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Jae-Woo Cho 9 Articles
The impact of COVID-19 on trauma patients and orthopedic trauma operations at a single focused training center for trauma in Korea
Wonseok Choi, Hanju Kim, Whee Sung Son, Seungyeob Sakong, Jun-Min Cho, Nak-Jun Choi, Tae-Wook Noh, Namryeol Kim, Jae-Woo Cho, Jong-Keon Oh
J Trauma Inj. 2022;35(3):195-201.   Published online December 1, 2021
DOI: https://doi.org/10.20408/jti.2021.0078
  • 2,718 View
  • 67 Download
AbstractAbstract PDF
Purpose

The objective of this study was to determine the effects of coronavirus disease 2019 (COVID-19) on the volume of trauma patients, the number of orthopedic trauma operations, and the severity of injuries. We also investigated the correlations between social distancing and these variables.

Methods

This was a retrospective review of trauma patient cases at a single focused training center for trauma in Korea from January 2017 to April 2021. The COVID-19 group included patients treated from January 1 to April 30 in 2020 and 2021, and the control group included patients treated during the same months from 2017 to 2019. The volume of trauma patients according to the level of social distancing was evaluated among patients treated from August 2, 2020 to November 23, 2020.

Results

The study included 3,032 patients who presented to the emergency department with traumatic injuries from January to April 2017 to 2021. The average number of patients was 646.7 and 546.0 in the control and COVID-19 groups, respectively. The percentage of patients injured in traffic accidents (TAs) decreased from 25.0% to 18.2% (p<0.0001). The proportions of in-car TAs and pedestrian TAs also decreased from 6.7% and 10.8% to 3.5% and 6.0%, respectively (p=0.0002 and p<0.0001). The percentage of bicycle TAs increased from 2.4% to 4.0% (p=0.0128). The proportion of patients with an Injury Severity Score above 15 and the mortality rate did not change significantly. As the level of social distancing increased, the number of trauma patients and the number of trauma injuries from TAs decreased. The number of orthopedic trauma operations also depended on the social distancing level.

Conclusions

The number of trauma patients presenting to the emergency department decreased during the COVID-19 period. The volume of trauma patients and orthopedic trauma operations decreased as the social distance level increased.

Summary
Percutaneous two unilateral iliosacral S1 screw fixation for pelvic ring injuries: a retrospective review of 38 patients
Whee Sung Son, Jae-Woo Cho, Nam-Ryeol Kim, Jun-Min Cho, Nak-Jun Choi, Jong-Keon Oh, HanJu Kim
J Trauma Inj. 2022;35(1):34-42.   Published online November 3, 2021
DOI: https://doi.org/10.20408/jti.2021.0075
  • 3,951 View
  • 86 Download
AbstractAbstract PDF
Purpose
Percutaneous iliosacral (IS) screw fixation for pelvic ring injuries is a minimally invasive technique that reduces the amount of blood loss and shortens the procedure time. Moreover, two unilateral IS S1 screws exhibit superior stability to a single IS screw and are also safer for neurological injuries than an S2 screw. Therefore, this study aimed to evaluate fixation using percutaneous two unilateral IS S1 screws for pelvic ring injuries and its subsequent clinical outcomes. Methods: We retrospectively reviewed 38 patients who underwent percutaneous two unilateral IS S1 screw fixation for pelvic ring injuries. The procedure time, blood loss, achievement of bone union, radiological outcomes (Matta and Tornetta grade), and postoperative complications were evaluated. Results: The mean procedure time, hemoglobin loss, bone union rate, and time to union were 40.1 minutes (range, 18–102), 0.6 g/dL (range, 0.3–1.0), 100%, and 153.2 days (range, 61–327), respectively. The Matta and Tornetta grades were excellent, good, and fair in 24 (63.1%), 11 (28.9%), and 3 patients (7.9%), respectively, and the postoperative complications were S1 screw loosening, widening of the symphysis pubis (2.3 and 2.5 mm), lumbosacral plexopathy, and S1 radiculopathy in one (2.6%), two (5.3%), one (2.6%), and one patient (2.6%), respectively. However, all neurological complications recovered spontaneously. Conclusions: Percutaneous two unilateral IS S1 screw fixation was useful for treating pelvic ring injuries. In particular, it involved a short procedure time with little blood loss and also led to 100% bone union and good radiological outcomes.
Summary
The Effects of a Trauma Team Approach on the Management of Open Extremity Fractures in Polytrauma Patients: A Retrospective Comparative Study
Seungyeob Sakong, Eic Ju Lim, Jun-Min Cho, Nak-Jun Choi, Jae-Woo Cho, Jong-Keon Oh
J Trauma Inj. 2021;34(2):105-111.   Published online March 15, 2021
DOI: https://doi.org/10.20408/jti.2020.0043
  • 9,440 View
  • 112 Download
AbstractAbstract PDF
Purpose

Open extremity fractures require prompt antibiotic medication and initial debridement surgery to reduce the infection rate and restore functional stabilization. We aimed to report the effects and positive outcomes of a trauma team approach on the management of open extremity fractures in polytrauma patients.

