Journal of Trauma and Injury

Original Articles

Vascularized tissue coverage of trauma and acute care surgery defects with ovine forestomach matrix: interim results of a prospective multicenter study: Michael T. Cormican, W. Matthew Vassy, Carolyn Cook, Christopher A. Butts, John Loftus, Jessica Simon, D. Adam Young, Alison A. Smith; Received April 16, 2025 Accepted September 1, 2025 Published online January 20, 2026; DOI: https://doi.org/10.20408/jti.2025.0090 [Epub ahead of print]

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Abstract PDF Supplementary Material: Purpose
Traumatic soft tissue defects present challenges due to their diverse presentations. This variability necessitates tailored approaches for effective management, requiring advanced reconstruction strategies to achieve rapid coverage and tissue infill while minimizing complications. The study aimed to evaluate the safety of ovine forestomach matrix (OFM) grafts in traumatic defects from four level I trauma centers.
Methods
This prospective observational study used a multicenter registry to collect deidentified data from adult trauma/acute care surgery patients who received OFM-based grafts for soft tissue repair from August 2022 through September 2024. After the application of OFM grafts, defects were regularly assessed for the development of vascularized tissue coverage and/or fill, and ultimately epithelialization.
Results
During the study, 49 participants with 61 soft tissue defects underwent procedures with OFM-based grafts. The mean participant age was 58.8±17.7 years. Most defects (55.7%) resulted from traumatic injuries, with additional etiologies including necrotizing soft tissue infections (13.1%), enterocutaneous fistulas (4.9%), acute pressure injuries (stages III and IV, 6.6%), surgical dehiscence (4.9%), amputations (3.3%), and hematoma evacuation (3.3%). All defects achieved vascularized tissue coverage within a median of 22.5 days (interquartile range, 13.3–33.5 days) after a median of one product application (interquartile range, 1–1). Four cases of superficial infection were reported, all resolving without major complications.
Conclusions
OFM-based grafts showed promising results in tissue regeneration for trauma and acute care defects, with minimal postoperative complications. These results are interim findings from an ongoing prospective multicenter registry study evaluating the safety and efficacy of OFM-based grafts in various surgical applications.; Summary

From trauma surgery to acute care surgery: a 4-year observational study at a single trauma center in Korea: Jung-Woo Woo, Jae Yool Jang, Yo Seok Cho, Hongkyung Shin, Chan Yong Park; J Trauma Inj. 2025;38(4):382-388. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0248

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Abstract PDF: Purpose
The acute care surgery (ACS) model establishes the capacity to immediately accommodate nontraumatic emergency surgery requiring urgent treatment while simultaneously elevating the existing trauma care system to the highest level. This study aims to evaluate the 4-year experience of operating after expanding the trauma surgery domain to ACS at this institution, which was designated as a lower-level trauma center by the local government in 2020.
Methods
A retrospective study was conducted using clinical records for patients who underwent surgery in the Division of Trauma and Acute Care Surgery over a 54-month period, from March 2021 to August 2025.
Results
Trauma volumes remained stable (10–20 cases semiannually) after ACS implementation, with surgical case numbers similar to those recorded before its introduction. Nontrauma volumes increased from 3 cases in March–August 2023 to 163 in March–August 2025.
Conclusions
The transition from the trauma surgery model to the ACS model successfully increased the efficiency of trauma and emergency general surgery within the level II low-volume environment, accomplishing without reducing the existing trauma caseload. These findings support the adoption of ACS in similar emergency medical institutions and offer insights relevant for national policy development concerning emergency general surgery in Korea.; Summary

Correlation of base deficit and age shock index with in-hospital mortality in geriatric major trauma patients: a 1-year retrospective study at a single level I trauma center in Indonesia: Miftahul Khairat Musmar Elbama, M. Iqbal Rivai, Irwan , Avit Suchitra, Aulia Rahman, Rose Dinda Martini; J Trauma Inj. 2025;38(3):204-210. Published online September 3, 2025; DOI: https://doi.org/10.20408/jti.2025.0021

