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Original Article
Usefulness of presepsin as a prognostic indicator for patients with trauma in the emergency department in Korea: a retrospective study
Si Woo Kim, Jung-Youn Kim, Young-Hoon Yoon, Sung Joon Park, Bo Sun Shim
J Trauma Inj. 2024;37(1):13-19.   Published online January 12, 2024
DOI: https://doi.org/10.20408/jti.2023.0061
  • 493 View
  • 11 Download
AbstractAbstract PDF
Purpose
Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma.
Methods
The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed.
Results
Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8–79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041).
Conclusions
Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.
Summary
Case Report
Conservative treatment of corpus callosum hemorrhage due to a falling coconut in Indonesia: a case report
Hanan Anwar Rusidi, Ferry Wijanarko
J Trauma Inj. 2024;37(1):79-82.   Published online January 12, 2024
DOI: https://doi.org/10.20408/jti.2023.0052
  • 435 View
  • 10 Download
AbstractAbstract PDF
The potential for traumatic brain injury resulting from falling coconuts is frequently overlooked. These incidents can cause focal lesions in the form of brain hemorrhage. Corpus callosum hemorrhage due to blunt trauma from a falling object is rare and typically associated with poor prognosis. The purpose of this report is to detail a case of corpus callosum hemorrhage caused by a coconut fall and to discuss the conservative management approach employed. We report the case of a 54-year-old woman who was admitted to the hospital with symptoms of unconsciousness, headache, and expressive aphasia after being struck by a falling coconut. Notably, hemorrhage was detected within the body of the corpus callosum, as revealed by imaging findings. The patient received intensive monitoring and treatment in the intensive care unit, including oxygen therapy, saline infusion, an osmotic diuretic, analgesics, and medication to prevent stress ulcers. The patient demonstrated marked clinical improvement while undergoing conservative treatment. Despite the typically unfavorable prognosis of these rare injuries, our patient exhibited meaningful clinical improvement with conservative treatment. Timely diagnosis and appropriate interventions were crucial in managing the patient’s condition. This report emphasizes the importance of considering traumatic brain injury caused by falling coconuts and highlights the need for further research and awareness in this area.
Summary
Original Articles
Comparison of mortality between open and closed pelvic bone fractures in Korea using 1:2 propensity score matching: a single-center retrospective study
Jaeri Yoo, Donghwan Choi, Byung Hee Kang
J Trauma Inj. 2024;37(1):6-12.   Published online January 3, 2024
DOI: https://doi.org/10.20408/jti.2023.0063
  • 495 View
  • 11 Download
AbstractAbstract PDF
Purpose
Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures.
Methods
Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching.
Results
Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6–30 days vs. median 5 days, IQR 2–13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6–30 days vs. median 8 days, IQR 4–19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different.
Conclusions
The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.
Summary
Effect of trauma center operation on emergency care and clinical outcomes in patients with traumatic brain injury
Han Kyeol Kim, Yoon Suk Lee, Woo Jin Jung, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang, Oh Hyun Kim
J Trauma Inj. 2023;36(1):22-31.   Published online December 6, 2022
DOI: https://doi.org/10.20408/jti.2022.0049
  • 1,397 View
  • 45 Download
AbstractAbstract PDF
Purpose
Traumatic brain injury (TBI) directly affects the survival of patients and can cause long-term sequelae. The purpose of our study was to investigate whether the operation of a trauma center in a single tertiary general hospital has improved emergency care and clinical outcomes for patients with TBI.
Methods
The participants of this study were all TBI patients, patients with isolated TBI, and patients with TBI who underwent surgery within 24 hours, who visited our level 1 trauma center from March 1, 2012 to February 28, 2020. Patients were divided into two groups: patients who visited before and after the operation of the trauma center. A comparative analysis was conducted. Differences in detailed emergency care time, hospital stay, and clinical outcomes were investigated in this study.
Results
On comparing the entire TBI patient population via dividing them into the aforementioned two groups, the following results were found in the group of patients who visited the hospital after the operation of the trauma center: an increased number of patients with a good functional prognosis (P<0.001 and P=0.002, respectively), an increased number of surviving discharges (P<0.001 and P<0.001, respectively), and a reduction in overall emergency care time (P<0.05, for all item values). However, no significant differences existed in the length of intensive care unit stay, ventilator days, and total length of stay for TBI patients who visited the hospital before and after the operation of the trauma center.
Conclusions
The findings confirmed that overall TBI patients and patients with isolated brain injury had improved treatment results and emergency care through the operation of a trauma center in a tertiary general hospital.
Summary
Case Report
Nonoperative management of colon and mesocolon injuries caused by blunt trauma: three case reports
Naa Lee, Euisung Jeong, Hyunseok Jang, Yunchul Park, Younggoun Jo, Jungchul Kim
J Trauma Inj. 2022;35(4):291-296.   Published online September 19, 2022
DOI: https://doi.org/10.20408/jti.2022.0009
  • 1,720 View
  • 39 Download
AbstractAbstract PDF
The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.
Summary
Original Articles
Surgical Outcomes in Patients with Simultaneous Traumatic Brain and Torso Injuries in a Single Regional Trauma Center over a 5-Year Period
Jung-Ho Yun
J Trauma Inj. 2021;34(4):270-278.   Published online December 31, 2021
DOI: https://doi.org/10.20408/jti.2021.0099
  • 2,421 View
  • 76 Download
AbstractAbstract PDF
Purpose

