• 제목/요약/키워드: Neck trauma

검색결과 253건 처리시간 0.03초

Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw

  • Choi, Han Joo
    • Journal of Trauma and Injury
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    • 제32권3호
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    • pp.168-171
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    • 2019
  • The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

Biomechanics of stabbing knife attack for trauma surgeons in Korea: a narrative review

  • Kun Hwang;Chan Yong Park
    • Journal of Trauma and Injury
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    • 제37권1호
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    • pp.1-5
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    • 2024
  • The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.

이하선수술시 안면신경의 위치에 따른 신경 보존 술식의 개선방법 (Rolling Method to Preserve Facial Nerve in Parotidectomy)

  • 유영삼
    • 대한두경부종양학회지
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    • 제26권1호
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    • pp.19-23
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    • 2010
  • Objectives : In parotidectomy, facial nerve dissection technique had been evolved for its safety. Surgical landmarks are important and good guides to facial nerve detection. Conventional exposure and release of the nerve requires hemostat for elevation of parotid tissue from nerve and #11 blade for cutting the parotid away from the nerve. Material and Methods : The rolling the parotid tissue over the nerve after dissecting with Metzembaum scissors instead of knife, lessen pulling trauma and nerve cutting by knife. Eleven superficial parotidectomies since June 2009 were done with rolling technique and preliminary report is presented. Results : Total 11 parotidectomies were done using proposed technique with tolerable complications(temporary facial dysfunction in 4 cases). Conclusion : Rolling method using metzembaum scissors could be applied to parotid operation.

공기음영으로 오인될 수 있는 두경부 영역의 관통성 나무이물에 대한 컴퓨터 전산화 단층촬영의 의의 (CT in Penetrating Wooden Foreign Bodies of Head and Neck)

  • 오승철;김찬우;박병훈;강인봉;김선태;장일환;차흥억;이선규
    • 대한기관식도과학회지
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    • 제4권1호
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    • pp.142-147
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    • 1998
  • Retained wooden foreign bodies following penetrating trauma are a difficult diagnostic problem. However, penetrating wooden foreign bodies of head and neck have the potential for misinterpretation or failure to detect such foreign bodies on CT. Given the likelihood that such a miss will result in an abscess or neurovascular injury, we present the method with higher window settings, they had a higher attenuation with a unique striated internal architecture and different Hounsfield numbers readily differentiate air and non-air hypodense material such as fat, or possibly wood. Being aware of the potential appearance of wood, we may also find CT useful in excluding small retained fragments in postoperative patients with persistent symptoms. This article presents two cases in which wooden foreign bodies of head and neck were present with CT evaluation.

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슬링을 이용한 경부관절 운동이 고문생존자의 수면장애, 두통, 경부 기능장애에 미치는 영향 : 단일사례연구 (Effects of Cervical Exercise with Sling Program on Sleep Disturbance and Headache, Neck Disfunction in Torture of Survivor : Single Case Study)

  • 유성훈
    • 대한통합의학회지
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    • 제5권1호
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    • pp.11-18
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    • 2017
  • Purpose : The purpose of this case study was to clinical effects of cervical exercise with sling program using on torture of survivor with sleep disturbance and Headache, neck disfunction. Methods : This study selects 1 subjects for 55 years old who were diagnosed with torture of survivor with sleep disturbance and headache. The Design is ABA of single-subject study design. Baseline(A) and TypeII Baseline(A : 6weeks) phases were received with musculoskeletal disease of prevention education, Intervention(B : 6weeks) phase provided with 65 minute exercise with sling program using in a session twice a week. In order to analyze the measure results of PSQI-K(korean version of the pittsburgh sleep quality index), VAS(visual analog scale), NDI(neck disability index), FABQ(fear-avoidance beliefs questionnaire) in torture of survivor during baseline, intervention and typeII baseline phase. Result : A significant differences in PSQI-K during baseline, intervention, typeII baseline. A significant differences in VAS during baseline, intervention, typeII baseline. A significant differences in NDI during baseline, intervention, typeII baseline. A significant differences in FABQ during baseline, intervention, typeII baseline. Conclusion : In conclusion, The intervention method to applied cervical exercise with sling program on torture of survivor effectively improve on sleep disturbance and neck function, headache.

갑상선결절 세침흡인 세포검사 후 기관 압박을 초래한 전경부 혈종 1예 (A Case of Anterior Neck Hematoma Causing Tracheal Compression after Fine Needle Aspiration Cytology of the Thyroid Nodule)

  • 박민호;조문형;서경원;윤정한;제갈영종
    • 대한두경부종양학회지
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    • 제21권2호
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    • pp.170-173
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    • 2005
  • Fine needle aspiration cytology (FNAC) of thyroid gland lesions has become a routine diagnostic method. And fine needle aspiration cytology is considered a safe, reliable and cost-effective means of selecting thyroid nodules with risk for malignancy. However, fine needle aspiration cytology of the thyroid may cause hemorrhage, infection, or trauma to adjacent structures. Hemorrhage sufficient to cause tracheal compression has not been reported. So we present a case of anterior neck hematoma causing tracheal compression after FNAC of the thyroid nodule.