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Abstract PDF: Purpose
Base deficit (BD) and age shock index have been utilized as an indicator of resuscitation adequacy and a predictor of poor outcomes in trauma cases, respectively. However, evidence regarding their correlation with in-hospital mortality among geriatric major trauma patients remains scarce in the literature.
Methods
This analytical observational study employed a retrospective cohort design involving 82 geriatric major trauma patients treated at our institution between November 2023 and November 2024. Data were collected from patients’ medical records at admission (age, trauma mechanism, vital signs, Glasgow Coma Scale [GCS], Injury Severity Score, hemoglobin, BD, and comorbidities) and at discharge (survival or death).
Results
The geriatric major trauma patients who experienced in-hospital mortality were predominantly male, with an average age of 69.6 years. Traffic accidents constituted the most common trauma mechanism. Most patients presented with a GCS score between 13 and 15, and hypertension was the most frequently recorded comorbidity. BD demonstrated a significant correlation with in-hospital mortality (P<0.05). Severe BD was associated with the highest odds of in-hospital mortality (adjusted odds ratio, 40.72; 95% confidence interval, 2.90–560.86). Although age shock index did not directly correlate with mortality, it played a confounding role. Additionally, a GCS score of <9 was significantly correlated with in-hospital mortality (P<0.05).
Conclusions
The findings of this study can inform initial clinical management strategies for geriatric major trauma patients at trauma centers. Prompt resuscitation and treatment should be prioritized for patients presenting with moderate or severe BD to reduce preventable mortality in this population.; Summary

Case Reports

Inferior vena cava injuries at a level I trauma center: a case series: Rachith Sridhar, Abdul Vakil Khan, Harendra Kumar, Abdul Hakeem, Deepak Kumar, Majid Anwer; J Trauma Inj. 2025;38(3):299-306. Published online June 27, 2025; DOI: https://doi.org/10.20408/jti.2025.0054

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Abstract PDF: Inferior vena cava (IVC) injuries are rare but deadly. Depending on the mechanism of injury, patient status, and type of injury, intervention may be surgical or endovascular. These injuries typically pose challenges in identification and treatment. During surgical intervention, rapid access and timely control of the bleeding site may be difficult. In this series, we aim to describe various IVC injuries presented at our center, detailing challenges and outcomes in their management. The study aims to characterize the presentation, interventions, and outcomes of IVC injury cases at a level I trauma center over a period of 30 months. In this report, a total of six cases of IVC injury were treated at our center. All patients underwent surgical intervention. Each patient experienced a high-energy trauma mechanism, with three patients sustaining blunt trauma and three sustaining penetrating trauma. Of the six patients, three survived while three died. Mortality was attributed to delayed presentation, complexity of injuries, and technical difficulties. Adherence to Advanced Trauma Life Support (ATLS) protocols, timely diagnosis and resuscitation, and rapid decision-making can reduce mortality associated with IVC injuries. Nonetheless, surgeons must remain cognizant of the inherent challenges and pitfalls in managing these injuries.; Summary

Endoscopic transorbital approach for the removal of a frontal lobe foreign body: a case report: Charles Gervais, Conrad Pelletier, Mathieu Laroche, Pascal Lavergne; J Trauma Inj. 2024;37(4):281-285. Published online September 25, 2024; DOI: https://doi.org/10.20408/jti.2024.0002; Correction in: https://doi.org/

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Abstract PDF: Low-velocity orbital penetrating injuries may result in an intracranial retained foreign body that requires surgical removal. We describe the endoscopic transorbital removal of a retained umbrella tip in the frontal lobe, which was secondary to trauma to the orbital roof. This technique facilitated the complete removal of the foreign body without causing additional damage to the surrounding tissue. The patient had a successful postoperative recovery. We also discuss the utility of the transorbital neuroendoscopic procedure in managing these traumatic injuries.; Summary

Treatment of a penetrating inferior vena cava injury using doctor-helicopter emergency medical service and direct-to-operating room resuscitation in Korea: a case report: Dongmin Seo, Jieun Kim, Jiwon Kim, Inhae Heo, Jonghwan Moon, Kyoungwon Jung, Hohyung Jung; J Trauma Inj. 2024;37(1):74-78. Published online January 12, 2024; DOI: https://doi.org/10.20408/jti.2023.0055

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Abstract PDF: Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.; Summary

