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Volume 31(1); 2018
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Original Articles
Clinical Analysis of the Patients with Isolated Low-Velocity Penetrating Neck Injury
Junepill Seok, Hyun Min Cho
J Trauma Inj. 2018;31(1):1-5.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.1
  • 3,592 View
  • 70 Download
AbstractAbstract PDF
Purpose

Although there has been substantial progress for the treatment of thoracic trauma, the mortality of the penetrating neck injury is still high, has been reported about 10?15%. However, there has not been a report which is reflecting Korean medical present. We retrospectively analyzed the penetrating neck injury patients based on the Korean Trauma Data Base.

Methods

Between December 2013 and June 2017 at the trauma center of the Pusan National University Hospital, Busan, Korea, total of 36 patients with isolated low-velocity penetrating neck injuries were included. We analyzed the patients’ age, gender, injury mechanism and causes by medical chart review.

Results

Among total of 36 patients, 26 (72.2%) were male and 10 (27.8%) were female. Homicidal neck injuries were most common, followed by accidental and suicidal injuries (47% vs. 33% vs. 19%, respectively). All penetrating injuries in our study were low-velocity trauma such as following: knife (n=16, 44.4%); glass or glass bottle (n=11, 30.6%); scissors (n=4, 11.1%); grinder (n=2, 5.6%); and three (8.3%) of miscellaneous injuries. Twenty-seven (75.0%) patients underwent emergency surgery, and only one (2.8%) patient underwent elective surgery. Eleven (30.6) patients were diagnosed with superficial injuries, including six patients who had conservative treatment. Twelve (33.3%) patients had arterial injuries and 10 (27.8%) patients had venous injuries. The patients who had deep injuries showed significant difference against the patient with superficial injury (98.0 vs. 129.1, p=0.008).

Conclusions

Low velocity penetrating injury confined to the neck is able to be successfully treated with prompt surgical management. Regardless of the conditions which are evaluated at emergency department, all penetrating neck injury patients should be regarded as urgent surgical candidates.

Summary
Analysis of the Importance of Sacroiliac Joint Fractures as a Prognostic Factor of the Patients with Pelvic Fractures
Yeon-Uk Ju, Jun-Min Cho, Nam-Ryeol Kim, Kyung-Bum Lee, Jin-Kak Kim, Jong-Keon Oh
J Trauma Inj. 2018;31(1):6-11.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.6
  • 3,199 View
  • 64 Download
AbstractAbstract PDF
Purpose

The diagnosis of pelvic fractures pattern has become to be essential in the decision making of treatment modality and reducing morbidity and mortality in multiple trauma patients. Sacroiliac joint (SIJ) disruption can cause life-threatening massive arterial bleeding. This study aimed to determine a method of predicting the prognosis and treatment direction with pelvis X-ray alone in the emergency room. We investigated whether SIJ disruption can be used alone as a poor prognostic factor.

Methods

We analyzed the medical records and radiologic examination results of 167 patients with pelvic fractures from January 1, 2015 to December 31, 2016 retrospectively. Patients with pathologic fractures, thoraco-abdominal bleeding, and acetabulum fractures and pediatric patients (n=63) were excluded. Factors related to the clinical manifestations and treatments, such as transfusion and surgery, were statistically compared.

Results

The cross-sectional analysis showed that there was no correlation between SIJ injury and sex; there were statistically significant relationships between occurrences of shock, conjoined fractures, transfusion, and surgeries. The hospitalization period and partial thromboplastin time and prothrombin time values increased. The logistic regression analysis showed that when an SIJ injury occurred, blood transfusion and hypotension possibilities increased.

Conclusions

When pelvic fractures occur near the SIJ, blood transfusion and shock possibilities increase. Physicians must be aware of the high severity and poor prognosis of such fractures when these are diagnosed in the emergency room. And furthermore, the physician has to predict and prepare the intensive care and multidisciplinary approaches.

