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12 "Jong-Keon Oh"
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Original Articles
The impact of COVID-19 on trauma patients and orthopedic trauma operations at a single focused training center for trauma in Korea
Wonseok Choi, Hanju Kim, Whee Sung Son, Seungyeob Sakong, Jun-Min Cho, Nak-Jun Choi, Tae-Wook Noh, Namryeol Kim, Jae-Woo Cho, Jong-Keon Oh
J Trauma Inj. 2022;35(3):195-201.   Published online December 1, 2021
DOI: https://doi.org/10.20408/jti.2021.0078
  • 3,586 View
  • 76 Download
AbstractAbstract PDF
Purpose

The objective of this study was to determine the effects of coronavirus disease 2019 (COVID-19) on the volume of trauma patients, the number of orthopedic trauma operations, and the severity of injuries. We also investigated the correlations between social distancing and these variables.

Methods

This was a retrospective review of trauma patient cases at a single focused training center for trauma in Korea from January 2017 to April 2021. The COVID-19 group included patients treated from January 1 to April 30 in 2020 and 2021, and the control group included patients treated during the same months from 2017 to 2019. The volume of trauma patients according to the level of social distancing was evaluated among patients treated from August 2, 2020 to November 23, 2020.

Results

The study included 3,032 patients who presented to the emergency department with traumatic injuries from January to April 2017 to 2021. The average number of patients was 646.7 and 546.0 in the control and COVID-19 groups, respectively. The percentage of patients injured in traffic accidents (TAs) decreased from 25.0% to 18.2% (p<0.0001). The proportions of in-car TAs and pedestrian TAs also decreased from 6.7% and 10.8% to 3.5% and 6.0%, respectively (p=0.0002 and p<0.0001). The percentage of bicycle TAs increased from 2.4% to 4.0% (p=0.0128). The proportion of patients with an Injury Severity Score above 15 and the mortality rate did not change significantly. As the level of social distancing increased, the number of trauma patients and the number of trauma injuries from TAs decreased. The number of orthopedic trauma operations also depended on the social distancing level.

Conclusions

The number of trauma patients presenting to the emergency department decreased during the COVID-19 period. The volume of trauma patients and orthopedic trauma operations decreased as the social distance level increased.

Summary
Percutaneous two unilateral iliosacral S1 screw fixation for pelvic ring injuries: a retrospective review of 38 patients
Whee Sung Son, Jae-Woo Cho, Nam-Ryeol Kim, Jun-Min Cho, Nak-Jun Choi, Jong-Keon Oh, HanJu Kim
J Trauma Inj. 2022;35(1):34-42.   Published online November 3, 2021
DOI: https://doi.org/10.20408/jti.2021.0075
  • 4,795 View
  • 109 Download
AbstractAbstract PDF
Purpose
Percutaneous iliosacral (IS) screw fixation for pelvic ring injuries is a minimally invasive technique that reduces the amount of blood loss and shortens the procedure time. Moreover, two unilateral IS S1 screws exhibit superior stability to a single IS screw and are also safer for neurological injuries than an S2 screw. Therefore, this study aimed to evaluate fixation using percutaneous two unilateral IS S1 screws for pelvic ring injuries and its subsequent clinical outcomes. Methods: We retrospectively reviewed 38 patients who underwent percutaneous two unilateral IS S1 screw fixation for pelvic ring injuries. The procedure time, blood loss, achievement of bone union, radiological outcomes (Matta and Tornetta grade), and postoperative complications were evaluated. Results: The mean procedure time, hemoglobin loss, bone union rate, and time to union were 40.1 minutes (range, 18–102), 0.6 g/dL (range, 0.3–1.0), 100%, and 153.2 days (range, 61–327), respectively. The Matta and Tornetta grades were excellent, good, and fair in 24 (63.1%), 11 (28.9%), and 3 patients (7.9%), respectively, and the postoperative complications were S1 screw loosening, widening of the symphysis pubis (2.3 and 2.5 mm), lumbosacral plexopathy, and S1 radiculopathy in one (2.6%), two (5.3%), one (2.6%), and one patient (2.6%), respectively. However, all neurological complications recovered spontaneously. Conclusions: Percutaneous two unilateral IS S1 screw fixation was useful for treating pelvic ring injuries. In particular, it involved a short procedure time with little blood loss and also led to 100% bone union and good radiological outcomes.
Summary
The Effects of a Trauma Team Approach on the Management of Open Extremity Fractures in Polytrauma Patients: A Retrospective Comparative Study
Seungyeob Sakong, Eic Ju Lim, Jun-Min Cho, Nak-Jun Choi, Jae-Woo Cho, Jong-Keon Oh
J Trauma Inj. 2021;34(2):105-111.   Published online March 15, 2021
DOI: https://doi.org/10.20408/jti.2020.0043
  • 10,153 View
  • 124 Download
AbstractAbstract PDF
Purpose