Original Article

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

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2 Citations

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

Citations

Citations to this article as recorded by

Sternal fracture management
Bracken A. Armstrong, Steven M. Lorch, Jose J. Diaz
Current Problems in Surgery.2025; 64: 101725. CrossRef
Monitoring and Outcomes of Central Line-Associated Bloodstream Infections in a Tertiary Care Intensive Care Unit
Peter B Kharduit, Kaustuv Dutta, Clarissa J Lyngdoh, Prithwis Bhattacharyya, Valarie Lyngdoh, Annie B Khyriem, Suriya K Devi
Cureus.2024;[Epub] CrossRef

Case Reports

Rare complication of skin necrosis after endoscopic debridement and cutaneo-fascial suture for a massive Morel-Lavallée lesion in Korea: a case report: Youngmin Kim, Jayun Cho, Myung Jin Jang, Kang Kook Choi; J Trauma Inj. 2023;36(3):304-309. Published online August 25, 2023; DOI: https://doi.org/10.20408/jti.2023.0007

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Abstract PDF

A Morel-Lavallée lesion (MLL) is a pathologic fluid collection within an abnormally formed space, resulting from an internal degloving injury between the muscle fascia and subcutaneous fat layer. Due to its resistance to conservative treatments such as drainage or compression dressing, various therapeutic methods have been developed for MLL. However, no standardized guidelines currently exist. Recently, endoscopic debridement and cutaneo-fascial suture (EDCS) has been introduced for the treatment of MLL, particularly for large lesions resistant to conservative approaches. While this procedure is known to be effective, limited reports are available on potential complications. The authors present a case of skin necrosis following EDCS for a massive MLL.

Summary

Citations

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Morel-Lavallée Lesion Treated With Single-Use Portable Negative Pressure Wound Therapy: A Case Report and Literature Review
Koshi Ota, Kazuaki Shimazu, Kanna Ota, Akira Takasu
Cureus.2025;[Epub] CrossRef

Sphenoid sinus foreign body following airbag deployment in the United States: a case report: Birk J. Olson, Joseph B. Vella, Justin P. McCormick; J Trauma Inj. 2023;36(2):133-136. Published online August 16, 2022; DOI: https://doi.org/10.20408/jti.2022.0030

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1 Citations

Abstract PDF

We report a unique case of penetrating foreign bodies following a motor vehicle accident with airbag deployment. The patient presented with evidence of facial trauma and was found to have three retained foreign bodies on imaging. Notably, one foreign body was within the sphenoid sinus. This foreign body was removed uneventfully through endoscopic sinus surgery. The patient was doing well at follow-up visits. We concluded that the foreign bodies were steering wheel accessories, which detached upon airbag deployment and penetrated the patient’s face. This case report is intended to inform the public regarding the dangers of placing accessories on a steering wheel.

Summary

Citations

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Fatal Penetrative Cervical Spine Injury Following Misdeployed Airbag
Osama Said Elserafy, Faisal Mohammed Alzubaidi, Yahya Hadi Zakari, Hussam Eid Alshanawani, Fahd Geleel Alanzi, Saba Mohammed Aldusaymani, Nourah Ibraheem Alfaifi, Saeed Ali Alzahrani, Samah Fathy Ibrahim
The Saudi Journal of Forensic Medicine and Science.2024; 4(1): 26. CrossRef

Humeral intramedullary nail bending following trauma: a case report: Siem A. Willems, Alexander P. A. Greeven; J Trauma Inj. 2023;36(1):65-69. Published online June 17, 2022; DOI: https://doi.org/10.20408/jti.2022.0002

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1 Web of Science
1 Citations

Abstract PDF

The surgical approach for humeral implant failure can be challenging due to neurovascular anatomy and the possible necessity of osteosynthesis removal. We present a rare case of humeral nail bending after secondary trauma in a patient with preexistent nonunion of the humerus after intramedullary nailing. During revision surgery, the nail was sawed in half and the distal part was removed, followed by plate osteosynthesis with cable fixation to achieve absolute stability. The patient regained a full range of motion 1 year after surgery, and complete healing of the fracture was seen on imaging.

