PURPOSE To compare clinical and radiographic outcomes of between two and three Kirschner wire(K-wire) intramedullary fixation for fractures in the neck of the metacarpal bone. METHODS A single institutional retrospective review identified 28 cases of metacarpal fractures between March 2010 and August 2014. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the neck of the metacarpal bone. The patient groups were divided by the number of K-wire. Outcomes were compared for range of motion of the metacarpophalangeal joint, radiographic parameters, and period until union. RESULTS The fractures were treated with either 2 Kirschner wire fixation (n=10) or 3 Kirschner wire fixation (n=18). The active range of motion of metacarpophalangeal joint and radiographic result showed no statistically significant difference between the two groups. The mean union period was 5.9 weeks. However, four cases suffered distal head perforation in 2 K-wire fixation group and one case in 3 K-wire fixation group. CONCLUSION Multiple retrograde intramedullary Kirschner wire fixation is a good treatment of choice for fractures in the neck of the metacarpal bone. To prevent metacarpal head perforation, it is preferred to use three K-wires than two K-wires.
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Factors affecting healing following percutaneous intramedullary fixation of metacarpal fractures Chul-Ho Kim, Dong Hwan Kim, Han-Vit Kang, Won Jun Kim, Minkyu Shin, Ji Wan Kim Medicine.2021; 100(50): e27968. CrossRef
PURPOSE Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. METHODS We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. RESULTS All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was 64.0+/-11.1 (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors (17.8+/-8.5 vs. 27.0+/-16.0; p=0.010). CONCLUSION With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.
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Analysis of Cultivator-related Trauma Cases in a Regional Trauma Center in the Rural Area of Gyeongbuk Province Ui Kang Hwang, Seok Hwa Youn, Chan Yong Park Journal of Trauma and Injury.2017; 30(3): 80. CrossRef
Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma caused by chordal rupture, anterior papillary muscle rupture and anterior leaflet tear. Since clinical symptoms are vague, early diagnosis is difficult and some patient exhibit symptoms of right heart failure. Right heart failure has been the traditional indication for surgical treatment, such as tricuspid valve replacement. Recently, early detection using transthoracic echocardiography and surgical treatment, like valve repair, prior to overt right heart failure have been shown to better prognosis. We report a case of traumatic tricuspid regurgitation with chordal rupture in patient due to traffic accident.
Seon Hee Kim, Sun Woo Choi, Sung Jin Park, Kwang Hee Yeo, Chang Wan Kim, Sang Bong Lee, Ho Hyun Kim, Chan Yong Park, Jae Hun Kim, Jung Joo Hwang, Hyun Min Cho
J Trauma Inj. 2015;28(2):71-74. Published online June 30, 2015
Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.
Mandible dislocation during endotracheal intubation is an unusual occurrence but easy to be overlooked for its unfamiliarity. We recently had a case of iatrogenic bilateral dislocation of a temporomandibular joint during orotracheal intubation and emphasize the importance of an early awareness of this possible complication.
Simple rib fracture is one of most common injury after blunt thoracic trauma found in approximately 7% to 40% of cases. Delayed traumatic diaphragmatic injury with massive hemothorax after rib fracture is rare but a potentially life-threatening condition. We present a rare case of a 79-year-old male with delayed diaphragmatic injury with massive hemothorax due to fracture of the lower ribs. Under thoracoscopy, hemothorax was evacuated, diaphragmatic rupture was identified and repaired, and the lower ribs were fixed with metal plate (s). Although simple lower rib fractures may be the only clinical finding, close observation and monitoring are required because of the possibility of diaphragmatic and/or intraabdominal organ injury.
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Fatal Delayed Hemothorax after Simple Rib Fracture Minju Lee, Sang Bum Lim, Hye Jeong Kim, Sohyung Park, Hongil Ha Korean Journal of Legal Medicine.2017; 41(2): 56. CrossRef
Central venous cannulation is one of the most commonly performed procedures for critically ill patients in the emergency room. Serious complications like a rupture of subclavian artery may occur during this procedure. We report a case of successful stent graft deployment for iatrogenic ruptured subclavian artery after attempted right subclavian vein catheterization in a 31 year-old female patient with hypovolemic shock due to cervical os laceration during vaginal delivery.