• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.5
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• pp.259-264
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• 2016

Objectives: We evaluated and recorded post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve (IAN) in mandibular fracture in order to identify associated risk factors. Materials and Methods: This was a prospective cohort study composed of 60 patients treated for mandibular fracture. The primary study variable was the change between the post-traumatic IAN neurosensory examination score and the score after fracture reduction. Risk factors were categorized as demographic, anatomic, fracture displacement, and treatment. Appropriate descriptive and bivariate statistics were computed. Results: Sixty patients with unilateral mandibular fracture reported within 24 hours of injury were evaluated over a one-year period. A post-traumatic neurosensory deficit was observed in 52 patients (86.7%), the percentage of which was reduced to 23.3% over the follow-up period. Abnormal postoperative neurosensory scores were significantly higher in angle fracture cases (33.3%) compared to body fracture cases (11.1%). When recovered and non-recovered neurosensory scores were compared by fracture location, 88.9% of body fracture cases showed significant recovery compared to 66.7% of mandibular angle fracture cases. Cases with less than 5 mm fracture displacement showed statistically significantly higher neurosensory recovery scores (90.6%) compared to those with more than 5 mm fracture displacement (60.7%). Conclusion: Use of a miniplate with mono-cortical screws does not play a role in increasing IAN post-traumatic neurosensory deficit. Early management can reduce the chances of permanent neurosensory deficit. Mandibular fracture displacement of 5 mm or more and fracture location were found to be associated with an increased risk of post-traumatic IAN neurosensory score worsening.

• Korean Journal of Applied Biomechanics
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• v.19 no.4
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• pp.647-653
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• 2009

The purpose of this study was to investigate the differences between female and male ballet dancers in anterior cruciate ligament injury risk factors during the box drop landing task. Nine female and nine male collegiate ballet dancers participated in this study. Kinematic and ground reaction data were collected and combined with inverse dynamics to estimate the knee extensor and abductor moment. EMG data from the biceps femoris and rectus femoris were used to estimate the ratio of quadriceps-hamstrings muscle activity. No gender differences in anterior cruciate ligament injury risk factors were found during the box drop landing task. A significant relationship was found between female and male ballet dancers in the knee flexion angle.

• Journal of Korean Foot and Ankle Society
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• v.22 no.3
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• pp.95-99
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• 2018

Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson's chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16~57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

• Journal of the Society of Disaster Information
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• v.15 no.1
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• pp.20-27
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• 2019

Purpose: In this study, the status and the risk of fire occurrence in domestic automobile were evaluated and the damage reduction effect by using the fire extinguishing mechanism was evaluated. Method: The analysis of the risk of the occurrence of Vehicle Fires in Korea and the damage of human and property by the use of fire extinguisher applied to fire extinguisher were investigated and analyzed. Results: The annual damage rate of the damage caused by the automobile fire is 4.74%, which shows an annual increase. As a result of the analysis of the personal injury caused by the passenger car in the car fire situation, the damage amount per 100 cases of the fire occurrence increased from 424.65 million won to 473.06 million won in the past 5 years (2012 ~ 2016). Conclusion: When fire extinguishers are used in the case of passenger Vehicle Fires, the average amount of property damage per fire occurrence is estimated to be about 307.5 million, emphasizing the importance and necessity of the initial fire fighting.

• The Journal of Korean Society for School & Community Health Education
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• v.23 no.4
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• pp.29-39
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• 2022

Objectives: The purpose of this study was to assess the incidence of delivery and puerperium complications in South Korea and analyze the correlations between the patient's characteristics and delivery and complications before and after 10 years. Methods: This study used the data from an Korean National Hospital Discharge In-depth Injury Survey. Cases of which the principal diagnosis and second diagnoses were disease classification ICD code O00-O99(Pregnancy, childbirth and the puerperium) were defined as the study subjects, and the first study group was divided as the year of discharge from 2005 to 2007, and the second study group from 2015 to 2017. Results: The number of patients discharged whose principal diagnosis or second diagnoses was O00-O99 was 21,598(Weighted 423,306) from 2005 to 2007 and 19,028(Weighted 364,384) from 2015 to 2017, which decreased by 13.9% compared to 10 years ago. The average age of discharged patients increased by about 2 years and was statistically significant (p<.0001). Factors associating spontaneous delivery, caesarean section and puerperium complication were hospitalization route, bed size, maternal age, length of hospital stay, and the year of discharge. Conclusion: Based on the results of this study, health and education policies and economic support for medical care for high-risk pregnancy and delivery management would be necessary continuously. In addition, policies to strengthen the medical system for high-risk pregnancy management in non-metropolitan areas with high fertility rates would also be needed.