Summary

Citations

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Removal of bent intramedullary nail in diaphyseal segmental femoral fracture with intra-articular distal femoral fracture after below-knee amputation
Saurabh Gupta, Aakarsh Aggarwal, Akhil Mathew Jacob, Abhay Elhence
BMJ Case Reports.2025; 18(3): e263938. CrossRef

Management of a traumatic anorectal full-thickness laceration: a case report: Laura Fortuna, Andrea Bottari, Riccardo Somigli, Sandro Giannessi; J Trauma Inj. 2022;35(3):215-218. Published online May 19, 2022; DOI: https://doi.org/10.20408/jti.2021.0049

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Abstract PDF: The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.; Summary

Original Articles

Changes in patterns of plastic surgery emergencies at a level I trauma center in India during the COVID-19 pandemic: Veena Singh, Ansarul Haq, Sarsij Sharma, Sanjeev Kumar, Aditya Kumar, Amarjeet Kumar, Neeraj Kumar, Anil Kumar; J Trauma Inj. 2022;35(2):108-114. Published online May 11, 2022; DOI: https://doi.org/10.20408/jti.2021.0015

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Abstract PDF

Purpose
The coronavirus disease 2019 (COVID-19) pandemic has had major effects worldwide, including sudden and forceful setbacks to the healthcare system. The COVID-19 pandemic has also led to changes in the plastic and reconstructive management of emergency cases, including those due to road traffic accidents. This study analyzed changes in patterns of plastic surgery emergencies and modifications in consultation policies to minimize the exposure of healthcare workers.
Methods
Data on plastic surgery emergency calls received from the trauma and emergency department were collected for a period of 2 months before and during lockdown. The data were then analyzed with respect to the cause, mechanism, and site of the injury, as well as other variables.
Results
During lockdown, there was a 40.4% overall decrease in the plastic surgery emergency case volume (168 vs. 100). The average daily number of consultations before lockdown was 2.8 as compared to 1.6 during lockdown. Road traffic accidents remained the most common mechanism of injury in both groups (45.8% vs. 39.0%) but decreased in number during the lockdown (77 vs. 39). Household accidents, including burns, were the second most common cause of injury in both phases (7.7% vs. 20.0%), but their proportion increased significantly from 7.7.% to 20.0% in the lockdown phase (P=0.003). The percentage of minor procedures done in the emergency department increased from 53.5% to 72.0% during lockdown (P=0.002). Procedures in the operating room decreased by 73.1% during lockdown (67 vs. 18, P=0.001).
Conclusions
The COVID-19 pandemic and lockdown orders in India greatly influenced trends in traumatic emergencies as observed by the plastic surgery team at our tertiary care center. Amidst all the chaos and limitations of the pandemic period, providing safe and prompt care to the patients presenting to the emergency room was our foremost priority.

Summary

Citations

Citations to this article as recorded by

National Academy of Burns India (NABI) online tutorials: Pursuit of excellence in burns education
Veena Kumari Singh, Sanjeev Uppal, Raj Manas, Sameek Bhattacharya
Burns.2024; 50(9): 107223. CrossRef

Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients: Kyung-Chul Moon, Yu-Kyeong Yun; J Trauma Inj. 2022;35(4):261-267. Published online December 10, 2021; DOI: https://doi.org/10.20408/jti.2021.0086

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5 Web of Science
5 Citations

Abstract PDF

Purpose
With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center.
Methods
Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments.
Results
The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department.
Conclusions
The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

Summary

Citations

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Proactive Surgical Management and Outcomes of Unilateral Zygomaticomaxillary Complex Fractures in Major Trauma Patients: A National Level I Center Experience
Min Ji Kim, Jun Suk Lee, Hyoseob Lim
Journal of Craniofacial Surgery.2025; 36(5): 1520. CrossRef
Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU®
Nora Kirsten, Georg Maximilian Franke, Rolf Lefering, Tim Klüter, Matthias Weuster, Michael Müller, Sebastian Lippross, Andreas Seekamp, Stefanie Fitschen-Oestern
Frontiers in Medicine.2025;[Epub] CrossRef
Facial Subunit Transplantation: Current Concepts and Future Directions
Felix J. Klimitz, Leonard Knoedler, Helia Hosseini, Stav Brown, Samuel Knoedler, Robert L. Walton, Bohdan Pomahac, Martin Kauke-Navarro
Annals of Plastic Surgery.2025; 95(4): 427. CrossRef
Evaluation and analysis of clinical outcome prediction for trauma patients based on machine learning
Hui Shi, Yongqin Zhang, Ying Xia, Ji Cai, Haiping Yu, Li Feng, Fang Wang
Chinese Journal of Traumatology.2025;[Epub] CrossRef
Interdisziplinäres Extremitäten-Board in der Behandlung von Komplexverletzungen
T. Omar Pacha, P. Mommsen, V. Brauckmann, G. Aktas, M. Krempec, B. Wilhelmi, J.-D. Clausen, V. März, N. Krezdorn, P. M. Vogt, S. Sehmisch, J. B. Hinrichs, J. Ernst
Die Unfallchirurgie.2023; 126(3): 175. CrossRef

