adjunctive electrostimulation, may accelerate functional recovery from postoperative radial palsy, and provide a useful alternative treatment in this situation.

• Journal of Korean Neurosurgical Society
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• 제30권sup2호
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• pp.332-336
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• 2001

This 18-year-old male patient had a massive epistaxis after motorcycle traffic accident on 1st day of admission. There were no other significant brain parenchymal lesion on initial brain CT exam, except multiple pneumocephalus and basal skull fracture lines. We treated epistaxis conservatively till vital signs were corrected, and then conventional cerebral angiogram was followed. On angiogram, there was traumatic pseudoaneurysm on C5 portion(by Fischer) of ICA, so we treated it only by endovascular stenting. For the purpose of sparing parent arterial patency, endovascular stenting on pseudoaneurysm may play a role with safety and good results.

• Structural Engineering and Mechanics
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• 제82권2호
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• pp.233-244
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• 2022

Following a loss of control, the impact against a road barrier in a turn predominates among the most severe motorcyclist accidents. These road restraint devices can be equipped with a motorcycle screen, the function of which is to restrain the rider and minimize the consequences of the impact in terms of the severity of injuries. The performance of these screens is evaluated by the European normative procedure EN1317-8, which specifies the test conditions, based on one or two configurations. In practice, however, these impact conditions are very diverse, difficult to extrapolate from accident analysis and therefore poorly investigated. This study is interested in improving knowledge of these impact conditions in terms of impact speed, impact angle and particularly position of the rider. A finite element model has been developed to simulate the dynamic behavior of the rider from loss of control to impact on the screen. Statistical analysis of the results shows a high variability of the impact conditions, in particular with regard to the direction of turn (to the right or to the left). Some improvements are suggested in order to overcome the limitations inherent in standard procedures.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.183-188
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• 2021

We report a case of a 69-year-old right-dominant man who had an open Monteggia-like lesion of the right elbow (Gustilo-Andersen IIIA) with severe proximal ulna bone loss associated with an ipsilateral ulnar shaft fracture due to a motorcycle accident. The patient underwent two-stage surgery. Wound debridement and bridging external fixation were performed at first. Three months later, a frozen massive osteochondral ulnar allograft was implanted and fixed with a locking compression plate. A superficial wound infection appeared 5 weeks after the second surgery. Superficial wound debridement, negative pressure therapy, and antibiotics were administered for 3 months, achieving infection healing. At 3 years post-surgery, the elbow range of motion was satisfactory with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 16.7. Radiographs and computed tomography scans showed good allograft-bone integration without allograft reabsorption or hardware loosening. Although not complication-free, massive ulna osteochondral allograft implantation can be considered a valid option in cases of open Monteggia-like lesions associated with ulnar shaft fracture and severe bone loss in active patients, whenever osteosynthesis or joint replacement is not a proper solution. This type of bone stock restoration allows for future surgery, if needed.

• Journal of Trauma and Injury
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• 제37권3호
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• pp.243-246
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• 2024

Traumatic ureteral injuries account for fewer than 1% of traumatic urologic injuries, and those caused by blunt trauma are even rarer than those caused by penetrating trauma. The symptoms associated with ureteral injury may be subtle, with or without hematuria, making it difficult to diagnose. We report the case of a 31-year-old man with a delayed diagnosis of proximal ureter injury after abdominal blunt trauma sustained in a motorcycle traffic accident. The patient underwent emergency laparotomy on admission for liver injury, mesenteric injury, and resultant hemoperitoneum. On postoperative day 6, he underwent angioembolization for suspected remnant intra-abdominal bleeding. Persistent symptoms of flank pain and leukocytosis led to follow-up imaging studies that revealed proximal ureter injury, and the patient underwent unilateral nephrectomy. This case stresses the importance of clinical suspicion for genitourinary injuries in the presence of abdominal trauma.

• 한국ITS학회 논문지
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• 제15권1호
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• pp.28-38
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• 2016

최근 차량, 도로간 실시간 연결로 교통상황별 능동적 대응이 가능한 Cooperative-Intelligent Transport Systems(C-ITS) 기술에 대한 관심이 증가하고 있다. 정부는 C-ITS 기술 개발 및 도입을 위해 다양한 연구를 진행하고 있다. 하지만 현재 C-ITS기술은 자동차를 대상으로 자동차 안전 및 경제적 운행을 위한 기술개발에 치중하고 있다. 자동차 이외에 도로 주행이 가능한 자전거를 위한 기술은 포함하지 않고 있다. 본 연구에서는 자전거 주행 시 위험요인과 사고요인 분석을 통해 C-ITS 환경에서 구현가능한 자전거 안전서비스를 도출한다. 자전거 및 이륜차 안전서비스 도출을 위하여 우선적으로 과거 2011~2013년 발생한 우리나라 과거 자전거 및 이륜차 교통사고 이력자료를 분석하여 관련 교통사고 특성 및 원인을 진단하였다. 자전거 및 이륜차 교통사고 이력자료 분석으로 파악된 주요 교통사고 특성에 효율적으로 대처하기 위한 서비스 도출을 위해 별도의 전문가 회의를 4회에 걸쳐 수행하였다. 이를 통해 자전거 및 이륜차 통합 안전 서비스 모델 8개를 도출하였다.

• Archives of Reconstructive Microsurgery
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• 제18권2호
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• pp.55-61
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• 2009

Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.143-149
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• 2019

Purpose: No previous study has assessed elderly pedestrian traffic accidents based on a nationwide database. This study aimed to help primary physicians who examine patients in emergency departments to determine and make prompt and accurate treatment decisions. Methods: This study used data from the Emergency Department-based Injury Indepth Surveillance from 2013 to 2017, managed by the Korea Centers for Disease Control and Prevention. Pedestrians aged ${\geq}65years$ were included, and using multivariate logistic regression multiple factors were analyzed to determine their relationship with injury severity. Results: Of 227,695 subjects, 6,498 were included, of whom 2,065 (31.8%) were severely injured. There were more female than male patients in all severity groups. Most accidents occurred in the afternoon and on general roads. In the multivariate analysis, the odds ratio (OR) of injury severity for male pedestrians was 1.165 (95% confidence interval: 1.034-1.313, p=0.012). Older age of patients and the use of ambulances were associated with greater injury severity. The accident time affected the degree of injury severity; i.e., compared to dawn, injury severity increased in the morning (OR: 1.246, p=0.047) and decreased at night (OR: 0.678, p<0.001). A significant difference was noted in the correlation between the type of vehicle causing the accident and the accident severity; i.e., motorcycle accidents had lower severity than bicycle accidents (OR: 0.582, p=0.047). Conclusions: Injury severity was correlated with sex, age, transportation to the ED, TA onset time, and type of vehicle. The study results suggest that injury severity may be positively reflected in initial assessments and overall integrated treatments by physicians and in the related policies.