• Archives of Plastic Surgery
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• 제47권5호
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• pp.451-459
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• 2020

Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint. Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients' age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups. Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P =0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant. Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

• 한국응급구조학회지
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• 제17권2호
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• pp.89-97
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• 2013

Purpose : The purpose of this study was to investigate the correlation between stress and maxillofacial injuries in male students. Methods : The subjects were 386 male students who were 18 years or more. Mean age was $20.99{\pm}2.80$ years. Data were collected using a self-reported questionnaire from March 7 to March 28, 2013. We surveyed maxillofacial injuries, mouth guards use and stress in male students majoring physical education. The data were analyzed by Cochran's Mantel-Haenszel, McNemar test and logistic multiple regression. Results : Those who had clenching habit and maxillofacial pain accounted for 48.7%. The pain was 3.23 folds higher in clenching habit than those who had not (OR=3.23, p <.001). The more stress they had, the more clenching habit (OR=2.13) and pain(OR=1.68) did they have. Within 2 years, those having maxillofacial injury accounted for 53.2% and 78.6% of them put on maxillofacial protection guard. In rule for mouth guard use, 39.9% had no maxillofacial injury. Maxillofacial injury was 2.41 folds higher in those who had no mouth guard usee (OR=2.41). Conclusion : Maxillofacial injury had a close correlation with mouth guard use and stress. Therefore, it is very important to establish the rule for mouth guard use in sports activities.

• 한국안전학회지
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• 제1권1호
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• pp.51-59
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• 1986

This study was conducted to analyse the exact causes of occupational accidents in Korean construction industry and to contribute to the accident prevention programs. The results and conclusions of the field survey are as follows ： 1) The accidents caused by hazardous conditions are 96 percent, and those by unsafe acts are 97.3 percent. The accidents caused simultaneously by two categories are nore than 96 percent. 2) The injured workers who were employed less than 3 months are 71.1 percent. Safety training for newly recruited workers should be required. 3) More than 40 percent of all accidents were occurred in the morning and more than 30 percent were in summer. Required caution should be paid for the time and season. 4) Fracture, cut/laceration/puncture and multiple injuries in the lower extremeties, upper entremeties and head as well as many kinds of injuries by the fall from elevation mainly occurred. Safety. shoes, safety gloves, safety helmets, safety glasses, face shields and safity belts should be used 5) As the sources of injuries, each of building/structure and materials is one third of all sources, and machinery is a quarter. 6) The use of hazardous methods/procedures, defects of agencies and inadequate guarding of builing/structure, materials' and machinery mainly caused the accident types, such as s truck by, struck against, fall from elevation, and fall on same level. Such a hazardous conditiion should not be used and be correctet 7) The unsafe acts, such as improper use of hands or body parts, the operation or working at unsafe speed and improper use of equipment mainly caused accidents. Safety training for the control of such a unsafe acts should be strengthened.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.300-303
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• 2013

Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

• Journal of Oral Medicine and Pain
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• 제41권3호
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• pp.118-125
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• 2016

Purpose: The aims of this study were to evaluate the clinical characteristics of patients with altered sensation and/or pain, and to determine outcome predictors affecting persistent neuropathy. Methods: Patients who complained an altered sensation or pain following trigeminal nerve trauma were involved in this study. To determine outcome predictors affecting persistent neuropathy, the patients were divided into two groups; transient vs. persistent, and the clinical phenotypes are compared between groups. Data were analyzed with t-tests, chi-square, and multiple regression analyses with 95% confidence interval and p<0.05 significance level. Results: A total of 111 patients were included: 23 with transient and 88 persistent groups. The panoramic result and pin-prick test score were statistically different between the groups. Radiating symptoms after blunt and pinprick stimuli were also significantly different between groups. The results revealed that the presence of a neurologic lesion in the panoramic view result, reduced sensation in the pinprick test, and radiation in the pinprick test could affect the persistent group. Conclusions: The presence of a neurologic lesion in panoramic view result and reduced sensation and radiating symptoms in the pin prick test would be defining features of one of the main clinical features of persistent neuropathy. These features could serve as outcome predictors diagnosing the permanent nerve injury in trigeminal nerve.