Open extremity fractures require prompt antibiotic medication and initial debridement surgery to reduce the infection rate and restore functional stabilization. We aimed to report the effects and positive outcomes of a trauma team approach on the management of open extremity fractures in polytrauma patients.

Methods

This retrospective review included all polytrauma patients with open extremity fractures admitted between March 2009 and December 2019. Patients were divided into two groups according to whether they were treated before or after the implementation of the trauma team approach (March 2014). We analyzed the outcomes in each group with respect to the time interval until the doctor’s arrival, total length of stay in the emergency department, the time interval until initial antibiotic treatment and operation, whether the initial operation was performed within 24 hours, and the rate of deep infections.

Results

A total of 123 patients met the inclusion criteria. There were no statistically significant differences in demographic characteristics. The time interval until the doctor’s arrival (64.12±49.2 minutes vs. 19.82±15.23 minutes; p=0.035) and initial antibiotic treatment (115.47±72.12 minutes vs. 48.78±30.12 minutes; p=0.023) significantly improved after implementing the trauma team approach. The union rate was not significantly different. However, the time interval until initial debridement, opportunity for initial debridement within 24 hours, and the rate of deep infections demonstrated better results.

Conclusions

The reduced time interval until initial antibiotic treatment and debridement could be attributed to the positive effect of the trauma team approach on the management of open extremity fractures in polytrauma patients.

Summary
Case Report
Hemorrhagic Shock in a Patient with a Morel-Lavallée Lesion Combined with Active Arterial Bleeding without Fracture
Eic Ju Lim, Jong-Keon Oh, Jae-Woo Cho, Seungyeob Sakong, Jun-Min Cho
J Trauma Inj. 2021;34(1):61-65.   Published online November 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0013
  • 4,328 View
  • 107 Download
AbstractAbstract PDF

A Morel-Lavallée lesion is a closed degloving injury caused by traumatic separation of the skin and subcutaneous tissue from the underlying fascia. However, since physicians tend to focus on treating the bone fracture, hemodynamic instability accompanying a Morel-Lavallée lesion can sometimes be overlooked. We report the case of a hemodynamically unstable 73-year-old man who had a Morel-Lavallée lesion of the thigh, but no femur fracture. Angiography showed active bleeding from the muscular branch of the right deep femoral artery, which was then successfully embolized.

Summary
Original Articles
Analysis of Risk Factors for Infection in Orthopedic Trauma Patients
Gi Ho Moon, Jae-Woo Cho, Beom Soo Kim, Do Hyun Yeo, Jong-Keon Oh
J Trauma Inj. 2019;32(1):40-46.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.023
  • 5,370 View
  • 144 Download
  • 3 Citations
AbstractAbstract PDF
Purpose

We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery.

Methods

We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS.

Results

Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor.

Conclusions

The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

Summary

Citations

Citations to this article as recorded by  
  • Analysis of Risk Factors and Association of Cluster of Differentiation (CD) Markers With Conventional Markers in Delayed Fracture Related Infection for Closed Fracture
    Archana Raikwar, Ajai Singh, Vikas Verma , Abbas Ali Mehdi, Narendra Singh Kushwaha, Rashmi Kushwaha
    Cureus.2021;[Epub]     CrossRef
  • Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen
    Kyunghak Choi, Kwang-Hwan Jung, Min Ae Keum, Sungjeep Kim, Jihoon T Kim, Kyu-Hyouck Kyoung
    Journal of Trauma and Injury.2020; 33(1): 18.     CrossRef
  • Characterization and Antibiofilm Activity of Mannitol–Chitosan-Blended Paste for Local Antibiotic Delivery System
    Leslie R. Pace, Zoe L. Harrison, Madison N. Brown, Warren O. Haggard, J. Amber Jennings
    Marine Drugs.2019; 17(9): 517.     CrossRef
Management and Outcome of Patients with Acetabular Fractures: Associated Injuries and Prognostic Factors
Do-Hyun Yeo, Jong-Keon Oh, Jae-Woo Cho, Beom-Soo Kim
J Trauma Inj. 2019;32(1):32-39.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.016
  • 4,474 View
  • 94 Download
  • 3 Citations
AbstractAbstract PDF
Purpose

