• Title/Summary/Keyword: Thoracic fracture

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Surgical Retrieval of Fractured Percutaneous Coronary Intervention Guidewire (경피적 관상동맥 중재술 시 골절된 가이드 와이어의 외과적 제거)

  • Lee Jun-Wan;Kim Sang-Pil
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.640-642
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    • 2006
  • Entrapment and fracture of coronary angioplasty hardware are rare complications of percutaneous coronary intervention (PCI). Retained guidewire should be removed either percutaneously or surgically, because it could serve as a nidus for thrombus formation. We report on a successful surgical retrieval of entrapped PCI guidewire and subsequent bypass grafting of the affected coronary vessel.

Traumatic Tricuspid Regurgitation Treated by the Minimally Invasive Double Orifice Technique

  • Lee, Chan Kyu;Jang, Jae Hoon;Lee, Na Hyeon;Song, Seunghwan
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.68-71
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    • 2021
  • A 37-year-old man was transferred to our level I trauma center after a road traffic accident, presenting with right acetabular fracture, multiple rib fractures, epidural hemorrhage, and liver contusion. Severe traumatic tricuspid regurgitation was also discovered during the work-up for surgery. Our initial attempt at acetabular surgery failed when the patient experienced near cardiac arrest during anesthetic induction. It was hence decided that tricuspid valve repair should precede orthopedic surgery. Minimally invasive tricuspid valve repair using the double orifice technique was successfully performed. Subsequently, acetabular surgery was performed and he was discharged 35 days post-trauma without any complications.

Isolated Spinous Process Fracture of the $7^{th}$ Cervical Vertebrae in a Novice Golfer: a case report (골프 초보자에서 발생한 제 7경추 극돌기 골절 -1예 보고-)

  • Hwang, Jung Chul;Chung, Duke Whan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.96-98
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    • 2012
  • Fractures of isolated spinous processes of cervical and thoracic vertebrae are called as Clay shoveler's fracture. Such fractures related to sports activities are quite rare. In this report, a case of 27-year-old male with isolated spinous process fracture of C7 during golf swing is reported. The patient was prescribed on muscle relaxant and analgesic therapy. Cervical immobilization was maintained for four weeks with a cervical collar. The patient gradually recovered and was asymptomatic. He started playing golf twice a week after 5 months from the onset of pain.

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Clinical Ewperiences of Rib Fixation Using Judet's Strut (Judet's strut를 사용한 늑골 고정술의 임상적 고찰)

  • Kim, Jae-Ryeon;Im, Jin-Su
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.847-850
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    • 1995
  • For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.

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Spontaneous Femoral Capital Physeal Fracture with Proximal Tibial Epiphyseal Dysplasia in a Cat

  • Yoo, Saejong;Kim, Dae-Hyun;Lee, Yunsub;Yeo, Seungyeob;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.112-115
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    • 2019
  • An 11-month-old, 5.6 kg, grade 4 on a 5-point scale body condition score, castrated male Korean short hair cat was presented with right hindlimb lameness for 3 days without trauma. On physical examination, severe pain with crepitation was elicited at the hip region but not at the stifle. Radiographic examination and computed tomography revealed a Salter-Harris type 1 fracture of the femoral capital physis and dysplasia of the proximal tibial epiphysis. Spontaneous femoral capital physeal fracture was suspected and femoral head and neck osteotomy was performed. Treatment for proximal tibial dysplasia was not performed. On histopathologic examination of femoral head, a cluster of chondrocytes in a proliferative zone at the epiphyseal plate was observed. Therefore, spontaneous femoral capital physeal fracture was diagnosed. The patient recovered his gait, and no related clinical signs were observed during 6 months of follow-up.

