Journal of Trauma and Injury

Seokyong Ryu

4 Articles

The Consequence of Delayed Diagnosis of an Occult Hip Fracture: Sangbong Je, Hyejin Kim, Seokyong Ryu, Sukjin Cho, Sungchan Oh, Taekyung Kang, Seungwoon Choi; J Trauma Inj. 2015;28(3):91-97. Published online September 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.3.91

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PURPOSE
Occult hip fracture is not evident on radiographs and the diagnosis is often missed or delayed. This study was undertaken in order to identify the clinical characteristics and complications of patients with a delayed diagnosis of an occult hip fracture.
METHODS
We retrospectively reviewed patients with occult hip fracture who had normal findings on initial radiographs, the diagnosis was made on additional studies between August 2006 and February 2012. Patients who were diagnosed as having occult hip fractures at the first visit were categorized as non-delayed group and those who were not diagnosed at the first visit were categorized as delayed group.
RESULTS
Non-delayed group included 43 patients (86%). In the remaining 7 patients (delayed group), the diagnosis was delayed by a mean of 9.6 days (range 3~19 days). Patients who were diagnosed with an occult fracture on the initial visit presented later than those with a delayed diagnosis (41/43 .vs. 3/7, p=0.002). Other clinical features were no difference between the two groups. Patients in the delayed diagnosis group were more likely to have fracture displacement (4/7 .vs. 0/43)15patients in non-delayed group (34.9%) needed operative treatment, whereas all delayed patients (100%) needed operative treatment.
CONCLUSION
A delayed diagnosis of occult hip fractures was associated with increased rate of displacement and operation. In patients suspected of having occult hip fractures, additional studies should be recommended.

Summary

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APPLICATION OF ARTIFICIAL INTELLIGENCE TO ASSIST HIP FRACTURE DIAGNOSIS USING PLAIN RADIOGRAPHS
Phichai Udombuathong, Ruthasiri Srisawasdi, Waravut Kesornsukhon, San Ratanasanya
Journal of Southeast Asian Medical Research.2022; 6: e0111. CrossRef
Differential diagnosis of acute traumatic hip pain in the elderly
Matthew Hampton, Richard Stevens, Adrian Highland, Richard Gibson, Mark B Davies
Acta Orthopaedica Belgica.2021; 87(1): 1. CrossRef
The Necessity of CT Hip Scans in the Investigation of Occult Hip Fractures and Their Effect on Patient Management
Thomas Gatt, Daniel Cutajar, Lara Borg, Ryan Giordmaina, Panagiotis Korovessis
Advances in Orthopedics.2021; 2021: 1. CrossRef
Clinical characteristics and short to mid term functional outcomes of surgically treated occult hip fractures in the elderly
Sean W.L. Ho, Lynn Thwin, Ernest B.K. Kwek
Injury.2018; 49(12): 2216. CrossRef

Practical Approach to the Diagnosis of Pediatric Nasal Bone Fractures: Yulkok Lee, Sungchan Oh, Sukjin Cho, Hyejin Kim, Taekyung Kang, Seungwoon Choi, Hanbin Yoo, Seokyong Ryu; J Trauma Inj. 2014;27(4):95-100.

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Abstract PDF: PURPOSE
Nasal bone fractures are the most common childhood facial bone fractures, with an incidence of about 39%. While taking a nasal bone x-ray is a common modality used in the emergency department, reports have expressed concerns with its low sensitivity and low specificity. Our study was aimed at comparing accuracy of physical and x-ray examination with that of facial bone computed tomography (CT).
METHODS
Electronic medical records (EMR) were retrospectively reviewed for patients under the age of 15 who visited our emergency department from January 2010 to December 2011with a chief complaint of nasal pain due to trauma and who had also undergone a nasal bone x-ray and facial bone CT. Patients who had not taken facial bone CT, who had been transferred, and who did not have EMR were excluded. We divided the patients into 2 groups, those who had nasal bone fractures and those without a fracture on their facial bone CT. We analyzed other parameters such as age, sex, and type of fracture to find statistical differences between the two groups.
RESULTS
A total of 209 patients were included. The patients with nasal bone fractures on their facial bone CT were older, and their traumas were more violent. Ten patients who had apparent nasal bone fractures on their facial bone CT had no definite signs of a fracture on their plain x-ray.
CONCLUSION
Though facial bone CT is an effective modality in detecting nasal bone fractures, in evaluating younger patients suspected of having nasal bone fractures, prudent use of facial bone CT is needed to reduce unnecessary exposure to radiation.; Summary

