• Title/Summary/Keyword: impact of trauma

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Epidemiologic Changes of Facial Bone Fracture before and after Coronavirus Disease 2019: A Level 1 Trauma Center in Korea

  • Jeong Ho Kim;Chae Eun Yang;Sug Won Kim;Jiye Kim
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.37-41
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    • 2023
  • Background The coronavirus disease 2019 (COVID-19) outbreak has had a major impact worldwide. Several countries have implemented restrictions on social interaction ("social distancing"). Several studies have reported that the epidemiology of trauma patients, such as those with facial bone fractures, has changed after COVID-19 pandemic. This study aimed to further explore these specific changes. Methods This was a retrospective study of patients who presented to a single institution with facial bone fractures between January 1, 2016, and December 31, 2020. Baseline patient demographics, clinical information, type of fracture, etiology, and operative management were compared before and after COVID-19. Results Of all cases, 3,409 occurred before COVID-19, and 602 occurred after COVID-19. Since the outbreak of COVID-19, the number of patients with facial fractures has not decreased significantly. A significant increase was noted in fractures that occurred outdoors (p < 0.001). However, a decrease was observed in operative management between the groups (p < 0.001). There was no significant difference in the proportion of assault, fall-down, industrial accident, or roll-down. In contrast, the proportion of traffic accidents and slip-down categories increased significantly (p < 0.05). Moreover, a significant decrease was found in the proportion of the sports category (p = 0.001) Conclusions It was confirmed through this study that COVID-19 pandemic also affected epidemiology of facial fractures. Focusing on these changes, it is necessary to develop safety measures to reduce facial fractures.

Hip Function after Surgically Treated Isolated Traumatic Acetabular Fracture: A Prospective Series of Consecutive Cases

  • Indy Smits;Niek Koenders;Vincent Stirler;Erik Hermans
    • Hip & pelvis
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    • v.35 no.2
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    • pp.133-141
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    • 2023
  • Purpose: Isolated acetabular fractures can occur as a result of a high energy impact on the hip joint. Surgery is required for most patients with an isolated acetabular fracture in order to alleviate pain, restore joint stability, and regain hip function. This study was conducted in order to examine the course of hip function in patients after surgical treatment of an isolated traumatic acetabular fracture. Materials and Methods: This prospective series of consecutive cases included patients who underwent surgery for treatment of an isolated acetabular fracture in a European level one trauma center between 2016 and 2020. Patients with relevant concomitant injuries were excluded. Scoring of hip function was performed by a trauma surgeon using the Modified Merle d'Aubigné and Postel score at six-week, 12-week, six-month, and one-year follow-up. Scores between 3-11 indicate poor, 12-14 fair, 15-17 good, and 18 excellent hip function. Results: Data on 46 patients were included. The mean score for hip function was 10 (95% confidence interval [CI] 7.09-12.91) at six-week follow-up (23 patients), 13.75 (95% CI 10.74-16.76) at 12-week follow-up (28 patients), 16 (95% CI 13.40-18.60) at six-month follow-up (25 patients), and 15.50 (95% CI 10.55-20.45) at one-year follow-up (17 patients). After one-year follow-up, the scores reflected an excellent outcome in 11 patients, good in five patients, and poor in one patient. Conclusion: This study reports on the course of hip function in patients who have undergone surgical treatment for isolated acetabular fractures. Restoration of excellent hip function takes six months.

The Relationship between Adult Interpersonal Traumatic Experience and Posttraumatic Growth : The Multiple Mediating Effect of Optimism and Quality of Relationship (성인의 대인외상경험과 외상 후 성장의 관계 : 낙관성과 관계의 질의 다중매개효과)