Sudden death caused by diaphragmatic rupture following rib fracture in a female sika deer (Cervus nippon) at a zoo

  • Kim, Kyoo-Tae;Lee, Seung-Hun;Kwak, Dongmi
    • Korean Journal of Veterinary Research
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    • v.56 no.4
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    • pp.265-267
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    • 2016
  • A one-year-old female sika deer died suddenly with no preliminary signs during exhibition at a zoo. At necropsy, the carcass was emaciated and had dried fur. Examination of the thoracic cavity revealed a diaphragmatic rupture measuring 2 cm in diameter and a fracture in the middle of the right eighth rib. The liver and lungs had irregular circular discolorations caused by diaphragmatic rupture and subsequent herniation. Dark-brown-colored ascitic fluid, hydrothorax, and yellowish hydropericardium were also observed. The cause of death was determined to be diaphragmatic rupture caused by a rib fracture, which led to respiratory imbalance and circulatory disorders.

Osteoporotic Vertebral Fractures: SPECT Findings (골다공증에 동반된 척추골절의 골 SPECT 소견)

  • Baik, Jun-Hyun;Park, Young-Ha;Ihn, Yon-Kwon;Kim, Sung-Hoon;Chung, Yong-An;Yoo, Ie-Ryung;Kim, Jee-Yeung;Jung, Hyun-Seok;Sohn, Hyung-Seon;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.522-527
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    • 2004
  • Purpose: The purpose of this study was to evaluate the usefulness of single photon emission computed tomography (SPECT) of bone using Tc-99m MDP in the diagnosis of osteoporotic vertebral fractures. Materials and Methods: Thirty two patients with osteoporotic vertebral fracture were included in this study (mean age: $67{\pm}8$, male: 5, female: 27). Seventy nine vertebral fractures were detected (38 thoracic/thoracolumbar lesions and 41 lumbar lesions), which were classified by type of deformity (wedge, biconcave or compression). The patterns and locations of increased uptakes were examined and analyzed. Results: Forty seven wedge fractures, 20 biconcave fractures and 12 compression fractures were found. Diffuse and asymmetric uptakes were common in fractured bodies. More than one uptake were examined in 69 posterior elements of fractured vertebrae (87.3%) including 40 of 47 wedge fractures (85.1%), 17 of 20 biconcave fractures (85.0%) and 12 of 12 compression fractures (100%). Wedge fractures were predominant fracture in thoracic/thoracolumbar spine whereas incidence of biconcave or compression type war similar to that of wedge fracture in lumbar spine (p=0.04). Spinous process uptake was more frequently seen in lumbar lesions than thoracic/thoracolumbar lesions (p=0.009). Facet joint uptake in biconcave fracture was more common in lumbar spine (92.3%) than thoracic/thoracolumbar spine (57.1%). Spinous process uptake in biconcave fracture was also more frequently detected in lumbar spine (p=0.043). Conclusion: Bone SPECT was useful in the evaluation of osteoporotic vertebral fracture, especially posterior elements of vertebrae.

Clinical Evaluation of Chest Trauma - Analysis for 97 cases - (흉부외상의 임상적 고찰)

  • 정원상
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.307-315
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    • 1988
  • A clinical analysis was performed on 97 cases of chest injuries experienced at Department of Thoracic and cardiovascular Surgery, Armed Forces Capital Hospital during 2 years period from 1986 to 1988. Of 97 patients of chest trauma, 39 cases were result from penetrating injuries whereas 58 cases were from non-penetrating injuries, and there were 77 cases of hemothorax and / or pneumothorax, 47 of rib fracture, 8 of foreign body, 6 scapular and clavicle fracture, 5 of diaphragmatic injuries, 4 of paraplegia. The majority of chest injuries were encounted in the age group between 21 and 30 years-old, mean age was 25.9 years-old and all cases were male except one. Gun-shot wound was the most common cause in the penetrating injuries and the majority of non-penetrating chest injury patients were traffic accident and fist or kick accounted for next. The principles of therapy for chest trauma were rapid expansion of the lung by closed thoracostomy[45 cases] and thoracentesis only[3 cases] but thoracotomy done at 27 cases because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic injury and bronchial rupture. The over-all mortality was 2.07 percent[2 cases among all], a case was from penetrating injuries and another was from non-penetrating injuries.