The purpose of the study is to analyze the results of surgical treatment of patients with brain and torso injury for 5 years in a single regional trauma center.

Methods

We analyzed multiple trauma patients who underwent brain surgery and torso surgery for chest or abdominal injury simultaneously or sequentially among all 14,175 trauma patients who visited Dankook University Hospital Regional Trauma Center from January 2015 to December 2019.

Results

A total of 25 patients underwent brain surgery and chest or abdominal surgery, with an average age of 55.4 years, 17 men and eight women. As a result of surgical treatment, there were 14 patients who underwent the surgery on the same day (resuscitative surgery), of which five patients underwent surgery simultaneously, four patients underwent brain surgery first, and one patient underwent chest surgery first, four patients underwent abdominal surgery first. Among the 25 treated patients, the 10 patients died, which the cause of death was five severe brain injuries and four hemorrhagic shocks.

Conclusions

In multiple damaged patients require both torso surgery and head surgery, poor prognosis was associated with low initial Glasgow Coma Scale and high Injury Severity Score. On the other hand, patients had good prognosis when blood pressure was maintained and operation for traumatic brain injury was performed first. At the same time, patients who had operation on head and torso simultaneously had extremely low survival rates. This may be associated with secondary brain injury due to low perfusion pressure or continuous hypotension and the traumatic coagulopathy caused by massive bleeding.

Summary
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
  • 3,272 View
  • 123 Download
AbstractAbstract 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 Reports
Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw
Han Joo Choi
J Trauma Inj. 2019;32(3):168-171.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.027
  • 8,646 View
  • 139 Download
  • 2 Citations
AbstractAbstract PDF

The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

Summary

Citations

Citations to this article as recorded by  
  • Thoracoabdominal injury with evisceration from a chainsaw assault: a case report
    Babatunde Abayomi Salami, Babatunde Adeteru Ayoade, El-Zaki Abdullahi Shomoye, Chigbundu Collins Nwokoro
    Journal of Trauma and Injury.2022; 35(2): 118.     CrossRef
  • Unusual Chainsaw Related Penetrating Neck Injury: Initial Management & Surgical Repair, Case Report
    Woohyen Jin, Sang-Wook Park, Seong Jun Won, Jung Je Park
    Journal of Clinical Otolaryngology Head and Neck .2022; 33(4): 259.     CrossRef
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
  • 10,839 View
  • 261 Download
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
Original Articles
PARK Formula Can Replace “Guide to Medical Certificate” Published by Korean Medical Association in Deciding the Treatment Duration
Chan Yong Park, Kwang Hee Yeo, Sora Ahn
J Trauma Inj. 2018;31(2):58-65.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.58
  • 3,292 View
  • 63 Download
AbstractAbstract PDF
Purpose

Many doctors have difficulty in deciding the treatment duration in trauma patients to write in the casualty medical certificate. We tried to find a solution for this problem by using abbreviated injury scale (AIS).

Methods

A total of 39 patients treated in our regional trauma center who requested an author to write treatment duration on casualty medical certificate from January 2014 to April 2017 were included. And the treatment duration was decided based on the PARK Formula (AIS). PARK Formula (AIS)=(AIS×2) ~ ([AIS×2]+2)

Results

Among 39 patients included and 36 (92.3%) had treatment duration on casualty medical certificate within the range of treatment duration calculated by PARK Formula (AIS). Compared to the PARK Formula (AIS), the mean value was 0.13 week (0.90 day) smaller. Comparing the treatment duration between Korean Medical Association (KMA) guideline and PARK Formula (AIS), only 22 patients (56.4%) showed agreement. The mean value was 1.02 week (7.18 days) smaller in KMA guideline.

