• Title/Summary/Keyword: Pedestrian Injury

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Rectal Injury Associated with Pelvic Fracture

  • Gwak, Jihun;Lee, Min A;Yu, Byungchul;Choi, Kang Kook
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.201-203
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    • 2016
  • Rectal injury is seen in 1-2% of all pelvic fractures, and lower urinary tract injury occurs in up to 7%. These injuries are rare, but if missed, can lead to a severe septic response. Rectal injury may be suspected by the presence of gross blood on digital rectal examination. However, this classic sign is not always present on physical examination. If an Antero-Posterior Compression type pelvic fracture is seen, we should consider the possibility of rectal and lower urinary tract injury. It is important to define the anatomic location of the rectal injury as it relates to the peritoneal reflection. Trauma to the intraperitoneal rectum should be managed as a colonic injury. Extraperitoneal rectal injury should be managed with fecal diversion regardless of primary repair. We present the case of a 46-year-old man who was referred to our hospital following a major trauma to the pelvis in a pedestrian accident.

Factors and Their Correlation with Injury Severity of Elderly Pedestrian Traffic Accidents

  • Hyun, Tae gyu;Yeom, Seok-Ran;Park, Sung-Wook;Lee, Deasup;Kim, Hyung bin;Wang, Il Jae;Bae, Byung Gwan;Song, Min keun;Cho, Youngmo
    • Journal of Trauma and Injury
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    • v.32 no.3
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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.

Crumple Zone Design and Upper Legform Impactor Analysis for Pedestrian Protection (보행자 보호를 위한 크럼플 존 설계 및 상부 다리모형 충격해석)

  • Jeon, Young-Eun;Moon, Hyung-Il;Kim, Yong-Soo;Kim, Heon-Young
    • Transactions of the Korean Society of Automotive Engineers
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    • v.20 no.3
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    • pp.126-132
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    • 2012
  • Recently, pedestrian protection related research topics have been actively studied by automotive designers and engineers due to the enhanced pedestrian protecting regulations. It is required to design an energy absorbing structure, such as crumple zone that can sufficiently absorb the impact energy to reduce the leg injury when accident happens. The structure is designed by reducing the height of front end module, considering the mounting location, and investigating impact characteristics. In this paper, the concept of the crumple zone was introduced and the role of the crumple zone was investigated by analyzing the performance of upper legform impact to a bonnet leading edge test, and the design process was suggested.

Ureteral Injury Caused By Blunt Trauma: A Case Report (둔상에 의한 요관 손상 1례)

  • Kwon, Oh Sang;Mun, Yun Su;Woo, Seung Hwo;Han, Hyun Young;Hwang, Jung Joo;Lee, Jang Young;Lee, Min Koo
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.291-295
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    • 2012
  • Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient. A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery. We detected the ureteral injury early and took a definitive action within 24 hours. In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.

Clinical analysis of heart trauma: a review of 13 cases (심장손상에 대한 임상분석: 13례 분석보)

  • 기노석
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.715-722
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    • 1984
  • From 1978 to April 30 84 thirteen cases of cardiac injured patients were operated under general anesthesia at Department of Thoracic and Cardiovascular Surgery in Chonnam National University. These patients were divided Into two groups according to their cause of trauma: Group 1, penetrating cardiac injury and Group II, blunt cardiac injury. 1.In 7 cases of Group 1, 6 cases were stab wound and one case was gunshot wound, and among 6 cases of Group II, 3 cases traffic accident, 2 cases pedestrian, 1 case agrimotor accident. 2.The sites of cardiac injury in penetrating trauma were right ventricle mainly and the next left ventricle and in blunt trauma right ventricle, myocardial contusion, right atrium, and inferior vena cava in order. 3.In most of cases central venous pressure was elevated above 15 cmH2O and in 5 of 13 cases revealed cardiomegaly in simple chest X-ray. 4.The relationship between the condition on arrival and the time to operation is not significant. 5.Associated injuries in penetrating cardiac trauma were hemothorax, pneumothorax, laceration of lung and in blunt trauma hemothorax, sternal fracture, rib fracture and pneumothorax in order. 6.One case of gunshot injury died after operation.

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Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States