Thoracic Trauma: Analysis of 150 Cases (흉부손상 150례에 대한 임상적 관찰)

  • 김형묵;김인수
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.113-124
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    • 1972
  • Clinical observations were performed on 150 cases of chest trauma, those were admitted and treated at the Department of Surgery, Korea University Woosok Hospital, during the past 8 years period from August 1965 to August 1972. 1. The ratio of male to female patient of chest trauma was 3.4:1 in male predominence and age from 20 to 50 occupied 62% of the total cases. 2. The most common cause of chest trauma was traffic accident in this series. Eighty-one cases[54%] were injured by traffic accident and total cases due to blunt trauma [non-penetrating injury] were 113 cases[75.4%]including the cases with traffic accident, and remaining 37 cases[24.6%] were due to penetrating injury including 25[16.6%] cases of stab wounds. 3. Hemopneumothorax were observed in 645/[96 cases] of the total cases, and etiologic distribution revealed 78.1% due to non-penetrating trauma and 20.8% due to penetrating injury. 4. Rib fracture was found in 50% of cases. Common injuries associated with rib fracture were lung, brain and liver. 5. Most common symptom was chest pain and respiratory difficulty, and common sign associated with chest injury was decreased respiratory sound and subcutaneous emphysema. 6. Conservative non-operative treatment was performed in 94 cases[62.6%] and 56 cases [37.4%] were treated with operative treatment including 31 cases[20.6%] with open thoracotomy. 7. Overall mortality was 9.3%[14 cases] and most common causes of death were due to brain edema,asphyxia and shock.

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Traumatic Asphyxia with Compressive Thoracic Injuries -4 Cases Report- (흉부손상에 의한 외상성 가사 4예)

  • 김현순
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.212-218
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    • 1980
  • A severe crushing injury of the chest produce a very striking syndrome referred to as traumatic asphyxia. This syndrome is characterized by bluish-red discoloration of the skin which is limited to the distribution of the valveless veins of the head and neck. And also if it is characterized by bilateral subconjunctival hemorrhages and neurological manifestations. But these clinical entities faded away progressively in a few weeks. Apporximately 90% of the patients who live for more than a few hours will recover from traumatic asphyxia when it occurs as a single entity. And so, death results from either severe associated injuries of from subsequent infection, rather than from pulmonary or cardiac insufficiency in traumatic asphyxia. We have experienced 4 cases of traumatic asphyxia with severe crushing thoracic injuries at department of the chest surgery, Captial Armed forces General Hospital during about 3 years from April 1977 to Aug. 1980. The 1st 22 year-old male was struct 2$\frac{1}{2}$ ton truck on the road and was transferred to this hospital immediately. He had taken tracheostomy due to severe dyspnea with contusion pneumonia and for removal of a large amount of bronchial secretion. The 2nd case was 23 year-old male who was got buried in a chasm. In this case, the heavy metal post tumbled over him back while at work. The 3rd case was 39 year-old male who leapt out of a window in 5th story while fire broke out in living room by oil stove heating. He had multiple rib fracture with right hemothor x and right colle's fracture and pelvic bone fracture. The last 22 year-old male was run over by a gun carriage. The wheel of this gun carriage passed over his thorax and right chin. He was brought to this hospital by helicopter. when he was first examined at emergency room, he was in semicomatose state and has pneurmomediastinum with multiple rib fracture and severe subcutaneous emphysema. As soon as he arrived, bilateral closed thoracostomy was performed and cardiopulmonary resuscitation was done. In hospital 8th weeks, chest series showed fibrothorax in right side even if chest wall stabilized. All 4 cases had multiple petechiae over their facees and chest and bilateral subconjunctival hemorrhages referred to as traumatic asphyxia. 3 cases except one case who received splenectomy, had been suffered from contusion pneumonia and had been treated with respiratory care. In these 3 cases, they had warning of impending injury before accident, and took a deep breath hold it and braces himself. And also, even if he had not impending fear in remaining one case, he had taken a deep breath and had got valsalva maneuver for pulling off the heavy metal post. Intrathoracic pressure rose suddenly and resulted to traumatic asphyxia in this situation. All these cases were recovered completely without sequelae except one fibrothorax, right.

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