Summary
Case Reports
Rib Fixation for a Patient with Severely Displaced and Overlapped Costal Cartilage Fractures
Sung Ho Han, Soon-Ho Chon, Jong Hyun Lee, Min Koo Lee, Oh Sang Kwon, Kyoung Hwan Kim, Jung Suk Kim, Ho hyoung Lee
J Trauma Inj. 2018;31(1):12-15.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.12
  • 8,333 View
  • 63 Download
AbstractAbstract PDF

Rib fixations for flail chest or displaced rib fractures are not a new technique. However, reports on rib fixations involving costal cartilage fractures are very few and surprisingly there are no reports of internal fixations involving only the costal cartilage in the English literature. The diagnosis is difficult and the necessity of the procedure may be quite controversial. Placing plates in screws into the costal cartilage alone may seem unstable and easily dislodged or stripped through the cartilage. We report a 31-year-old male scuba diver instructor who underwent rib fixations over his 7th and 8th costal cartilage ribs for severe pain. The procedure was done with conventional plates and screws. He had the plates and screws removed 2 months later due to lingering pain, but with them removed he is now quite happy with the results without pain. The procedure for fixation of painful overlapped costal cartilage is quite simple and can be done with the usual conventional methods, fixating plate and screws directly over the cartilage alone without fixation over the bony rib.

Summary
Esophageal Rupture Due to Diving in Shallow Waters
Sung Ho Han, Soon-Ho Chon, Jong Hyun Lee, Min Koo Lee, Oh Sang Kwon, Kyoung Hwan Kim, Jung Suk Kim, Ho hyoung Lee, June Raphael Chon
J Trauma Inj. 2018;31(1):16-18.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.16
  • 3,872 View
  • 55 Download
AbstractAbstract PDF

Delayed esophageal rupture due to blunt injury is not new. However, rupture due to suspected barotrauma is very rare. We describe a case of esophageal rupture in a male 24-year-old patient after diving in shallow waters. The patient was quadriplegic and could not experience the typical chest pain related to rupture and resulting mediastinitis. The rupture was discovered 4 days after emergency decompressive laminectomy and fusion for his cervical spine. The rupture was evidently caused by barotrauma and was discovered four days after admission. He underwent primary closure and pericardial flap as a life-saving procedure.

Summary
Traumatic Bilateral Diaphragmatic Ruptures in a 6-Year-Old Boy
Sung Jin Kim, Hyuck Kim, Jun Ho Lee
J Trauma Inj. 2018;31(1):19-23.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.19
  • 2,933 View
  • 41 Download
AbstractAbstract PDF

Traumatic diaphragmatic rupture is an unusual finding that may occur after blunt trauma. In addition, diaphragmatic rupture occurring bilaterally is extremely rare. We experienced a 6-year-old boy with bilateral diaphragmatic rupture, whom survived after surgical treatment by open thoracotomy but, complicated with spinal cord injury discovered after surgery.

Summary
Delayed Ascending Aorta Replacement in Blunt Chest Trauma with Aortic Injury
Shin-Ah Son, Gun-Jik Kim, Young Woo Do, Tak-Hyuk Oh
J Trauma Inj. 2018;31(1):24-28.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.24
  • 3,452 View
  • 54 Download
  • 1 Citations
AbstractAbstract PDF

Ascending aortic injury after blunt chest trauma is an emergency condition that requires urgent diagnosis and treatment. The authors report the case of a patient with traumatic ascending aortic injury who received ascending aorta replacement under cardiopulmonary bypass after failure of primary repair.

Summary

Citations

Citations to this article as recorded by  
  • Traumatic Aortic Dissection (Stanford Type A, DeBakey Type II) Caused by Blunt Chest Trauma
    Shuntaro Ito, Kenji Mogi, Manabu Sakurai, Kengo Tani, Masafumi Hashimoto, Yoshiharu Takahara
    Japanese Journal of Cardiovascular Surgery.2021; 50(1): 65.     CrossRef
Delayed Surgical Management of Traumatic Pseudoaneurysm of the Ascending Aorta in Multiple Trauma
Dae Sung Ma, Sung Jin Kim, Seok Joo, Sung Youl Hyun, Yang Bin Jeon
J Trauma Inj. 2018;31(1):29-33.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.29
  • 3,523 View
  • 49 Download
AbstractAbstract PDF