• 대한교통학회지
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• 제10권3호
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• pp.103-122
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• 1992

The objective of this research is to develop a traffic accident forecasting model using traffic accident data in pusan from 1963 to 1991 and then to make short-term forecasts('93~'94) of traffic accidents in pusan. In this research, several forecasting models are developed. They include a multiple regression model, a time-series ARIMA model, a Logistic curve model, and a Gompertz curve model. Among them, the model which shows the most significance in forecasting accuracy is selected as the traffic accident forecasting model. The results of this research are as followings. 1. The existing model such as Smeed model which was developed for foreign countries shows only 47.8% explanation for traffic accident deaths in Korea. 2. A nonliner regression model ($R^2$=0.9432) and a Logistic curve model are appeared to be th gest forecasting models for the number of traffic accidents, and a Logistic curve model shows th most significance in predicting the accident deaths and injuries. 3. The forecasting figures of the traffic accidents in pusan are as followings: . In 1993, 31, 180 accidents are predicted to happen, and 430 persons are predicted to be deaths and 29, 680 persons are predicated to be injuries. . In 1994, 33, 710 accidents are predicted to happen, and 431.persons are predicted to be deat! and 30, 510 persons are predicted to be injuried. Therefore, preventive measures against traffic accidents are certainly required.

• Journal of Yeungnam Medical Science
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• 제38권4호
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• pp.356-360
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• 2021

Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.427-439
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• 2022

Peripheral nerve injuries (PNIs) often present with variable symptoms, making them difficult to diagnose, treat, and monitor. When neurologic compromise is inadequately assessed, suboptimal treatment decisions can result in lasting functional deficits. There are many available tools for evaluating pain and functional status of peripheral nerves. However, the literature lacks a detailed, comprehensive view of the data comparing the clinical utility of these modalities, and there is no consensus on the optimal algorithm for sensory and pain assessment in PNIs. We performed a systematic review of the literature focused on clinical data, evaluating pain and sensory assessment methods in peripheral nerves. We searched through multiple databases, including PubMed/Medline, Embase, and Google Scholar, to identify studies that assessed assessment tools and explored their advantages and disadvantages. A total of 66 studies were selected that assessed various tools used to assess patient's pain and sensory recovery after a PNI. This review may serve as a guide to select the most appropriate assessment tools for monitoring nerve pain and/or sensory function both pre- and postoperatively. As the surgeons work to improve treatments for PNI and dysfunction, identifying the most appropriate existing measures of success and future directions for improved algorithms could lead to improved patient outcomes.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.284-287
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• 2021

We report a case of delayed chest wall reconstruction after thoracotomy. A 53-yearold female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and "on the way out" SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.

• Archives of Reconstructive Microsurgery
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• 제19권1호
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• pp.12-20
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• 2010

Purpose: Industrial punch accidents involving fingers cause segmental injuries to tendons and neurovascular bundles. Although multiple-level segmental amputations are not replanted to regain function, most patients with an amputated finger want to undergo replantation for cosmetic as much as functional reason. The authors describe four cases of digital amputation by an industrial punch that involved the reinstatement of the amputated finger involving a joint and neurovascular bundle. Amputated segments were replanted to restore amputated surfaces and distal segments. Methods: A single institution retrospective review was performed. Inclusion criteria of punch injuries requiring replantation were applied to patients of all demographic background. Injury extent (size, tissue involvement), operative intervention, pre- and postoperative hand function were recorded. Result: Four cases of amputations were treated at our institute from 2004 to 2008 from industrial punch machine injury. Average patient age was 32.5 years (25~39 years) and there were three males and one female. Sizes of amputated segments ranged from $1.0{\times}1.0{\times}1.2\;cm^3$ to $3{\times}1.5{\times}1.6\;cm^3$. Tenorrhaphy was conducted after fixing fractured bone of the amputated segments with K-wire. Proximal and distal arteries and veins were repaired using the through & through method. The average follow-up period was thirteen months (2~26 months), and all replanted cases survived. Osteomyelitis occurred in one case, skin grafting after debridement was performed in two cases. Because joints were damaged in all four cases, active ranges of motion were much limited. However, a secondary tendon graft enhanced digit function in two cases. The two-point discrimination test showed normal values for both static and dynamic tests for three cases and 9 mm and 15 mm by dynamic and static testing, respectively, in one case. Conclusion: Though amputations from industrial punch machines are technically challenging to replant, our experience has shown it to be a valid therapy. In cases involving punch machine injury, if an amputated segment is available, the authors recommend that replantation be considered for preservation of finger length, joint mobility, and overall functional recovery of the hand.