The aim of this study was to determine which factors contribute to the surgical treatment outcomes of acetabular fractures. Simultaneously, we aim to report on the treatment results after our hospital was designated as the focused training center for trauma.

Methods

We conducted a retrospective review of all patients who experienced acetabular fractures from January 1, 2014 to May 1, 2017 and visited our hospital. Patients who had associated pelvic ring fractures or were lost to the one-year follow-up were excluded; a total of 37 fractures were evaluated. We evaluated the clinical results using the scoring system of Merle d’Aubign? (MDA) and grade of Brooker for heterotopic ossification.

Results

Thirty-seven patients (31 men and 6 women) were identified. The mean injury severity score (ISS) was 8.7, with 32.4% of patients having a score >15. The average blood transfusion in the first 24 hours was 0.54 pints. Falling was the most common injury mechanism (32.4%). Chest injury was the most common associated injury (16.2%), followed by head injury (13.5%). The posterior wall and both column fracture were the most common (37.8%) fracture patterns. Excellent and good clinical grades of MDA included 28 patients (75.6%) and fair and poor grades included nine (24.3%), respectively. Four patients were diagnosed with a post-operative infection (10.8%); one out of four patients who had co-morbidity died (2.7%), and another patient underwent a replacement surgery (2.7%). Multivariate analysis showed that age and operation time were associated with MDA. In addition, operation time and ISS were significant co-factors of the Brooker grade.

Conclusions

Korea University Guro Hospital showed similar treatment results of acetabular fractures compared to other publications. The age and operation time were co-factors of the clinical outcome of this fracture. Additionally, increased operation time and injury severity score were suggested to increase the Brooker grade.

Summary

Citations

Citations to this article as recorded by  
  • Functional Outcome Measures after Operative Management of Acetabular Fractures
    Shiela Marie Delizo, Rodel Banggiacan, Isagani Garin
    Philippine Journal of Orthopaedics.2024; 39(2): 16.     CrossRef
  • Outcome of acetabulum fractures treated with open reduction and internal fixation through Kocher-Langenbeck Approach: A retrospective study
    Dharmendra Kumar, Narendra Singh Kushwaha, Prakash Gaurav Tiwari, Yashvardhan Sharma, R.N. Srivastava, Vineet Sharma
    Journal of Clinical Orthopaedics and Trauma.2021; 23: 101599.     CrossRef
  • FUNCTIONAL AND RADIOLOGICAL OUTCOMES OF ACETABULAR FRACTURES
    Sangam Jain, Dishit Vaghasia, Tanay Nahatkar, Spandan Koshire, Amol Salve, Vinod Kumar Yadav
    INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2021; : 1.     CrossRef
Case Reports
Minimally Invasive Stabilization with Percutaneous Screws Fixation of APC-3 Pelvic Ring Injury
Beom-Soo Kim, Jong-Keon Oh, Jae-Woo Cho, Do-Hyun Yeo, Jun-Min Cho
J Trauma Inj. 2019;32(1):60-65.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.015
  • 6,679 View
  • 136 Download
AbstractAbstract PDF

Pelvic fractures are associated with life-threatening injuries and high rates of morbidity and mortality. Management of internal blood loss associated with unstable pelvic ring injuries is paramount during the initial period. The reconstruction of the pelvic ring is of importance because it is a major contributor to the stability of the pelvic ring. We report the case of a 25-year-old man who had an unstable pelvic ring fracture combined with rupture of an obturator artery and had a successful and satisfactory treatment using minimally invasive surgery with percutaneous antegrade screw fixation.

Summary
Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail
Beom-Soo Kim, Jae-Woo Cho, Do-Hyun Yeo, Jong-Keon Oh
J Trauma Inj. 2018;31(2):96-102.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.96
  • 12,679 View
  • 304 Download
  • 1 Citations
AbstractAbstract PDF

Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.

