Journal of Trauma and Injury

Volume 29(1); March 2016

Original Articles

The Surgical Outcome for Patients with Tracheobronchial Injury in Blunt Group and Penetrating Group: Chang Wan Kim, Jung Joo Hwang, Hyun Min Cho, Jeong Su Cho, Ho Seok I, Yeong Dae Kim, Do Hyung Kim; J Trauma Inj. 2016;29(1):1-7. Published online March 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.1.1

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PURPOSE
Tracheobronchial injuries caused by trauma are rare, but can be life threatening. The objective of this study was to evaluate the surgical outcome for patients with tracheobronchial injuries and to determine the difference, if any, between the outcomes for patients with penetrating trauma and those for patients with blunt trauma.
METHODS
From January 2010 to June 2015, 40 patients underwent tracheobronchial repair surgery due to trauma. We excluded 14 patients with iatrogenic injuries, and divided the remaining 26 into two groups.
RESULTS
In the blunt trauma group, injury mechanisms were motor vehicle accident (9 cases), free falls (3 cases), flat falls (1 case) and mechanical injury (1 case). In the penetrating trauma group, injury mechanisms were stab wounds (10 cases), a gunshot wound (1 case) and a stab wound caused by metal pieces (1 case). The mean RTS (Revised Trauma Score) was 6.89±1.59 (range: 2.40-7.84) and the mean ISS (Injury Severity Score) was 24.36±7.16 (range: 11-34) in the blunt group; the mean RTS was 7.56±0.41 (range: 7.11-7.84), and the mean ISS was 13±5.26 (range: 9-25) in the penetrating trauma group. In the blunt trauma group, 9 primary repairs, 1 resection with end-end anastomosis, 2 lobectomies, 1 sleeve bronchial resection and 1 pneumonectomy were performed. In the penetrating trauma group, 10 primary repairs and 2 resections with end-end anastomosis were performed. Complications associated with surgery were found in one patient in the blunt trauma group, and one patient in the penetrating trauma group. No mortalities occurred in either groups.
CONCLUSION
Surgical management of a traumatic tracheobronchial injury is a safe procedure for both patients with a penetrating trauma and those with a blunt trauma.

Summary

Citations

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A Case of Total Laryngectomy after Severe Penetrating Laryngeal Trauma
Youngjin Cho, Sung-Chan Shin, Byung-Joo Lee, Yong-Il Cheon
Journal of Clinical Otolaryngology Head and Neck .2022; 33(4): 250. CrossRef
Damage Control of Laryngotracheal Trauma: The Golden Day
Mario Alain Herrera, Luis Fernando Tintinago, William Victoria, Carlos Alberto Ordoñez, Michael Parra, Mateo Betancourt-Cajiao, Yaset Caicedo, Monica Guzman, Linda M. Gallego, Adolfo Gonzalez Hadad, Luis Fernando Pino, Jose Julian Serna, Alberto García, C
Colombia médica.2020;[Epub] CrossRef

Effect on Trauma Patients of Having Even One General Trauma Surgeon on Duty: Jang Whan Jo, Jun Min Cho, Nam Ryeol Kim; J Trauma Inj. 2016;29(1):8-13. Published online March 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.1.8

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PURPOSE
Specialized general trauma surgeons play an important role in the care of trauma patients. Hemoperitoneum is a severe, but representative, condition following a life-threatened trauma. The objective of this study was to compare the outcomes for polytrauma patients with hemoperitoneum between the periods during which a trauma surgeon was available and that unavailable.
METHODS
Thirty-one trauma patients with hemoperitoneum who were treated at Korea University Guro Hospital over a period of 4 years were included in this study, and their case records were analyzed retrospectively. The patients were divided into two groups, the 2011 and 2012 group and the 2013 and 2014 group corresponding, respectively, to the periods that a trauma surgeon was not and was working. Vital signs on admission, scores on the injury severity scale and, Glasgow coma scale, elapsed time to diagnostic, and therapeutic, and/or operative interventions were studied. The effects on intensive care unit and hospital lengths of stay, as well as mortality, were also studied.
RESULTS
The study population consisted of 16 and 15 patients in group 1 and 2, respectively. The patients in both groups had six unstable hemodynamic on admission. The time to the main procedure (intervention, operation etc.) was longer during the periods when a trauma surgeon was not working than it was during the period when working. This difference did not reached statistical significance. The mortality rates for the two groups were not statistically different either (18.75% vs 26.67%; p=0.928).
CONCLUSION
Having at least one specialized general trauma surgeon on duty may reduce the time to intervention and surgery for severe trauma patients with hemoperitoneum, but appears to have no effect on the mortality rates. In conclusion, having only one trauma surgeon on duty does not improve the quality of care for trauma patients.