  • Park, Euna
    • Korean Journal of Social Welfare
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    • v.67 no.1
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    • pp.263-288
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    • 2015
  • This study is to research the mediating effects of optimism and quality of relationship which interpersonal traumatic experience influences posttraumatic growth. It focuss on verifying the impact of interpersonal traumatic experience to optimism and quality of relationship and the influence of optimism and quality of relationship to posttraumatic growth. And also it is to verify dual mediating effect between optimism and quality of relationship. Data for this study were collected through the use of a survey instrument completed by 405 interpersonal traumatic experience, 30-60 age group. Collected data were analysed by AMOS program, Structure Equation Model(SEM) was implemented to verify the mediating effect between optimism and quality of relationship. Finally, Phantom Variable was utilized for verification of indirect influence of a multi mediating effects. The findings of this study were as follows, First, the result shows that the higher level interpersonal traumatic experience, the higher posttraumatic growth they have. Second, it shows that optimism and quality of relationship have partial mediating effect between interpersonal traumatic experience and posttraumatic growth. Third, it was analyzed that optimism and quality of relationship had double mediating effect. Based on these findings, the research discussion reinforced the importance of intervene with its optimism and quality of relationship in the site of those who experience interpersonal trauma. Theological, political and practical implications of this study are as follows. First, it has a series of significance in terms of that this study confirmed its influence considering the quality of relationship from interpersonal experience among relevant factors of traumatic accident, optimism among individual factors, quality of relationship among environmental factors based on 'the crisis of life and the theory of individual growth'. econd, even though optimism and quality of relationship were proved as major predictors for posttraumatic growth of those who experience interpersonal traumatic, psychological support center for traumatic experience is not operated systematically in Korea. Third, this study implies that it should intervene mainly with its optimism and quality of relationship in the site of those who experience interpersonal trauma such as any abuses including sexual abuse, bullying, and divorce.

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The impact of the presence and aspect of mandibular third molars to the mandibular angle and condyle fractures (하악 제3대구치의 존재여부 및 매복양상이 하악 우각부 골절과 과두 골절의 발생에 미치는 영향)

  • Lee, Young-Joo;Song, Yun-Jung;Hong, Soon-Min;Chae, Sang-Sik;Kang, Hyeon-Woo;Choi, Dong-Ju;Park, Jun-Woo
    • The Journal of the Korean dental association
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    • v.50 no.9
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    • pp.566-573
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    • 2012
  • Purpose : This study evaluated the impact of the presence and aspect of mandibular third molars to the mandible angle fracture or condyle fractures in Korean. Materials and Methods : A retrospective study was designed for patients attending the division of Oral and Maxillofacial Surgery, Kang-dong sacred heart hospital for treatment of mandibular fracture from January 2006 to September 2010. The primary variable was the presence of mandibular third molar and the secondary variable was the aspects of third molar impaction. Mandibular third molars were classified by the impaction depth and the available space as Pell & Gregory system. Outcome variables were the presence of mandibular angle fracture or condyle fracture. Also the source of trauma, age, sex were studied. Hospital charts, radiographs were used for study. Statistic analysis was done with descriptive statistics, the X2-test, linear-by-linear association. P value under 0.05 was considered significant statistically. Results : The number of involved patients was 86. The ratio of male to female patients was about 9:1 for angle fracture and 7:3 for condyle fracture. The most common source of trauma was assault for angle fracture and fall down for condyle fracture. The presence of mandibular third molar increased frequency of angle fracture and decreased condyle fracture with larger impaction depth. But available space of mandibular third molar did not show high association with angle or condyle fractures. Conclusion: Preventive extraction of mandibular third molar is recommended for patients with high risk of angle fracture. Male patients at their third decade or martial artists, police officer could be the case. But it is not recommended for patients with low risk of angle fracture and high risk of condyle fracture relatively. Elder female patients without any symptom on their third molar could be the case.

Clinical Analysis of the Nasal Bone Fracture (비골골절에 대한 임상적 분석)