Summary

Citations

Citations to this article as recorded by  
  • Multiple fractures of the femur: Case report, literature review, and proposal for a shared algorithm of treatment
    Pasquale Sessa, Michele Galluzzo, Edoardo Leone, Schirò Antonio Maria, Giuseppe Giannicola
    SAGE Open Medical Case Reports.2024;[Epub]     CrossRef
Non-Operatively Treated Thoracolumbar Burst Fracture with Posterior Ligamentous Complex Injury: Case Report and Consideration on the Limitation of Thoracolumbar Injury Classification and Severity (TLICS) Score
Woo-Keun Kwon, Jong-Keon Oh, Jun-Min Cho, Taek-Hyun Kwon, Youn-Kwan Park, Hong Joo Moon, Joo Han Kim
J Trauma Inj. 2018;31(2):76-81.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.76
  • 4,501 View
  • 69 Download
  • 1 Citations
AbstractAbstract PDF

Fractures at the thoracolumbar region are commonly followed after major traumatic injuries, and up to 20% of these fractures are known to be burst fractures. Making surgical decisions for these patients are of great interest however there is no golden standard so far. Since the introduction of Thoracolumbar Injury Classification and Severity (TLICS) score in 2007, it has been widely used as a referential guideline for making surgical decisions in thoracolumbar fractures. However, there is still limitations in this system. In this clinical case report, we introduce a L1 burst fracture after motor vehicle injury, who was successfully treated conservatively even while she was graded as a TLICS 5 injury. A case report is presented as well as discussion on the limitations of this grading system.

Summary

Citations

Citations to this article as recorded by  
  • Nonoperative Management in Intact Burst Fracture Patient With Thoracolumbar Injury Classification and Severity Score of 5: A Case Report
    Gersham J Rainone, Yash Patel, Cody Woodhouse, Ryan Sauber, Alexander Yu
    Cureus.2022;[Epub]     CrossRef
Original Article
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
  • 3,550 View
  • 71 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
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
  • 4,309 View
  • 116 Download
  • 1 Citations
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

Citations

Citations to this article as recorded by  
  • Cysts and hematomas in the spine: Rare Entities
    Ali Msheik, Anthony Khoury, Anna-marina Nakhl, Elie Fahed, Philippe Younes
    International Journal of Surgery Case Reports.2024; 125: 110632.     CrossRef
Proximal Tibia Fracture after Proximal Tibia Autograft Harvest
Jin-Kak Kim, Jong-Hyeop Song, Kyungbum Lee, Jae-Woo Cho, Ki-Ho Moon, Do-Hyun Yeo, Beom-Soo Kim, Jong-Keon Oh
J Trauma Inj. 2017;30(4):247-252.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.247
  • 6,936 View
  • 67 Download
  • 3 Citations
AbstractAbstract PDF

Bone-grafting procedures are common in orthopedic trauma surgeries. There are only few reports on the morbidity after proximal tibia harvesting. Here, we report an experience of complication after proximal tibia harvesting while treating subtrochanteric femoral osteomyelitis.

Summary

Citations

Citations to this article as recorded by  
  • Efficacy and safety of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with autologous bone for the treatment of long bone nonunion: A report of a prospective case series
    Wonseok Choi, Beom-Soo Kim, Won-Tae Cho, Eic Ju Lim, Jeong Seok Choi, Yun Ki Ryu, Jae-Woo Cho, Seungyeob Sakong, Jong-Keon Oh
    Injury.2024; 55(10): 111711.     CrossRef
  • Is weight-bearing as tolerated safe after proximal tibial metaphyseal autogenous bone harvest? A systematic review and meta-analysis
    P. Sadr-Eshkevari, C. McGowan, M. Sekula, R.K. Sumner, D. Seligson, R.L. Flint
    International Journal of Oral and Maxillofacial Su.2024;[Epub]     CrossRef
  • Novel Vacuum-Assisted Method for Harvesting Autologous Cancellous Bone Graft and Bone Marrow From the Proximal Tibial Metaphysis
    Adam M. Lukasiewicz, Paul S. Bagi, Kristin E. Yu, Vineet Tyagi, Raymond J. Walls
    Foot & Ankle Orthopaedics.2021;[Epub]     CrossRef

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