  • Jennifer M. Brewer;Owen P. Karsmarski;Jeremy Fridling;T. Russell Hill;Chasen J. Greig;Sarah E. Posillico;Carol McGuiness;Erin McLaughlin;Stephanie C. Montgomery;Manuel Moutinho;Ronald Gross;Evert A. Eriksson;Andrew R. Doben
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.48-59
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    • 2024
  • Purpose: Research on rib fracture management has exponentially increased. Predicting fracture patterns based on the mechanism of injury (MOI) and other possible correlations may improve resource allocation and injury prevention strategies. The Chest Injury International Database (CIID) is the largest prospective repository of the operative and nonoperative management of patients with severe chest wall trauma. The purpose of this study was to determine whether the MOI is associated with the resulting rib fracture patterns. We hypothesized that specific MOIs would be associated with distinct rib fracture patterns. Methods: The CIID was queried to analyze fracture patterns based on the MOI. Patients were stratified by MOI: falls, motor vehicle collisions (MVCs), motorcycle collisions (MCCs), automobile-pedestrian collisions, and bicycle collisions. Fracture locations, associated injuries, and patient-specific variables were recorded. Heat maps were created to display the fracture incidence by rib location. Results: The study cohort consisted of 1,121 patients with a median RibScore of 2 (range, 0-3) and 9,353 fractures. The average age was 57±20 years, and 64% of patients were male. By MOI, the number of patients and fractures were as follows: falls (474 patients, 3,360 fractures), MVCs (353 patients, 3,268 fractures), MCCs (165 patients, 1,505 fractures), automobile-pedestrian collisions (70 patients, 713 fractures), and bicycle collisions (59 patients, 507 fractures). The most commonly injured rib was the sixth rib, and the most common fracture location was lateral. Statistically significant differences in the location and patterns of fractures were identified comparing each MOI, except for MCCs versus bicycle collisions. Conclusions: Different mechanisms of injury result in distinct rib fracture patterns. These different patterns should be considered in the workup and management of patients with thoracic injuries. Given these significant differences, future studies should account for both fracture location and the MOI to better define what populations benefit from surgical versus nonoperative management.

A Case-Control Study of Effectiveness of Injury Prevention Education on Elementary School Students (국민학교 어린이의 사고예방 교육 효과에 관한 연구)

  • 강희숙
    • Korean Journal of Health Education and Promotion
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    • v.11 no.2
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    • pp.18-32
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    • 1994
  • The purpose of this study was to analyze the effectiveness of injury prevention education on elementary school students. We are selected two elementary school in Tejeon, one was intervention school, the other was control school. Surveys were completed before the begining of the interventions in February in 1994 and again after their completion in July 1994. Intervention group was 284 students in pre-test and 218 students in post-test. And control group was 253 students in pre-test and 208 students in post-test. The results of this study was followed. 1. In the general characteristics of subjects studied, sex, mother education, father education, economic status, number of household, and traffic environment were not significant difference between intervention and control group(p>0.05). 2. The contents of injury prevention education that subjects wished to learn, were not significant difference between intervention and control group(p>0.05). Also the mothods of that were significant difference between intervention and control group in pre-test(p<0.05) but not in post-test(p>0.05). 3. Education in knowledge, attitude and practice of injury prevention was slightly effectiveness. Change in attitude of injury prevention was higher than in knowledge and attitude of that we guess that they require a lot of education in the pedestrian prevention. 4. Reative risk between intervention and control group in injury incidence was 1.53 in hospital-care students, and 1.43 in home-care children. Also relative risk of total injury incidence was 1.38, therefore we knew that injury incidence after education was reduced. 5. In the analysis of injury causes, pedestrain injury was remarkably reduced at hospital-care students in two group. At home-care students, two groups were high proportion in play injury. 6. In the analysis of injury places, intervention group was high proportion at near-the house in pre-test(35.4%) and at school in post-test(36.4%). And control group was high at inside-the house in pre-test(31.5%) and at near-the house in post-test(28.2%).

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ICECI Based External Causes Analysis of Severe Pediatric Injury (ICECI (International Classification of External Causes of Injuries)를 이용한 중증 소아외상의 분류)

  • Ahn, Ki Ok;Kim, Jae Eun;Jang, Hye Young;Jung, Koo Young
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.1-7
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    • 2006
  • Purpose: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. Methods: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (<0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). Results: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. Conclusion: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.

Severity Analysis of the Pedestrian Crash Patterns Based on the Ordered Logit Model (Ordered Logit Model을 이용한 보행자 사고 심각도 요인 분석)

  • Choi, Jai-Sung;Kim, Sang-Youp;Hwang, Kyung-Sung;Baik, Seung-Yup
    • International Journal of Highway Engineering
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    • v.11 no.1
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    • pp.153-164
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    • 2009
  • This Paper presents the severity analysis result of the year 2006 national pedestrian crashes using the data base of 37,589 records prepared for the National Police Bureau. A set of attributing factors considered to affect pedestrian crash patterns were selected, and their contributing effects were investigated by applying the Ordered Logit Model. This model was selected because this model has been able to afford satisfactory results when the dependent variable involved ordered severity levels; fatal, injury, and property- damage-only in this investigation. The investigation has unveiled the followings; First, the pedestrian crash patterns were dependent upon human -drivel and pedestrian- characteristics including gender, age, and drinking conditions. Second, other contributing factors included vehicle, roadway geometric, weather, and hour of day characteristics. Third, seasonal effect was not contributive to crash patterns. Finally, the application of the Ordered Logit Model facilitated the ordered severity level analysis of the pedestrian crash data. This paper concludes that conventional wisdom on the pedestrian crash characteristics is largely truthful. However, this conclusion is limited only to the data used in this analysis, and further research is required for its generalization.

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