  • Lim, Kwang-Ryeol;Kim, Hong-Il;Ahn, Sung-Min;Hwang, So-Min;Jung, Yong-Hui;Song, Jennifer K.
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.81-85
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    • 2011
  • Purpose: Nasal bone fracture is the most common facial fracture. Although nasal bone fractures are considered to be minor injuries, the incidence of post-traumatic nasal deformity remains high. This study is designed to support management and patient satisfaction by classifying the simple nasal bone fracture, and survey the care method and result, which is compared with other studies. Methods: From May 2008 to April 2010, 334 patients with simple nasal bone fractures visited our hospital. The incidence, cause, types of nasal bone fracture, treatment, and complications are analyzed according to clinical examination, patient's record and radiographic images. Results: The mean age of patients was 30 years old, with 74% of the patients having been male, and 26% were female. The highest incidence of this fracture was between late teens to late twenties. The causes of nasal bone fracture were the following: having slipped or fallen down (39%), violence (16%), sports accident (14%), traffic accident (11%), industrial accident (6%), and others (16%). Patient's radiographic images were analyzed by Stranc and Robertson classification, frontal impact plane I was 38%, plane II was 16%, plane III was 1%, lateral impact plane I was 21%, plane II was 21%, and plane III was 3%. On average, surgical treatment was performed 7.2 days after trauma under general anesthesia. Closed reduction of nasal bone fracture was performed in 99% of patients. In patients with septal injuries, septal management was performed in 76.7% of cases. Aesthetic surgery was done on same time in 24% of patients. There were some complications, such as residual nasal deformity (7.2%), nasal obstruction (0.9%) and hyposmia (0.3%). Conclusion: According to this study, nasal bone fractures occurred commonly in physically active age groups (age 15~29 years), as a result of having slipped or fallen down, at afternoon and at night time. And it could be treated successfully by closed reduction and septoplasty by 7 days after trauma.

Association between Maternal Adverse Childhood Experiences and Risk of Post-traumatic Stress Disorder in the Offspring

  • Na, Min Chull;Kim, Moon Doo;Park, Joon Hyuk;Jung, Young-Eun;Moon, Duk-Soo;Yang, Hyun-Ju;Kim, Bung-Nyun;Kang, Na Ri
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.2
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    • pp.63-70
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    • 2021
  • Objectives: Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. Methods: A total of 156 mothers with children aged 13-18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. Results: Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). Conclusion: Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.

Trend Analysis of Pediatric Dentistry Patients at Seoul National University Dental Hospital: a Study on the Impact of the COVID-19 Outbreak

  • Hee-Sun Choi;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Hong-Keun Hyun;Jung-Wook Kim;Ki-Taeg Jang;Young-Jae Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.4
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    • pp.452-468
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    • 2023
  • This study aims to investigate changes in dental service use among pediatric patients during the COVID-19 pandemic. The analysis was performed by collecting information about the number of visits, age, gender, diagnoses, and treatments for patients at the Pediatric Dentistry Department of Seoul National University Dental Hospital from January 2017 to December 2022. Compared with the period from 2017 to 2019, the total number of visits decreased during the COVID-19 pandemic, with a substantial decline in 2020. Patients in all age groups, except those aged 10 - 14, experienced decreased visits, and there was no significant gender difference. Z29.8 (need for other specified prophylactic measures) declined in all age groups, especially among those aged 0 - 4, except for those 20 years and older. K02.1 (caries of dentine) was sought by the age groups in the following order: 10 - 14, 15 - 19, 5 - 9, and 0 - 4 years, with the most significant decrease in the 0 - 4 years age group compared to others. K07.4 (malocclusion, unspecified) decreased in younger groups aged 9 and below but increased in older groups aged 10 and above. During the period from 2020 to 2022, preventive, restorative, pulp, and trauma treatments decreased, but surgical and orthodontic treatments increased compared with the previous three years. The use of sedation decreased and general anesthesia increased during COVID-19 compared to pre-pandemic. This study describes the impact of the COVID-19 pandemic on pediatric dentistry, making it a valuable reference for future pandemics.

Clinical Features of the Patients with Fracture on the Frontal Bone (전두골 골절손상 환자의 임상 고찰)

  • Kim, Sahng Hyun;Whang, Kum;Pyen, Jin Soo;Hu, Chul;Hong, Soon Ki Hong;Kim, Hun Joo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.353-359
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    • 2000
  • Objective : The fracture on the frontal bone in head-injured patients may be commonly encountered in the clinical situations. Biomechanical studies demonstrate that the anterior wall of the frontal sinus is intermediate in its ability to resist fracture on direct impact. If the frontal sinus is large and the anterior table is able to disperse the force of the impact over a greater area, the posterior table and intracranial contents usually can be spared. We analyzed the clinical features of the patients who presented with frontal skull fracture due to frontal blows. Patients and Methods : From January, 1992 to December, 1997, 172 patients with frontal skull fracture were selected among 1911 patients with head injury who were admitted to department of neurosurgery. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively. Results : The neurobehavioral changes was seen in 34 cases(19.8%) and showed statistical significances in case of facial bone fractures, acute subdural hematoma(SDH), and positive frontal lobe releasing sign(p<0.05). The good glasgow outcome score group(GOS, good recovery & moderate disability) at discharge was revealed in 77.3% of total patient population. The poor GOS group(severe disability & vegetative state & death) at discharge was revealed in 22.7%. The poor GOS group at discharge have statistical significances with acute epidural hematoma(EDH), traumatic intraventricular hemorrhage(t-IVH), traumatic intracranial lesion, poor initial glasgow coma scale(GCS) scores & Revised Trauma Score(RTS)(p<0.05). Conclusion : Because of their anatomical relationships and neurobehavioral patterns due to vulnerability of the frontal lobe, the frontal injury should be considered as complicated facial injuries. Therefore, these patients are more likely to have a cosmetic or neuropsychiatric problems.

