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- A decade of treating traumatic sternal fractures in a single-center experience in Korea: a retrospective cohort study
- Na Hyeon Lee, Seon Hee Kim, Jae Hun Kim, Ho Hyun Kim, Sang Bong Lee, Chan Ik Park, Gil Hwan Kim, Dong Yeon Ryu, Sun Hyun Kim
- J Trauma Inj. 2023;36(4):362-368. Published online November 30, 2023
- DOI: https://doi.org/10.20408/jti.2023.0027
- 673 View
- 33 Download
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Abstract
PDF - Purpose
Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution.
Methods
A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encompassed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain.
Results
Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5–18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3–23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3–48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention.
Conclusions
Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with offset-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications. -
Summary
- Clinical characteristics of patients with the hardware failure after surgical stabilization of rib fractures in Korea: a case series
- Na Hyeon Lee, Sun Hyun Kim, Seon Hee Kim, Dong Yeon Ryu, Sang Bong Lee, Chan Ik Park, Hohyun Kim, Gil Hwan Kim, Youngwoong Kim, Hyun Min Cho
- J Trauma Inj. 2023;36(3):196-205. Published online September 5, 2023
- DOI: https://doi.org/10.20408/jti.2023.0026
- 1,218 View
- 49 Download
- 1 Citations
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Abstract
PDF
- Purpose
Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors.
Methods
We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed.
Results
During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity.
Conclusions
HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure. -
Summary
Citations
Citations to this article as recorded by
- Komplikationen nach operativer vs. konservativer Versorgung des schweren Thoraxtraumas
Lars Becker, Marcel Dudda, Christof Schreyer
Die Unfallchirurgie.2024; 127(3): 204. CrossRef
Case Report- Gastric necrosis after gastric artery embolization in a patient with blunt abdominal trauma: a case report
- Gil Hwan Kim, Sung Jin Park, Chan Ik Park
- J Trauma Inj. 2022;35(4):287-290. Published online December 20, 2022
- DOI: https://doi.org/10.20408/jti.2022.0054
- 1,321 View
- 34 Download
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Abstract
PDF
- Gastric artery bleeding after blunt trauma is rare. In such cases, if vital signs are stable, angiographic embolization may be performed. Although gastric artery embolization is known to be safe due to its anatomical properties, complications may occur. We report a case of gastric necrosis after gastric artery embolization in a patient with blunt abdominal trauma. The 55-year-old male patient was found with gastric arterial bleeding after a traffic accident. His vital signs were stable, and gastric artery embolization was performed. Gastric necrosis was subsequently found, which was treated surgically.
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SummaryOriginal Article
- Incidence and Clinical Features of Urethral Injuries with Pelvic Fractures in Males: A 6-Year Retrospective Cohort Study at a Single Institution in South Korea
- Hyun Woo Sun, Hohyun Kim, Chang Ho Jeon, Jae Hoon Jang, Gil Hwan Kim, Chan Ik Park, Sung Jin Park, Jae Hun Kim, Seok Ran Yeom
- J Trauma Inj. 2021;34(2):98-104. Published online April 2, 2021
- DOI: https://doi.org/10.20408/jti.2020.0034
- 3,310 View
- 139 Download
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Abstract
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Purpose Severe pelvic fractures are associated with genitourinary injuries, but the relationship between pelvic trauma and concomitant urethral injuries has yet to be elucidated. This study evaluated the incidence, mechanism, site, and extent of urethral injuries in male patients with pelvic fractures.
Methods A retrospective cohort study was performed involving patients with urethral injuries accompanying pelvic fractures who visited Pusan National University Hospital from January 1, 2014 to December 31, 2019. Demographics, mechanisms of injury, clinical features of the urethral injuries, concomitant bladder injuries, methods of management, and the configuration of the pelvic fractures were analyzed.