Traumatic blunt aortic injury especially on proximal ascending aorta is a rare injury with a few reports. Generally emergency surgical management was performed. In this case, however, in multiple trauma with brain injury, emergency surgical management of aortic injury might result in unexpected secondary injury of the brain. Herein, we report a case of a 33-year-old man who was driving a truck was injured in a head-on collision. Evaluation revealed a pseudoaneurysm on his ascending aorta concomitant with epidural hemorrhage. He was treated by surgical management of his ascending aorta after 3 days from accident. There were no postoperative and neurologic complications and the patient was discharged after 18 days.

Summary
Upper Extremity Deep Vein Thrombosis after Clavicle Fracture and Immobilization
Sung Jin Kim, Dae Sung Ma, Sung Youl Hyun, Yang Bin Jeon, Seok Joo, Ahram Han
J Trauma Inj. 2018;31(1):34-37.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.34
  • 3,993 View
  • 45 Download
AbstractAbstract PDF

Upper extremity deep vein thrombosis (DVT) is an unusual condition compared to lower extremity DVT, and it represents about 10% of all DVTs. We report a case of upper extremity DVT after clavicle fracture and immobilization.

Summary
A Rare Case of Lumbar Traumatic Intradiscal Hematoma Followed by Repeatative Occupation Related Minor Trauma
Woo-Keun Kwon, Jong-Keon Oh, Taek-Hyun Kwon, Youn-Kwan Park, Hong Joo Moon, Joo-Han Kim
J Trauma Inj. 2018;31(1):38-42.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.38
  • 3,640 View
  • 100 Download
AbstractAbstract PDF

A case of surgically treated intervertebral disc extrusion with intraoperatively confirmed intradiscal hematoma in a 30-year-old physical trainer is presented. Preoperative magnetic resonance imaging revealed downward migrating disc herniation, without definite suggestive findings of intradiscal hematoma. Intervertebral disc herniation with concomitant intradiscal hematoma is extremely rare, but could occur in patients who have excessive axial stress to the spine occupationally. In our case, the patient was an occupational physical trainer who had repetitive minor trauma to the lumbar spine. Although the patient did not have any clear history of major trauma to the spine, the intraoperative findings revealed intradiscal hematoma, which is very rare. The presence of intradiscal hematoma is to be suspected even when preoperative imaging studies shows indefinite findings of hematoma, considering the change in signal intensity of hematoma by time.

Summary
Bilateral Asymmetric Traumatic Dislocation of the Hip Joint
Hee Gon Park, Hyung Suk Yi, Kyoo Hong Han
J Trauma Inj. 2018;31(1):43-50.   Published online April 30, 2018
DOI: https://doi.org/10.20408/jti.2018.31.1.43
  • 4,592 View
  • 78 Download
  • 1 Citations
AbstractAbstract PDF

Traumatic hip joint dislocations account for 2?5% of total joint dislocations. Bilateral asymmetric hip joint dislocation with anteriorly and posteriorly dislocation is an even more rare case because it was according to G. Loupasis reported in 11 cases only since 1879. We want to report 2 cases of bilateral asymmetric hip joint dislocation with unilateral acatabulum fracture which happened in our hospital. Bilateral asymmetric dislocation of hip joint accompanied by unilateral fracture of acetabulum is a very rare case so statistical verification cannot be done. However, close examinations are required at early treatment and follow-up because the patterns of dislocation and fracture of hip joint are variable and an orthopedic emergent condition and several complications may occur at both hip joints.

Summary

Citations

Citations to this article as recorded by  
  • Bilateral Hip Dislocation: Unusual Injury Mechanism
    Seyed Mohammad Mousavi, Mojhgan Taghizadeh Mayani, Sayyed Majid Sadrzadeh, Paria Khosravi, Elnaz Vafadar Moradi
    Eurasian Journal of Emergency Medicine.2022; 21(1): 73.     CrossRef

J Trauma Inj : Journal of Trauma and Injury