Conclusions

For the decision of the treatment duration in trauma patients, utilizing worldwide used AIS scoring system is very efficient. Using PARK Formula (AIS), doctors can document the treatment duration in the casualty medical certificate with ease. KMA should provide more practical ‘treatment duration of each diagnosis in writing casualty medial certificate’ for the doctors. We recommend PARK Formula (AIS) as a good alternative for KMA guide.

Summary
Management of High-grade Blunt Renal Trauma
Min A Lee, Myung Jin Jang, Gil Jae Lee
J Trauma Inj. 2017;30(4):192-196.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.192
  • 4,080 View
  • 162 Download
  • 5 Citations
AbstractAbstract PDF
Purpose

Blunt injury accounts for 80?95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80?85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury.

Methods

We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high?grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III?V) renal injury patients were included in the analysis.

Results

During the eight?year study period, there were 62 AAST grade III?V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade.

Conclusions

Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

Summary

Citations

Citations to this article as recorded by  
  • Functional range of the kidney after a low-severity injury: a randomized study
    K. A. Chiglintsev, A. V. Zyryаnov, A. Yu. Chiglintsev, A. A. Makarian
    Diagnostic radiology and radiotherapy.2023; 14(2): 74.     CrossRef
  • Outcome of Kidney Trauma Management: Experiences from a Tertiary Referral Hospital in East Indonesia
    Yufi Aulia Azmi, Danang Irsayanto, Kevin Muliawan Soetanto, Johan Renaldo, Soetojo Wirjopranoto
    Biomolecular and Health Science Journal.2023; 6(2): 135.     CrossRef
  • RENAL TRAUMA: PROFILE AND MANAGEMENT
    Vipul Bakshi, Tariq A Mir, Harmandeep Singh Chahal
    GLOBAL JOURNAL FOR RESEARCH ANALYSIS.2022; : 109.     CrossRef
  • Management of renal injury in a UK major trauma centre
    Robert Torrance, Abigail Kwok, David Mathews, Matthew Elliot, Andrew Baird, Marc A Lucky
    Trauma.2020; 22(1): 26.     CrossRef
  • Renal trauma: a 5-year retrospective review in single institution
    Syarif, Achmad M. Palinrungi, Khoirul Kholis, Muhammad Asykar Palinrungi, Syakri Syahrir, Reinaldo Sunggiardi, Muhammad Faruk
    African Journal of Urology.2020;[Epub]     CrossRef
Analysis of Cultivator-related Trauma Cases in a Regional Trauma Center in the Rural Area of Gyeongbuk Province
Ui Kang Hwang, Seok Hwa Youn, Chan Yong Park
J Trauma Inj. 2017;30(3):80-86.   Published online October 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.3.80
  • 2,024 View
  • 17 Download
AbstractAbstract PDF
PURPOSE
To analyze the data of patients who suffered trauma in a cultivator accident and visited the trauma center in rural Gyeongbuk Province.
METHODS
We retrospectively reviewed the medical records and Korean Trauma Data Bank data of 120 patients who suffered cultivator-related traumas and visited the rural regional trauma center in Gyeongbuk Province from January to December 2015.
RESULTS
The age of the patients ranged from 35 to 96 years (mean, 70 years). Ninety-one (75.8%) patients were men, and twenty-nine (24.2%) were women. Most of the patients were in their 70s (46 men [50.5%] and 13 women [44.8%]). In total, 113 patients (94.1%) arrived at the regional trauma center by ground transport and 7 (5.9%) arrived by air transport. Ninety-eight patients (81.7%) were transported to the regional trauma center directly from the scene of the accident, and twenty-two (18.3%) were transferred from another medical institute. The mean time from the accident to arrival at the emergency department was 139 minutes, and only 46 patients (38.3%) arrived within 1 hour. Twelve (10.0%) patients died, including two deaths on arrival and two post- cardiopulmonary resuscitation deaths in the emergency department. All deaths were of male cultivator operators. The causes of death were shock (hypovolemic, traumatic, or septic), subdural hematoma (open), hemothorax, rhabdomyolysis, and pneumonia.
CONCLUSIONS
As the government - led regional trauma center project is on process, it would be clinically important to summarize the initial outcome of cultivator injuries, which are characteristically found more in regional trauma centers in the rural area, and have high mortality. Based on this study, in the future, it will be necessary to follow up and analyze more number of patients and to construct accurate database about trauma cases related to cultivator in Gyeongbuk region.