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Surgical Treatment for Intranasal Synechiae (코안 점막유착의 치료)

  • Choi, Yo-Ahn;Choi, Hwan-Jun;Tark, Min-Seong
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.433-442
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    • 2010
  • Purpose: Many authors reported about the posttraumatic nasal aesthetic complications. However, the studies for functional or intranasal complications are not enough yet. We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae, and the synechiae formation was a frequently occurred after the nasal bone reduction. And then, the aim of this study is to identify the usefulness of the treatment of intranasal synechiae. Methods: We reviewed the data from 10 patients with symptomatic intranasal synechiae from June 2007 to June 2009. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We studied 10 patients with intranasal synechiae who had persistence postoperative symptoms. We studied the patients who were operated by removal of synechiae and ancillary surgical treatments in the last two years. Results: In the previous report, the incidence of intranasal synechiae was 15% (n=62) and symptomatic synechiae was 16% (10/62). We classified the nasal bone fracture according to Stranc classification. In this paper, the incidence of treated intranasal synechiae was 13% (2/15) in Frontal Impact (FI) Type I, 11% (2/18) in FI Type II, 100% (2/2) in FI Type III, 0% (0/2) in Lateral Impact (LI) Type I, 25% (3/12) in LI Type II, and 33% (1/3) in LI Type III, respectively. After removal of synechiae, all patients improved nasal obstruction and little improved olfactory disturbance. Conclusion: Simple removal of synechiae by scissors improved postoperative symptoms and complications such as nasal obstruction and olfactory dysfunction. After removal of synechiae, all patients improved nasal obstruction, however, little improved anosmia. So, we thought that olfactory dysfunction may result in many intranasal factors. First of all, education of delicate procedure regarding this subject should be empathized accordingly.

Clinical outcomes of a low-cost single-channel myoelectric-interface three-dimensional hand prosthesis

  • Ku, Inhoe;Lee, Gordon K.;Park, Chan Yong;Lee, Janghyuk;Jeong, Euicheol
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.303-310
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    • 2019
  • Background Prosthetic hands with a myoelectric interface have recently received interest within the broader category of hand prostheses, but their high cost is a major barrier to use. Modern three-dimensional (3D) printing technology has enabled more widespread development and cost-effectiveness in the field of prostheses. The objective of the present study was to evaluate the clinical impact of a low-cost 3D-printed myoelectric-interface prosthetic hand on patients' daily life. Methods A prospective review of all upper-arm transradial amputation amputees who used 3D-printed myoelectric interface prostheses (Mark V) between January 2016 and August 2017 was conducted. The functional outcomes of prosthesis usage over a 3-month follow-up period were measured using a validated method (Orthotics Prosthetics User Survey-Upper Extremity Functional Status [OPUS-UEFS]). In addition, the correlation between the length of the amputated radius and changes in OPUS-UEFS scores was analyzed. Results Ten patients were included in the study. After use of the 3D-printed myoelectric single electromyography channel prosthesis for 3 months, the average OPUS-UEFS score significantly increased from 45.50 to 60.10. The Spearman correlation coefficient (r) of the correlation between radius length and OPUS-UEFS at the 3rd month of prosthetic use was 0.815. Conclusions This low-cost 3D-printed myoelectric-interface prosthetic hand with a single reliable myoelectrical signal shows the potential to positively impact amputees' quality of life through daily usage. The emergence of a low-cost 3D-printed myoelectric prosthesis could lead to new market trends, with such a device gaining popularity via reduced production costs and increased market demand.