Characteristics of Patients with Occult Hip Fracture after Hip Trauma: Wookhyun Yu, Hyejin Kim, Sukjin Cho, Sungchan Oh, Taekyung Kang, Seungwoon Choi, Seokyong Ryu; J Trauma Inj. 2013;26(3):125-130.

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Abstract PDF: PURPOSE
This study was undertaken in order to identify the characteristics of patients diagnosed with occult an hip fracture after hip trauma.
METHODS
We retrospectively reviewed the medical records and radiology reports of all patients who underwent hip skeletal computed tomography (CT) for suspected hip fractures but had normal initial X-rays after hip trauma between August 2006 and January 2012. The variables evaluated included age, gender, body mass index (BMI), accident mechanism, previous fracture, independence, late presentation, ability to bear weight, pain on passive rotation, tenderness of the groin area, diagnosis and treatment. Patients were divided into two groups, with hip fracture (occult hip fracture group) and without hip fracture (no fracture group) to evaluate the characteristics associated with an occult hip fracture.
RESULTS
The patients, a total of 139, had a mean age of 58.3 years and included 72 male patients(51.8%). The occult hip fracture group included 43 patients(30.9%). Of those 43, 21 patients(48.8%) had intertrochanteric or trochanteric fractures, 8 patients(18.6%) had femur neck fractures and 14 patients(32.6%) had acetabular fractures. Of the 43, 15 patients(34.9%) needed operative treatment. Age was higher in the occult hip fracture group than it was in the no fracture group(64.4+/-19.1 years vs. 55.5+/-23.6 years, p=0.021). A previous fracture was associated with the presence of a new fracture (p=0.014; OR=3.971, 95% CI=1.314-11.997).
CONCLUSION
Further evaluation of patients who are older or have history of fractures is prudent, even though the initial X-rays are normal.; Summary

Usefulness of the Base Deficit as an Injury-severity Indicator in Multiple-trauma Patients with Head Injuries: Bongjoo Kim, Taekyung Kang, Seungwoon Choi, Hyejin Kim, Sungchan Oh, Sukjin Cho, Seokyong Ryu; J Trauma Inj. 2012;25(4):223-229.

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Abstract PDF: PURPOSE
The arterial base deficit and the serum lactate level are widely recognized indicators of injury severity, adequacy of resuscitation and outcome. The purpose of this study is to evaluate the usefulness of the arterial base deficit as an injury-severity indicator in multiple-trauma patients with head injuries.
METHODS
Data were retrospectively collected from trauma patients over 18 years of age who had been admitted at the emergency center between October 2005 and July 2006. The patients were divided into head-injury and non-head-injury groups. These patients were then sub-divided into minor (ISS< or =15)-injury and major (ISS> or =16)-injury groups according to their injury severity scores (ISS). We analyzed the differences in the base deficits and the serum lactate levels between the major- and the minor-injury sub-groups in both the head-injury and the non-head-injury groups.
RESULTS
In the non-head-injury group, we found statistically significant differences in the arterial base deficit between the major-injury and the minor-injury sub-groups(-6.86+/-2.40 mmol/L vs. -1.37+/-0.73 mmol/L, p=0.010). In the head-injury group, no significant differences were noted between the two sub-groups(-2.50+/-1.28 mmol/L vs. -1.51+/-0.74 mmol/L, p=0.897). Moreover, the differences in arterial base deficit between the major-injury and the minor-injury sub-groups were not significant both for either single-head-trauma or multiple-head-trauma patients (p=0.643 vs. p=0.832).
CONCLUSION
We conclude that neither the arterial base deficit nor the serum lactate level can be used to predict injury severity in multiple-trauma patients with head injuries.; Summary

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