• Hip & pelvis
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• v.36 no.1
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• pp.47-54
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• 2024

Purpose: Venous thromboembolism (VTE) is a major complication for hip fracture patients, and may exist preoperatively. This study aimed to examine the prevalence of VTE after immediate screening in hip fracture patients. Materials and Methods: Hip fracture patients with an elevated level of D-dimer underwent screening for VTE using computed tomography (CT) angiography. Anticoagulation treatments were administered preoperatively to patients diagnosed with VTE, followed by administration of additional anticoagulation postoperatively. Medical records were reviewed to identify risk factors for preoperative VTE and determine the prognosis of the patients. Results: Among 524 hip fracture patients, 66 patients (12.6%) were diagnosed with VTE, including 42 patients with deep vein thrombosis (DVT), 17 patients with pulmonary thromboembolism (PTE), and 7 patients with both DVT and PTE. Of the patients with VTE, 68.2% were diagnosed within 24 hours of injury, and 33.3% of these patients had PTE. VTE patients showed a tendency toward being overweight (P<0.01) and not on anticoagulant medication (P=0.02) compared to patients without VTE. The risk of VTE was higher for femur shaft fractures (odds ratio [OR] 4.83, 95% confidence interval [CI] 2.18-10.69) and overweight patients (OR 2.12, 95% CI 1.17-3.85), and lower for patients who were previously on anticoagulants (OR 0.36, 95% CI 0.18-0.74). Patients with preoperatively diagnosed VTE were asymptomatic before and after surgery. Conclusion: Clinicians should be aware that VTE may be present within 24 hours of injury, and screening for VTE or prophylactic measures should be considered for high-risk patients.

• Physical Therapy Korea
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• v.26 no.2
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• pp.34-48
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• 2019

Background: Fall-related injuries in older adults are a major health problem, and the risks and mechanisms of these injuries should be affected by race, culture, living environment, and/or economic status. Objects: Research articles have been systematically reviewed to understand fall-related injuries in older adults in South Korea. Methods: 128 published research papers have been found through the Korea Citation Index and the Korean Studies Information Service System, and reviewed in various perspectives, including incidents, fall death rates, medical costs, causes, injury sites and types, locations where falls occurred, prevention strategies, scholarly fields interested in fall injuries, and the role of physical therapy. Results: Fall-related injuries were found to be more common in women than in men, and the number of incidents increased with age, with the highest rate found in individuals over 85 years old. Risk of fall injury was associated with education level, comorbidities, and fear of falling. Common places where falls occurred included the bathroom, living room, stairs, and hallway. Common types of injury included bruises, fractures, and sprains in the lower extremities. Intervention strategies included exercise programs, education, and protective clothing. Scholarly fields interested in fall-related injuries in older adults included medicine, nursing, physical therapy, occupational therapy, physical education, pharmacology, oriental medicine, biomedical engineering, design, clothing, and textiles. Physical therapy intervention using proprioceptive neuromuscular facilitation has been used to improve one's balance. Conclusion: Any movement during the activities of daily living can lead to a fall. Physical therapists are highly educated to analyze human movements and should be involved in more research and practices to solve fall-related injuries in older adults.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.332-339
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• 2023

Objective : The present study aimed to investigate the clinical characteristics of electrolyte imbalance in patients with moderate to severe traumatic brain injury (TBI) who underwent craniotomy and its influence on prognosis. Methods : A total of 156 patients with moderate to severe TBI were prospectively collected from June 2019 to June 2021. All patients underwent craniotomy and intracranial pressure (ICP) monitoring. We aimed to explore the clinical characteristics of electrolyte disturbance and to analyze the influence of electrolyte disturbance on prognosis. Results : A total of 156 patients with moderate and severe TBI were included. There were 57 cases of hypernatremia, accounting for 36.538%, with the average level of 155.788±7.686 mmol/L, which occurred 2.2±0.3 days after injury. There were 25 cases of hyponatremia, accounting for 16.026%, with the average level of 131.204±3.708 mmol/L, which occurred 10.2±3.3 days after injury. There were three cases of hyperkalemia, accounting for 1.923%, with the average level of 7.140±1.297 mmol/L, which occurred 5.3±0.2 days after injury. There were 75 cases of hypokalemia, accounting for 48.077%, with the average level of 3.071±0.302 mmol/L, which occurred 1.8±0.6 days after injury. There were 105 cases of hypocalcemia, accounting for 67.308%, with the average level of 1.846±0.104 mmol/L, which occurred 1.6±0.2 days after injury. There were 17 cases of hypermagnesemia, accounting for 10.897%, with the average level of 1.213±0.426 mmol/L, which occurred 1.8±0.5 days after injury. There were 99 cases of hypomagnesemia, accounting for 63.462%, with the average level of 0.652±0.061 mmol/L, which occurred 1.3±0.4 days after injury. Univariate regression analysis revealed that age, Glasgow coma scale (GCS) score at admission, pupil changes, ICP, hypernatremia, hypocalcemia, hypernatremia combined with hypocalcemia, epilepsy, cerebral infarction, severe hypoproteinemia were statistically abnormal (p<0.05), while gender, hyponatremia, potassium, magnesium, intracranial infection, pneumonia, allogeneic blood transfusion, hypertension, diabetes, abnormal liver function, and abnormal renal function were not statistically significant (p>0.05). After adjusting gender, age, GCS, pupil changes, ICP, epilepsy, cerebral infarction, severe hypoproteinemia, multivariate logistic regression analysis revealed that hypernatremia or hypocalcemia was not statistically significant, while hypernatremia combined with hypocalcemia was statistically significant (p<0.05). Conclusion : The incidence of hypocalcemia was the highest, followed by hypomagnesemia, hypokalemia, hypernatremia, hyponatremia and hypermagnesemia. Hypocalcemia, hypomagnesemia, and hypokalemia generally occurred in the early post-TBI period, hypernatremia occurred in the peak period of ICP, and hyponatremia mostly occurred in the late period after decreased ICP. Hypernatremia combined with hypocalcemia was associated with prognosis.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.236-239
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• 2017

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.