Clinical Analysis of the 784 Traffic Accident Victims / 대한정형외과학회잡지

A retrospective study has been made of 784 cases of road traffic casualties who were treated at the Soon-Chun-Hyang Hospital between July 1980 and December 1981. This study was conducted to find out the nature and pattern of the traffic accident from the clinical and epidemiological standpoints. In additions, the mode of injury from the road accidents were persued which might help to reduce the misdiagnosis rate. The results obtained were as follows: l. In this survey, male dominated in numbers (casualty rate, 70%). The highest incidence was in the age group between 31–40 year (26.5%). The predominance was found in younger casualties (ages between 21–50 years, 72.1% of all casualties). 2. The large number of casualties followed the rush hours. There was a peak between 10PM to midnight. The explanation for this high incidence during the hours was the hurry-up life due to midnight crufew, pedestrian's carelessness and hurry-scurry, and the negligence of traffic rules, the poor labor conditions and weariness due to drivers long continuous working hours, especially in taxi drivers. The highest seasonal incidence was in October. 3. The high incidences were in drivers and students; the drivers were the commonest victims in car passenger accidents and students were injured by pedestrians accidents respectively. The causes of high risk of injury in drivers were intimately related with their vocational aptitudes, the employment status, the driving attitudes and car maintainances; and in students, their carelessness and emotional instability, unsolved mass transportation system and their negligence of traffic rules were listed as the causative factors. 4. Over 51.8% of all casualties were injured by passenger car accidents, and 21.5% were by truck and other types of special vehicles. 5. Approximately 60% of victims were injuried in the road as pedestrian and other 40% were in the car as passengers. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 6. About 40% of total pedestrian casualties sustained injury at pedestrian's cross road. 7. About 80%of injured drivers were in the drunken state on arrival, and 20.4% of pedestrians were also heavily drunken. 8. The trauma risk was about twice higher in the front-seated passengers than the rear-seated ones in the car. In buses, the highest incidence was in the passengers seated in the front 1/3 of the seats. 9. Orthopaedic (40.5%) and head injuries (38.2%) were the commonest types of the injuries among the hospitalized casualties; about 35% of total patients had the tibial fractures. 10. Of the 784 cases, 479(61.6%) victims arrived hospital within 30 minutes after accident, and among them only 94 cases (12%) were transported by ambulance from the accident site to the hospital.

Clinical Consideration on the Treatment of Fractures by Hoffmann's Transfixation Method / 대한정형외과학회잡지

Open long bone fracture is frequently difficult to reduce and maintain, especilly when there is extensive soft tissue damage. Infection, instability, malalignment and soft tissue complication often result in prolonged mobidity or failure. The Hoffmann's apparatus have merits, that can easily correct distracted, angular or rotational deformity of fracture site during early post-operative period, and stable fixation facilitates easily to the care of soft tissue injury. In addition, the affected limb can be elevated with balanced suspension, possible early exercise of neighboring joints. But we have exerienced some problems during treatment of fracture with Hoffmann's transfixation method. From February 1980 to December 1981, Hoffmann's transfixation method was employed in treatment of twenty-one patients that considered to have a poor prognosis with conversional forms of treatment. The results were obtained as follows; 1. For correction of distracted, angular, or rotational deformity, the fracture site should be reduced accurately. 2. Hoffmann pins should be transfixed as one plane and parrallel to each other. 3. Rigidity of fixation can be increased by increasing number of pins, actually three or more pins should be applied at each fragment of fracture. 4. Hoffmann's apparatus is more complex for management, more expensive and requires skillful technique compared with other external fixation apparatus. 5. The lateral view of fracture site could not be confirmed accurately due to overlapping of Hoffmann's adjustable connecting rod and bony shadow. 6. The main cause of injuries was due to traffic accidents in 17 cases (81%), involving tibia in 18 cases, femur in 2 cases and humerus in 1 case. 7. In the sixteen cases which could be assessed, the average times for external transfixation was 13.9 weeks and then followed by early weight bearing with P.T.B. cast or brace. The average time of bony union was 26.4 weeks. 8. The final result was excellent in 7 cases, good in 5 cases, acceptable in 3 cases, poor in 1 case.

Treatment of Patella Fracture / 대한정형외과학회잡지

The results of treatment upon 56 cases of fracture of the patella, during the period from July 1975 to October 1978 at the department of orthopedic surgery, Soon Chun Hyang Medical College have been analysed. In sex distribution, 47 were male and 9 were female cases. The incidence was remarkably higher in male and the age group of 20-40. 2. 39 cases were fractured by direct force and 17 cases were indirect force. The most common cause of fracture was traffic accident. 3. The most common site of fracture was midpole and 27 cases were communited type. 4. Our methods of treatment were simple cast, circlege wire loop, tension band technique, partial and total and total patelletomy, etc. as indicated. 5, The mean duration of rehabilitation in the group of immobilized in 10 of flexion was shorter than that of full extension group.