무통성 결절 양상의 갑상선에 발생한 만성 육아종성 염증 1예 (A Case of Chronic Granulomatous Inflammation of Thyroid Gland Presenting as a Painless Thyroid Nodule)

  • 곽슬기;최전하;김윤정;김승우
    • 대한두경부종양학회지
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    • 제29권2호
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    • pp.83-86
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    • 2013
  • Some clinical diseases, such as granulomatous thyroiditis, tuberculosis, and sarcoidosis can cause granulomatous inflammation in thyroid, and theses have various clinical presentations. Granulomatous thyroiditis is an inflammation of thyroid gland, and may be painful and tender in case of infection, radiation, or trauma. Otherwise, autoimmune conditions, medications, or an idiopathic fibrosis may cause to be a painless thyroididtis. It is self-limited, possibly viral, inflammatory thyroid disorder usually presented with thyroid pain and systemic symptoms. Tuberculosis of the thyroid occurs only rarely and the patient may be asymptomatic. In thyroid sarcoidosis, most common findings are painless, progressive enlargement of the thyroid with normal function. We have experienced a case of chronic granulomatous inflammation of thyroid gland presenting as a painless thyroid nodule and report it with a review of literature.

A step-by-step intraoperative strategy during one-stage reconstruction of an acute electrical burn injury in the neck for superior surgical outcome in India: a case report

  • Mainak Mallik;Sanjay Kumar Giri;M. Vishnu Swaroop Reddy;Kallol Kumar Das Poddar
    • Journal of Trauma and Injury
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    • 제37권2호
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    • pp.151-157
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    • 2024
  • Electrical burn injuries can cause more damage than clinical evaluations initially suggest. The energy waves penetrate from the surface to the deepest layers of tissue, causing extensive harm at every level. The neck is a critical area, both functionally and aesthetically. We present a case involving a young male patient with a severe fourth-degree electrical burn on the neck, who underwent a single-stage debridement and reconstructive surgery. The pectoralis major myocutaneous flap is a versatile option for various head and neck reconstructions. However, if the donor site cannot be closed primarily and requires split-thickness skin grafting, it can result in unsightly scars and deformities. For large flap paddles, it is ideal to reconstruct the secondary defect with locoregional flaps. In this case, we successfully reconstructed the donor site's secondary defect using a contralateral internal mammary artery perforator flap, without resorting to any skin grafts. The early postoperative results demonstrated satisfactory cosmesis, patient satisfaction, and functional outcomes.

선원들의 누적외상성질환 발생과 관련요인 (A Survey on the Prevalence of Cumulative Trauma Disorders and Related Factors among Seafares)

  • 김재호
    • 한국항해항만학회지
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    • 제32권5호
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    • pp.395-401
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    • 2008
  • 본 연구는 누적외상성질환 예방을 위한 기초자료를 제공하기 위한 목적으로 선원 재교육기관에서 교육이수중인 569명을 대상으로 조사하였다. 최근 12개월동안 누적외상성질환 증상을 경험한 선원은 68.5%였으며, 근무시간이 길수록(p<0.01), 승선경력이 많을수록(p<0.01) 증상경험이 높았고, 직무만족도는 낮을수록 증상 경험이 높았다(p<0.05). 신체부위별 증상 경험은 허리 43.6%, 무릎 23.9%, 어깨 19.3% 순으로 높은 빈도를 보였으며, 해기사가 부원보다 목 부위만 유의하게 높게 나타났고(p<0.01), 기관부가 갑판부 보다 팔꿈치의 증상경험이 유의하게 높게 나타났다(p<0.05). 통증지속기간은 7일 이하가 55.4%로 가장 많았고, 8-29일이하 20.6%, 30일이상 24%로 조사되었다. 증상 유발원인은 과중한 노동이 34.5%로 가장 높고, 원인불명이 30.1%로 조사되었다.

고도 중증외상 환자에서 급성 혈액응고장애가 초기 및 조기 사망에 미치는 영향 (The Effect of Acute Coagulopathy in Profoundly Traumatic Patients on Acute and Early Deaths)

  • 노민수;양성수;경규혁
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.158-164
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    • 2014
  • Purpose: Numerous studies have investigated the pattern of traumatic death with a focus on the injury mechanism, the severity of the injury and the presence of hemorrhage. Acute coagulopathy has been treated as only one of many complications. The purpose of this study was to investigate the influence of acute coagulopathy on acute and early death due to trauma. Methods: A retrospective analysis of trauma patients with injury severity score (ISS)${\geq}25$ who had been treated between January 2011 and December 2012 was conducted. Based on the time of injury, traumatic death was categorized into acute (within 48 hours) and early (from 3 to 7 days). The correlations between various parameters within 24 hours after injury and time of death were analyzed. Results: A total of 124 patients were enrolled. Of them, 8.1% (n=10) of the patients experienced acute mortality. For those patients, significant differences in initial systolic blood pressure, coagulopathy score, amount of transfusion, abbreviated injury scale of the head and neck, the abdomen and the extremities were noted. Early mortality was experienced by 7.0% (n=8) of the patients, only coagulopathy score was found to be a significant independent risk factor for acute (odds ratio: 3.127; 95% confidence interval: 1.185-8.252; p=0.021) and early mortality (odds ratio: 2.470; 95% confidence interval: 1.029-5.929; p=0.043). Conclusion: Acute traumatic coagulopathy has an important role in the mortality, even after the acute phase. Early management and prevention of acute coagulopathy may improve survival of trauma patients.