Results The final study population included 24 patients. The overall incidence of urethral injury with pelvic fracture was 2.6%, with the most common mechanism of urethral injury being traffic accidents (62.5%). Complete urethral disruption (16/24, 66.7%) was more common than partial urethral injuries (8/24, 33.3%), and unstable pelvic fractures were the most common type of pelvic fracture observed (70.8%). There was no definitive relationship between the extent of urethral injury and pelvic ring stability.
Conclusions The present study provides a 6-year retrospective review characterizing the incidence, mechanism, and clinical features of urethral injury-associated pelvic fractures. This study suggests that the possibility of urethral injury must be considered, especially in unstable pelvic fracture patients, and that treatment should be chosen based on the clinical findings.
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SummaryCase Reports
- Blunt Transection of the Entire Anterolateral Abdominal Wall Musculature Following Seatbelt-Related Injury
- Hohyun Kim, Jae Hun Kim, Gil Hwan Kim, Hyun-Woo Sun, Chan Ik Park, Sung Jin Park, Chan Kyu Lee, Suk Kim
- J Trauma Inj. 2020;33(2):128-133. Published online June 30, 2020
- DOI: https://doi.org/10.20408/jti.2020.0006
- 6,693 View
- 103 Download
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Abstract
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Traumatic abdominal wall hernias (TAWHs) are uncommon and the incidence of this, which is rarely encountered in clinical practice, has been estimated at 1%. Furthermore, blunt transection of the entire abdominal wall musculature caused by seatbelt is a very rare complication. We report a case of adult with a complete disruption of the entire anterolateral abdominal wall muscle following the seatbelt injury. A 32-year-old male was wearing a seat belt in a high speed motor vehicle collision. Abdominal computed tomography (CT) scan revealed the complete disruption of bilateral abdominal wall musculatures including TAWH without visceral injury. However, injuries of small bowel and sigmoid colon were observed in the intra-operative field. The patient underwent the repair by primary closure of the defect with absorbable monofilament sutures. This case suggests that especially in TAWH patients, even if a CT scan is normal, clinicians should keep the possibility of bowel injury in mind, and choose a treatment based on the clinical findings.
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Summary
- Hepatic Hemangioma Rupture Caused by Blunt Trauma
- Gil Hwan Kim, Jae Hun Kim, Sang Bong Lee
- J Trauma Inj. 2017;30(4):235-237. Published online December 30, 2017
- DOI: https://doi.org/10.20408/jti.2017.30.4.235
- 5,290 View
- 47 Download
- 1 Citations
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Abstract
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Hepatic hemangioma is the most frequently occurring benign tumor of the liver. Hepatic hemangioma rupture is a rare phenomenon, which can lead to life-threatening conditions. Here, we report a case of hepatic hemangioma rupture caused by blunt trauma. Explorative laparotomy was performed due to unstable vital signs and abdominal massive hemoperitoneum revealed on computed tomography. We detected arterial bleeding from a hepatic hemangioma and performed primary suture of the liver and postoperative angiographic embolization.
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Summary
Citations
Citations to this article as recorded by- Post‐traumatic rupture of hepatic haemangioma
Tessa Gaynor, Vanshika Sinh, Jonathan Reddipogu
ANZ Journal of Surgery.2023; 93(11): 2754. CrossRef
- Rectus Sheath Hematoma Caused by Noncontact Strenuous Exercise
- Gil Hwan Kim, Jae Hun Kim, Ho Hyun Kim
- J Trauma Inj. 2017;30(4):227-230. Published online December 30, 2017
- DOI: https://doi.org/10.20408/jti.2017.30.4.227
- 3,186 View
- 35 Download
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Abstract
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Rectus sheath hematoma (RSH) is an uncommon but well-documented clinical condition. It is usually caused by direct trauma or anticoagulation, although there are many other causes. However, RSH after noncontact strenuous exercise is very rare. We present a rare case of RSH after playing volleyball without direct trauma that was successfully treated by angiographic embolization.
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