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Significance of orthopedic trauma specialists in trauma centers in Korea
Yong-Cheol Yoon, Chang-Wug Oh, Jong-Keon Oh
Archives of Orthopaedic and Trauma Surgery.2019; 139(10): 1379. CrossRef

Treatment of Thoracolumbar and Lumbar Unstable Burst Fractures by Using Combined and Posterior Surgery: Jong Ki Shin, Tae Sik Goh, Seung Min Son, Jung Sub Lee; J Trauma Inj. 2016;29(1):14-21. Published online March 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.1.14

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PURPOSE
The purpose of this research was to analyze the results of the combined and posterior approaches for treating thoracolumbar and lumbar burst fractures and to find an adequate method of treatment.
METHODS
We retrospectively analyzed the cases of 46 patients with unstable thoracolumbar and lumbar burst fractures who had been surgically treated. All cases were divided into two groups based on the operation method used. Eleven patients had undergone the combined approach, while 35 patients had undergone the posterior approach. Radiological and clinical evaluations were performed before surgery, after surgery, and at the final follow-up.
RESULTS
The stenotic ratios of the area occupied by the retropulsed bony fragments to the estimated area of the original spinal canal were 68.2% and 45.6% for the combined and the posterior approaches, respectively. No significant differences in the neurological improvement or the corrected state of the sagittal index were noted, but the patients who had been treated with the combined approach group had better results than those who had been treated with the posterior approach group in terms of correction and maintenance of the sagittal index. The average kyphosis corrections at the final follow-up were 15.3 degrees for the patients in the combined approach group and 10.0 degrees for those in the posterior approach group. Surgical time and estimated blood loss were all significantly higher for patients in the combined approach group.
CONCLUSION
The combined and the posterior approaches showed similar results in the improvements of the neurologic state and the corrected state of the sagittal index. However, use of the combined approach is recommended for patients with severe kyphosis and with severe canal encroachment.

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Vertebrae at the thoracolumbar junction: A quantitative assessment using CT scans
Anneli Du Plessis, Albert Van Schoor, Quenton Wessels, Patrick Murphy, Francois Van Schouwenburg, Pulenge Ihuhua, Jana Kehrmann, Magda Scholtz, Natalie Keough
Journal of Anatomy.2022; 240(6): 1179. CrossRef
Minimally invasive reduction of thoracolumbar burst fracture using monoaxial percutaneous pedicle screws: Surgical technique and report of radiological outcome
Weng Hong Chung, Wei Cheong Eu, Chee Kidd Chiu, Chris Yin Wei Chan, Mun Keong Kwan
Journal of Orthopaedic Surgery.2020; 28(1): 230949901988897. CrossRef
Differentiation and classification of thoracolumbar transitional vertebrae
Anneli M. Du Plessis, Linda M. Greyling, Benedict J. Page
Journal of Anatomy.2018; 232(5): 850. CrossRef

Clinical Outcome of a Precontoured Symphysis Pubis Plate with Tension Band Wiring for Traumatic Symphysis Pubis Rupture in Pelvic Fractures: Jeong Moon Lee, Sun Jung Yoon, Myung Sik Park, Kyung Jin Song; J Trauma Inj. 2016;29(1):22-27. Published online March 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.1.22

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PURPOSE
The optimal method of fixation of symphysis pubis (SP) diastasis in pelvic ring injuries is still controversial. In this study, we investigated the radiological and the clinical results of a precontoured 4.5-mm symphysis pubis (SP) plate with tension band wiring (TBW) after an anterior pelvic injury in pelvic fractures.
METHODS
We treated 25 patients with traumatic SP diastasis by open reduction and internal fixation with plates and wires. We used a four-hole 4.5-mm precontoured SP plate with a tension band wiring.
RESULTS
Patients with a SP with TBW fixation achieved excellent or good results at final follow-up. Post-operative complications included two (8%) patients with metal work movement. The mean symphyseal width was smaller in 4.5 mm SP plate with TBW during 1-year follow up period.
CONCLUSION
A precontoured symphysis pubis plate (4.5 mm) with figure-of-eight fashion tension band wiring shows favorable radiological results, excellent or good clinical outcome, and a lower complication (hardware failure and revision surgery).

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Is there a clinical benefit of additional tension band wiring in plate fixation of the symphysis?
Myung-sik Park, Sun-Jung Yoon, Seung-min Choi, Kwanghun Lee
BMC Musculoskeletal Disorders.2017;[Epub] CrossRef

Case Reports

A Blunt Traumatic Vertebral Artery Injury: A Case Report: Min A Lee, Kang Kook Choi, Gil Jae Lee, Byung Chul Yu, Dae Sung Ma, Yang Bin Jeon, Min Chung, Jung Nam Lee; J Trauma Inj. 2016;29(1):28-32. Published online March 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.1.28

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Blunt traumatic vertebral artery injury (TVAI) is relatively rare, but it may frequently be associated with head and neck trauma. TVAI is difficult to diagnose with diverse outcomes, thus it is a clinical challenge. There are no widely accepted guidelines for treatment and diagnosis, so that the diagnosis of TVAI can be easily delayed. Therefore, any clinical suspicion from clues on the initial imaging is important for diagnosis of TVAI. The authors report on the case of a patient diagnosed as having a TVAI with a transverse foramen fracture.

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Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report
Rathna Paramaswamy
Journal of Dental Anesthesia and Pain Medicine.2018; 18(3): 183. CrossRef

Abdominal Impalement Injury Caused by Scaffolding Pipe following a Traffic Accident: A Case Report: Se Youl Lee, Jeong Moon Lee, Seok Jin Choi; J Trauma Inj. 2016;29(1):33-36. Published online March 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.1.33

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Traffic accidents involving agricultural machinery have been decreasing, but mortality is still high due to a lack of safety devices such as seat belts. Furthermore, secondary damage, such as abdominal impalement injury caused by loaded materials, is more likely to occur, and this type of injury leads to a poor prognosis. Impalement with pipes is often more fatal than other penetrating injuries because the diameter of the pipe is usually larger in size than other loaded materials. We report a case of a 72-year-old man with secondary abdominal impalement injury caused by a scaffolding pipe following a traffic accident.

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Crowbar impalement: the PHEM perspective
Saad Jawaid, Dan Cody
BMJ Case Reports.2018; 11(1): e227293. CrossRef

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