Summary
Operative Treatment for Midshaft Clavicle Fractures in Adults: A 10-Year Study Conducted in a Korean Metropolitan Hospital
Jeong Kook Baek, Young Ho Lee, Min Bom Kim, Goo Hyun Baek
J Trauma Inj. 2016;29(4):105-115.   Published online December 31, 2016
DOI: https://doi.org/10.20408/jti.2016.29.4.105
  • 2,553 View
  • 27 Download
AbstractAbstract PDF
PURPOSE
While all midshaft clavicle fractures have traditionally been treated with conservative measures, recent operative treatment of displaced, communited midshaft clavicle fractures has become more common. Though a recent increase in operative treatment for midshaft clavicle fractures, we have done the operative methods in limited cases. The aim of this study is to present indications, operative techniques and outcomes of the experienced cases that have applied to this limited group over the previous 10 years.
METHODS
This study consists of a retrospective review of radiological and clinical data from January of 2005 to July of 2015. Operative criteria for midshaft clavicle fractures having considerable risk of bone healing process were 4 groups - a floating shoulder, an open fracture, an associated neurovascular injury, and a nonunion case after previous treatment.
RESULTS
The study consisted of 18 patients who had operative treatment for midshaft clavicle fractures in adults. The most common surgical indication was a floating shoulder (10 cases, 55.6%), followed by nonunion (5 cases, 27.8%), an associated neurovascular injury (4 cases, 22.2%), and open fracture (3 cases, 16.7%). All cases were treated by open reduction and internal fixation in anterosuperior position with reconstruction plate or locking compression plate. Bone union was achieved in all cases except 1 case which was done bone resection due to infected nonunion. Mean bone union period was 19.5 weeks. There were no postoperative complications, but still sequelae in 4 cases of brachial plexus injury.
CONCLUSION
We have conducted an open reduction and internal fixation by anterosuperior position for midshaft clavicle fractures in very limited surgical indications for last 10 years. Our treatment strategy for midshaft clavicle fractures showed favorable radiological results and low postoperative complications.
Summary
Case Reports
Nonoperative Treatment for Abdominal Injury in Multiple Trauma Patients: Experience in the Metropolitan Tertiary Hospital in Korea (2009~2014)
Seung Young Oh, Gil Joon Suh
J Trauma Inj. 2015;28(4):284-291.   Published online December 31, 2015
DOI: https://doi.org/10.20408/jti.2015.28.4.284
  • 1,590 View
  • 6 Download
AbstractAbstract PDF
The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.
Summary
Pulmonary Bone Cement Embolism Following Percutaneous Vertebroplasty
Yong Han Cha
J Trauma Inj. 2015;28(3):202-205.   Published online September 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.3.202
  • 1,820 View
  • 6 Download
  • 1 Citations
AbstractAbstract PDF
PURPOSE
Pulmonary cement embolization after vertebroplasty is a well-known complication. The reported incidence of pulmonary cement emboli after vertebroplasty ranges frome 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Onset and severity of symptoms are variable.
CASE
DESCRIPTION: We present the case of a 83-year-old women who underwent fourth lumbar vertebroplasty and subsequently had dyspnea several days later. Posteroanterior chest radiography showed multiple linear densities. Computed tomography of thorax revealed also multiple bilateral, linear hyperdensities within the lobar pulmonary artery branches are detected in axial and coronal views. LITERATURE REVIEWS: Operative management of vertebral compression fractures has included percutaneous vetebroplasty for the past 25 years. Symptoms of pulmonary cement embolism can occur during procedure, but more commonly begin days to weeks, even months, after vertebroplsty. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces.
CONCLUSION
Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately.
Summary

Citations

Citations to this article as recorded by  
  • Micro- and Nanoparticulate Hydroxyapatite Powders as Fillers in Polyacrylate Bone Cement—A Comparative Study
    Anna Sobczyk-Guzenda, Paulina Boniecka, Anna Laska-Lesniewicz, Marcin Makowka, Hieronim Szymanowski
    Materials.2020; 13(12): 2736.     CrossRef

J Trauma Inj : Journal of Trauma and Injury