Methods

This retrospective review included all polytrauma patients with open extremity fractures admitted between March 2009 and December 2019. Patients were divided into two groups according to whether they were treated before or after the implementation of the trauma team approach (March 2014). We analyzed the outcomes in each group with respect to the time interval until the doctor’s arrival, total length of stay in the emergency department, the time interval until initial antibiotic treatment and operation, whether the initial operation was performed within 24 hours, and the rate of deep infections.

Results

A total of 123 patients met the inclusion criteria. There were no statistically significant differences in demographic characteristics. The time interval until the doctor’s arrival (64.12±49.2 minutes vs. 19.82±15.23 minutes; p=0.035) and initial antibiotic treatment (115.47±72.12 minutes vs. 48.78±30.12 minutes; p=0.023) significantly improved after implementing the trauma team approach. The union rate was not significantly different. However, the time interval until initial debridement, opportunity for initial debridement within 24 hours, and the rate of deep infections demonstrated better results.

Conclusions

The reduced time interval until initial antibiotic treatment and debridement could be attributed to the positive effect of the trauma team approach on the management of open extremity fractures in polytrauma patients.

Summary
Hemorrhagic Shock in a Patient with a Morel-Lavallée Lesion Combined with Active Arterial Bleeding without Fracture
Eic Ju Lim, Jong-Keon Oh, Jae-Woo Cho, Seungyeob Sakong, Jun-Min Cho
J Trauma Inj. 2021;34(1):61-65.   Published online November 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0013
  • 3,408 View
  • 90 Download
AbstractAbstract PDF

A Morel-Lavallée lesion is a closed degloving injury caused by traumatic separation of the skin and subcutaneous tissue from the underlying fascia. However, since physicians tend to focus on treating the bone fracture, hemodynamic instability accompanying a Morel-Lavallée lesion can sometimes be overlooked. We report the case of a hemodynamically unstable 73-year-old man who had a Morel-Lavallée lesion of the thigh, but no femur fracture. Angiography showed active bleeding from the muscular branch of the right deep femoral artery, which was then successfully embolized.

Summary
Analysis of Risk Factors for Infection in Orthopedic Trauma Patients
Gi Ho Moon, Jae-Woo Cho, Beom Soo Kim, Do Hyun Yeo, Jong-Keon Oh
J Trauma Inj. 2019;32(1):40-46.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.023
  • 4,344 View
  • 117 Download
  • 3 Citations
AbstractAbstract PDF
Purpose

We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery.

Methods

We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS.

Results

Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor.

Conclusions

The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

Summary

Citations

Citations to this article as recorded by  
  • Analysis of Risk Factors and Association of Cluster of Differentiation (CD) Markers With Conventional Markers in Delayed Fracture Related Infection for Closed Fracture
    Archana Raikwar, Ajai Singh, Vikas Verma , Abbas Ali Mehdi, Narendra Singh Kushwaha, Rashmi Kushwaha
    Cureus.2021;[Epub]     CrossRef
  • Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen
    Kyunghak Choi, Kwang-Hwan Jung, Min Ae Keum, Sungjeep Kim, Jihoon T Kim, Kyu-Hyouck Kyoung
    Journal of Trauma and Injury.2020; 33(1): 18.     CrossRef
  • Characterization and Antibiofilm Activity of Mannitol–Chitosan-Blended Paste for Local Antibiotic Delivery System
    Leslie R. Pace, Zoe L. Harrison, Madison N. Brown, Warren O. Haggard, J. Amber Jennings
    Marine Drugs.2019; 17(9): 517.     CrossRef
Management and Outcome of Patients with Acetabular Fractures: Associated Injuries and Prognostic Factors
Do-Hyun Yeo, Jong-Keon Oh, Jae-Woo Cho, Beom-Soo Kim
J Trauma Inj. 2019;32(1):32-39.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.016
  • 3,582 View
  • 63 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

The aim of this study was to determine which factors contribute to the surgical treatment outcomes of acetabular fractures. Simultaneously, we aim to report on the treatment results after our hospital was designated as the focused training center for trauma.

