• Journal of Chest Surgery
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• 제36권3호
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• pp.211-214
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• 2003

흉골골절은 흉부외상에서 흔히 볼 수 있는 손상으로 합병증 없이 잘 회복되며 골절에 의한 종격동혈종도 대부분 양성경과를 보이며 드물게 심혈관 손상을 동반한다. 저자들은 흉골골절에서 다른 출혈의 원인 없이 골절 자체에 의한 출혈로 생긴 종격동혈종에 의한 심낭외 압전을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제46권4호
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• pp.309-311
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• 2013

A 43-year-old man experienced chest trauma due to a car accident. Compound sternal fractures with severe dislocation were seen on computed tomography of the chest. Using a SternaLock plating system with manual reduction, fixation of the sternal fracture was successfully performed. There were no complications related to the operation.

• Journal of Trauma and Injury
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• 제32권2호
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• pp.107-110
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• 2019

Bilateral chylothorax due to blunt trauma is extremely rare. We report a 74-year-old patient that developed delayed bilateral chylothorax after falling off a ladder. The patient had a simple 12th rib fracture and T12 lamina fracture. All other findings seemed normal. He was sent home and on the 5th day visited our emergency center at Halla Hospital with symptoms of dyspnea and lower back pain. Computer tomography of his chest presented massive fluid collection in his right pleural cavity and moderate amounts in his left pleural cavity with 12th rib fracture and T11-12 intervertebral space widening with bilateral facet fractures. Chest tubes were placed bilaterally and chylothorax through both chest tubes was discovered. Conservative treatment for 2 weeks failed, and thus, thoracic duct ligation was done by video assisted thoracoscopic surgery. Thoracic duct embolization was not an option. Postoperatively, the patient is now doing well and happy with the results. Early surgical treatment must be considered in the old patient, whom large amounts of chylothorax are present.

• Journal of Chest Surgery
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• 제27권10호
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• pp.833-837
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• 1994

Lung contusion due to blunt chest trauma is the most common lung injury and correlated with the clinical course and prognosis. Its diagnosis by CT[Computerized Tomogram] gives a more clear and understandable three dimensional view, by which we are able to measure the volume of the contused and entire lung. Other variables are arterial blood gas, number of rib fracture, presence of hemopneumothorax, sternal fracture and clavicle fracture, number of associated non-thoracic injuries, ventilator time and presence of pulmonary complication. Percentage[%] of lung contusion are expressed as mean $\pm$ standard deviation and data analysis was performed by means of multivariate repeated measures analysis of variance to detect significant differences in variables between positive thoracic injury group and negative group. The paired t-test was used. Differences of percentage of lung contusion between groups were assessed by one-way analysis of variance. Simple linear regression was used to perform correlation analysis in the number of rib fracture and ventilator time. A p value less than 0.05 was considered statistically significant. Pneumothorax and the number of associated other injuries affect the amount of lung contusion and pulmonary complication group has more contused lung volume. Arterial blood gas study shows no correlation with the amount of lung contusion statistically. The number of rib fracture correlated with the amount of lung contusion, which also correlated with ventilator time[r=0.56, p<0.05]. In conclusion, quantitative anlysis of lung contusion by CT predicts the clinical course and treatment such as ventilator care.

• Journal of Chest Surgery
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• 제49권5호
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• pp.361-365
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• 2016

Background: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. Methods: We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. Results: Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. Conclusion: Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.

• Journal of Trauma and Injury
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• 제32권4호
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• pp.243-247
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• 2019

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1-4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors' knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1013-1019
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• 1992

A clinical evaluation was performed on 1, 110 cases of chest trauma treated at the Department of Chest Surgery, Chonnam University Hospital, during the past 23 years from January 1968 to June 1990. The ratio of male to female was 5.5: 1. The most common causes of chest trauma was stab wounds in penetrating trauma and traffic accidents in nonpenetrating trauma. The most common injuries in chest trauma were hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. Hemothorax or pneumothorax was observed in 592 cases [53.3%] of the total cases and rib fracture was observed in 527 cases[47.5%] of the total cases. Rib fracture was prevalent from the 3th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and other organ injuries. Open thoracotomy was performed in 163 cases[14.7%] and conservative nonoperative treatment in the others. Overall mortality rate was 8.5%[94 cases], and common causes of the death were shock and respiratory insufficiency.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.201-203
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• 2014

Patients with Horner's syndrome exhibit a variety of symptoms, including miosis, palpebral ptosis, and anhidrosis. This syndrome is caused by interruptions of the sympathetic neural pathways. This paper describes two cases of patients with Horner's syndrome who experienced a first rib fracture after crushing injuries.

• Journal of Chest Surgery
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• 제28권2호
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• pp.218-220
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• 1995

This 51 years old male patient was admitted to the department of thoracic and cardiovascular surgery via OPD because of anterior chest pain. 7days before admission, He got the chest trauma after traffic accidents,the lateral chest roentgenogram showed complete transverse sternal fracture. He also complained of mild dyspnea. We also noticed that he had depressed anterior chest wall. It looks like funnel chest. The operative findings revealed dislocated & callus formations at the both 4th and 5th costochondral junction and transverse fracture of sternal body between 4th and 5th costochondral junction, the upper end of sternal fracture was situated below the lower end of sternal fracture. The two ends of sternal fracture were situated at the same level and reapproximated the two ends by two-interrupted wire sutures. The patient is well on the road to recovery after the operation.

• Journal of Chest Surgery
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• 제42권5호
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• pp.674-676
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• 2009

제1늑골의 피로골절은 드물다. 반복되는 근육수축으로 인한 뼈의 피로가 골절의 원인이라고 생각된다. 자세한 병력 조사와 컴퓨터 단층 촬영 및 전자기 공명영상 등으로 진단할 수 있다. 진통제 등 보존적 요법으로 치료한다. 농구를 취미로 하는 18세 남자 대학생 환자에서 운동연습으로 인한 제1늑골의 피로골절을 경험하였기에 문헌 고찰과 함께 이에 보고한다.