Journal of Musculoskeletal Trauma

Analysis of Missed Fractures in Polytrauma Patients: Ki Chul Park, Hyun Uk Kim; J Korean Fract Soc 2014;27(4):281-286. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.281

Abstract PDF: PURPOSE
The purpose of this study is to determine the frequency of missed fractures in severe multiple trauma patients and to analyze any differences in treatment plan, after whole body bone scan.
MATERIALS AND METHODS
From September 2012 to December 2013, 49 patients were confirmed to have multiple trauma with an injury severity score (ISS) of 16 or higher. Whole body bone scan was performed at an average of 15.7 days (7-25) after injury. Missed fractures were diagnosed according to physical examination and additional radiologic reports. Locations and patterns of missed fractures were analyzed. We evaluated any differences in treatment plan after the diagnosis of missed fractures.
RESULTS
Missed fractures were diagnosed in 14 patients (16 cases) on the whole body bone scan. The most frequent location was the knee (three cases), followed by rib, clavicle, carpal bone, and foot. Seven cases were occult fractures, five cases were undisplaced fractures and four cases were displaced fractures. Conservative treatment was administered in 15 patients and surgery was necessary in one patient.
CONCLUSION
Delayed or missed diagnosis of fractures occurred frequently in patients of multiple trauma with a high ISS. Whole body bone scan appears to be effective in finding missed fractures in the whole body. Definitive assessment should be supplemented after initial trauma care in order to reduce the rate of missed fractures.

23 View
0 Download

Injury Severity and Patterns of Accompanying Injury in Spinal Fracture: Hun Park, Kyung Jin Song, Kwang Bok Lee, Joo Hyun Sim; J Korean Fract Soc 2012;25(3):203-207. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.203

PURPOSE
To examine the relationship between injury severity and patterns of associated injury in spinal fracture.
MATERIALS AND METHODS
From March 2004 to March 2010, a retrospective study was conducted on 291 patients who had undergone surgeries due to spinal fractures. Spinal fractures were categorized as upper cervical, lower cervical, thoracic, thoracolumbar, and lumbar region, and the severity of fracture was measured using the Abbreviated Injury Scale and Injury Severity Score (ISS). We evaluated the correlation between the fracture site and the incidence and injury severity of the associated injury, and compared the neurologic damage according to the presence/absence of the associated injury.
RESULTS
Spinal fracture occurred in the thoracic (43.5%) and lower cervical (30.0%) levels, and associated injury developed in 134 patients (47%). The area of associated injury was in the extremity (41.2%), thorax (25.5%), head, neck, and face (21.9%). Lower cervical fracture (34.5%) had a lower prevalence than thoracic (81%) and lumbar fracture (61%). The average ISS of the associated injury was 17.14 for the thoracic fracture, 12.30 for the lower cervical fracture, 8.7 for the thoracolumbar fracture and 5.69 for the lumbar fracture. Neurologic damage was highly frequent in the lower cervical fracture and included 54 patients (62.1%) and was less frequent in the upper cervical fracture, which included 7 patients (17.9%) (p=0.032).
CONCLUSION
Although the associated injury was less frequent in the lower cervical spine among the spinal fractures that underwent surgical treatment, there was a high risk of neurologic damage in the case of associated injury; therefore, there is a need to pay special attention to patients that suffer damage in this area. In addition, since the degree of the associated injury in the thoracic and lower cervical fracture is significant, an appropriate management strategy for the associated injury must be considered.

Citations

Citations to this article as recorded by

The Clinical Effects of Complex Korean Medicine Treatment in Patients with Cervical Spine Fracture Caused by Traffic Accident: A Report of 2 Cases
Si-Hoon Han, Gi-Eon Lee, Kyeong-Sang Jo, Da-Young Byun, Min-Seok Oh
Journal of Korean Medicine Rehabilitation.2018; 28(2): 113. CrossRef
Clinical results of early stabilization of spine fractures in polytrauma patients
Ki-Chul Park, Ye-Soo Park, Wan-Sik Seo, Jun-Ki Moon, Bo-Hyun Kim
Journal of Critical Care.2014; 29(4): 694.e7. CrossRef

36 View
0 Download
2 Crossref

Neglected Unilateral Subluxation of Facet Joint in Lumbar Spine of Multiple Trauma Patient: A Case Report: Ye Soo Park, Min Kun Kim, Jae Lim Cho; J Korean Soc Fract 2000;13(1):52-55. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.52

Abstract PDF: Unilateral dislocation or subluxation of a facet in lumbar spine is extremely rare, so it has been often neglected. The mechanism of injury is hyperflexion and distraction forces. As for the treatment of lumbar facet dislocation and subluxation, open reduction and internal fixation by the posterior approach has been recommended because the injuries are resistant to closed reduction and they may cause chronic instability. We report a case of neglected unilateral subluxation of facet joint in lumbar spine of multiple trauma patient, which was treated by open reduction and internal fixation with posterolateral fusion. In the multiple trauma patients, it is mandatory to the meticulous diagnosis and treatment.

23 View
0 Download

Search