Adult Trauma Patients with Isolated Thoracolumbar Spinous and Transverse Process Fractures May be Managed Conservatively to Improve Emergency Department Throughput: Kyrillos Awad, Dean Spencer, Divya Ramakrishnan, Marija Pejinovska, Areg Grigorian, Sebastian Schubl, Jeffry Nahmias; J Trauma Inj. 2021;34(1):31-38. Published online February 24, 2021; DOI: https://doi.org/10.20408/jti.2020.006

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Abstract PDF: Purpose
Traumatic vertebral injuries have a prevalence of 4–5% at level I centers. Studies have demonstrated that isolated thoracolumbar transverse process fractures (iTPF) rarely require brace or surgical interventions. We hypothesized that similarly isolated thoracolumbar spinous process fractures (iSPF) would have less need for bracing and operative interventions than SPFs with associated vertebral body (VB) fractures (SPF+VB). We performed a similar analysis for iTPF compared to transverse process fractures associated with VB injury (TPF+VB).
Methods
In this single-center, retrospective study from 2012 to 2016, patients were classified into iSPF, SPF+VB, iTPF, and TPF+VB groups. Data including the fracture pattern, neurologic deficits, and operative intervention were obtained. The primary outcome studied was the need for bracing and/or surgery. A statistical analysis was conducted.
Results
Of 98 patients with spinous process fractures, 21 had iSPF and 77 had SPF+ VB. No iSPF patients underwent surgery, whereas 24 (31.17%) SPF+VB patients did undergo surgery (p=0.012). In the iSPF group, three patients (15%) received braces only for comfort, whereas 37 (48.68%) of the SPF+VB group required bracing (p=0.058). Of 474 patients with transverse process fractures, 335 had iTPF and 139 had TPF+VB. No iTPF patients underwent surgery, whereas 28 (20.14%) TPF+VB patients did (p≤ 0.001). Of the iTPF patients, six (1.86%) were recommended to receive braces only for comfort, while 68 (50.75%) of the TPF+VB patients required bracing (p<0.001).
Conclusions
No patients with iSPF or iTPF required surgical intervention, and bracing was recommended to patients in these groups for comfort only. It appears that these injures may be safely managed without interventions, calling into question the need for spine consultation.; Summary

Case Report

Large Focal Extrapleural Hematoma of Chest Wall: A Case Report: Hohyoung Lee, Sung Ho Han, Min Koo Lee, Oh Sang Kwon, Kyoung Hwan Kim, Jung Suk Kim, Soon-Ho Chon, Sung Ho Shinn; J Trauma Inj. 2019;32(2):115-117. Published online June 30, 2019; DOI: https://doi.org/10.20408/jti.2019.001

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Abstract PDF

Although hemothorax and pneumothorax are common complications seen in rib fractures, focal extrapleural hematoma is quite rare. We report a 63-year-old female patient that developed large focal extrapleural hematoma after falling off a second floor veranda. The patient had sustained 3, 4, 5th costal cartilage rib fractures and a sternum fracture. She had developed suspected empyema with loculations with small amount of hemothorax. She underwent a planned early decortication/adhesiolysis by video assisted thoracoscopic surgery at the 12th post-trauma day due to failed drainage. Unexpectedly, she had no adhesions or any significant retained hematoma mimicking a mass, but was found with the focal extrapleural chest wall hematoma. She was discharged on postoperative 46th day for other reasons and is doing fine today.

Summary

Citations

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Diverse Pattern and Postmortem Changes of Hemorrhage on Postmortem Computed Tomography: An Integrated Analysis with Autopsy
Ji-Won Jang, Joo-Young Na, Jin-Haeng Heo, Min-Jae Kim, In-Gyu Son, Sang-Beom Im, Young-ll Park
Korean Journal of Legal Medicine.2025; 49(4): 180. CrossRef

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