Methods

We conducted a retrospective review of all patients who experienced acetabular fractures from January 1, 2014 to May 1, 2017 and visited our hospital. Patients who had associated pelvic ring fractures or were lost to the one-year follow-up were excluded; a total of 37 fractures were evaluated. We evaluated the clinical results using the scoring system of Merle d’Aubign? (MDA) and grade of Brooker for heterotopic ossification.

Results

Thirty-seven patients (31 men and 6 women) were identified. The mean injury severity score (ISS) was 8.7, with 32.4% of patients having a score >15. The average blood transfusion in the first 24 hours was 0.54 pints. Falling was the most common injury mechanism (32.4%). Chest injury was the most common associated injury (16.2%), followed by head injury (13.5%). The posterior wall and both column fracture were the most common (37.8%) fracture patterns. Excellent and good clinical grades of MDA included 28 patients (75.6%) and fair and poor grades included nine (24.3%), respectively. Four patients were diagnosed with a post-operative infection (10.8%); one out of four patients who had co-morbidity died (2.7%), and another patient underwent a replacement surgery (2.7%). Multivariate analysis showed that age and operation time were associated with MDA. In addition, operation time and ISS were significant co-factors of the Brooker grade.

Conclusions

Korea University Guro Hospital showed similar treatment results of acetabular fractures compared to other publications. The age and operation time were co-factors of the clinical outcome of this fracture. Additionally, increased operation time and injury severity score were suggested to increase the Brooker grade.

Summary

Citations

Citations to this article as recorded by  
  • Outcome of acetabulum fractures treated with open reduction and internal fixation through Kocher-Langenbeck Approach: A retrospective study
    Dharmendra Kumar, Narendra Singh Kushwaha, Prakash Gaurav Tiwari, Yashvardhan Sharma, R.N. Srivastava, Vineet Sharma
    Journal of Clinical Orthopaedics and Trauma.2021; 23: 101599.     CrossRef
  • FUNCTIONAL AND RADIOLOGICAL OUTCOMES OF ACETABULAR FRACTURES
    Sangam Jain, Dishit Vaghasia, Tanay Nahatkar, Spandan Koshire, Amol Salve, Vinod Kumar Yadav
    INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2021; : 1.     CrossRef
Minimally Invasive Stabilization with Percutaneous Screws Fixation of APC-3 Pelvic Ring Injury
Beom-Soo Kim, Jong-Keon Oh, Jae-Woo Cho, Do-Hyun Yeo, Jun-Min Cho
J Trauma Inj. 2019;32(1):60-65.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.015
  • 5,713 View
  • 118 Download
AbstractAbstract PDF

Pelvic fractures are associated with life-threatening injuries and high rates of morbidity and mortality. Management of internal blood loss associated with unstable pelvic ring injuries is paramount during the initial period. The reconstruction of the pelvic ring is of importance because it is a major contributor to the stability of the pelvic ring. We report the case of a 25-year-old man who had an unstable pelvic ring fracture combined with rupture of an obturator artery and had a successful and satisfactory treatment using minimally invasive surgery with percutaneous antegrade screw fixation.

Summary
Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail
Beom-Soo Kim, Jae-Woo Cho, Do-Hyun Yeo, Jong-Keon Oh
J Trauma Inj. 2018;31(2):96-102.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.96
  • 10,593 View
  • 256 Download
AbstractAbstract PDF

Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

Summary
Proximal Tibia Fracture after Proximal Tibia Autograft Harvest
Jin-Kak Kim, Jong-Hyeop Song, Kyungbum Lee, Jae-Woo Cho, Ki-Ho Moon, Do-Hyun Yeo, Beom-Soo Kim, Jong-Keon Oh
J Trauma Inj. 2017;30(4):247-252.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.247
  • 5,663 View
  • 54 Download
  • 1 Citations
AbstractAbstract PDF

Bone-grafting procedures are common in orthopedic trauma surgeries. There are only few reports on the morbidity after proximal tibia harvesting. Here, we report an experience of complication after proximal tibia harvesting while treating subtrochanteric femoral osteomyelitis.

Summary

Citations

Citations to this article as recorded by  
  • Novel Vacuum-Assisted Method for Harvesting Autologous Cancellous Bone Graft and Bone Marrow From the Proximal Tibial Metaphysis
    Adam M. Lukasiewicz, Paul S. Bagi, Kristin E. Yu, Vineet Tyagi, Raymond J. Walls
    Foot & Ankle Orthopaedics.2021; 6(1): 247301142098190.     CrossRef

J Trauma Inj : Journal of Trauma and Injury