PURPOSE: Rib fractures are the most common injuries resulting from blunt chest trauma. The sensitivity of conventional chest radiography (chest PA, rib series) in showing a rib fracture is limited, particularly in those involving the cartilage part of the rib. We investigated the possible rib fractures. We used ultrasonography (US) to investigate possible rib fractures in patients with minor blunt chest trauma who showed no evidence of a rib fracture on the conventional chest radiography. METHODS: A total of 96 patients with minor blunt chest trauma and showing no evidence of a rib fracture on the conventional chest radiography were examined with US performed with a 7.5-MHz linear transducer. RESULTS: A total of 44(45.8%) patients showed a rib fracture whereas 52(54.2%) patients had no evidence of a rib fracture. Fracture of the rib with displacement 24 patients was the most common finding. CONCLUSIONS: Rib US is a useful imaging method in showing rib fractures overlooked on chest X-rays in cases of minor blunt chest trauma. Compared with conventional chest radiography, rib US takes a shorter time and is not difficult. Additionally, lesions combined with rib fractures and costal cartilage fractures are diagnosed more easily when using rib US.
Cartilage ; Fractures, Cartilage ; Humans ; Radiography ; Rib Fractures* ; Ribs* ; Thoracic Injuries ; Thorax ; Transducers ; Ultrasonography*

Histologically, Schmorl's nodes are defined as the loss of nuclear material through the cartilage plate, growth plate, and end plate into the vertebral body. Most Schmorl's nodes are asymptomatic, although there are some reports of symptomatic Schmorl's nodes, which should be treated similarly to vertebral compression fractures, with conservative treatment as the first choice. We report the case that we reduced the pain by blocking the ramus communicans nerve in a patient with Schmorl's node.
Cartilage ; Fractures, Compression ; Growth Plate ; Humans ; Nerve Block

Articular cartilage can be damaged by trauma or by progressive degradation caused by disease. Unfortunately, it has a extremely limited capacity for repair and regeneration. The use of joint prosthesis has revolutionized but remains limited in its use. To know the possibility of clinical application of clinical application of autogenous bone-articular graft in open complicated intraarticular fractures we studied the change of bone-articular cartilage defect in medial femoral condyle of rabbits and viability of autogenous bone-articular graft stored within abdominal wall of rabbits. The results were obtained as follows: 1. There was over 90% viability of subchondral bone after 10 days storage in the adbominal wall but the articular cartilage showed degenerative change about 40% after 5 days passed. 2. The bone-articular defect was replaced by undifferentiated mesenchymal tissue and fibrous tissue, postoperative 6 weeks later. 3. In implanted bone-articular cartilage graft at 3 days, the chondrocyte of basal cell layer in articular cartilage was relatively well preserved but in 7 days, transplanted articular cartilage graft showed almost necrotic chage. Most of subchondral bones were well healed with host bone without regard to duration of implantation.
Abdominal Wall ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Intra-Articular Fractures ; Joint Prosthesis ; Rabbits ; Regeneration ; Transplants

OBJECTIVE: To explore the clinical curative effect of soft tissue wire rivet for the treatment of fracture of patella cartilage. METHODS: A retrospective study was conducted in 25 patients(25 knees) from June 2015 to February 2017 in patients with patellar cartilage fractures. Among them, 19 were male, 6 were female, 11 were left knee, 14 were right knee. The accident occurred in 2 cases, 23 cases of sprained athletes; the average age was(25.12±6.02) years old, the average weight was (62.48±7.91) kg, and the average body mass index was(23.25±1.51) kg/m². The average time from injury to admission was (1.96±1.51) d. The clinical manifestations were swelling of knee joint, positive floating patella sign, severe pain, occasional joint strangulation, limited flexion and extension, obvious tenderness of lateral patella, positive patellar extrapolation test and positive extrapolation fear test. X-ray and CT examination were performed before operation. X-ray showed the continuity of patellar bone and a loose body in the joint cavity. CT and 3D reconstruction showed patellar cartilage and facial defects. All 25 patients were fixed with soft tissue wire rivet. The clinical efficacy included preoperative Lysholm score and Insall evaluation. RESULTS: All the patients were followed up, and the duration ranged from 3 to 15 months, with an average of(9.72±4.07) months. The preoperative Lysholm score was 60.32±5.08, and the final follow-up was 88.24±4.37. The postoperative score was better than that before operation(-22.926, <0.05). According to Insall criteria, 21 cases were excellent, 4 cases were good, no fracture fragments were found and knee joint adhesion was found. Six weeks after operation, X-ray and CT showed that the fracture was well positioned, the cartilage surface was smooth without obvious steps, and the patella was in good shape. MRI showed the smooth articular surface of patellar cartilage at the 6th month after operation. CONCLUSIONS Soft tissue wire rivet for the treatment of massive patellar cartilage fracture has the advantages of simple operation, rapid postoperative recovery, no need for secondary operation pain, fewer complications, and definite effect, which is worthy of clinical promotion.
Adult ; Bone Wires ; Cartilage ; Female ; Fractures, Cartilage ; Humans ; Male ; Patella ; Retrospective Studies ; Treatment Outcome ; Young Adult

Fractures involving joints and about the joints provide complex problems with small comminuted fractures, surrounding soft tissue injuries and articular cartilage damage. Various problems are also encountered on the weight bearing surface, especially on the convex side of the distal Femur. Even though many auther had recommended kinds of management upto now, operative methods are more suggested in order to get good results regarding with the accurate anatomical reduction, rigid internal fixation and early joint motion. The clinical analysis of rnanagements of 20 cases of distai femoral fracture demonstrate that seperate dual incision-bilateral or right angle plane-to originate fracture site, and anatomical reduction & rigid internal fixation, early non-weight bearing ROM exercise of joint were sometimes mandatory to treat the displaced, comminuted fracture.
Cartilage, Articular ; Femoral Fractures ; Femur ; Fractures, Comminuted ; Joints ; Soft Tissue Injuries ; Weight-Bearing

Emergency physicians in the field are sometimes confronted with cases wherein patients cannot be intubated and ventilated. In some cases, cricothyrotomy, the method of choice for securing an emergency airway, may not have a successful outcome. We report a rare case of a 35-year-old male patient with avulsion of the larynx and a comminuted fracture of the jawbone, due to entrapment in a dung excavator. Prehospital tracheotomy was successfully performed. In cases with crush injuries to the larynx, anatomic structures, including the ligamentum conicum, are destroyed. In addition, massive subcutaneous emphysema blurs the anatomical key structures; hence, only a tracheotomy can prevent a lethal outcome.
Adult ; Emergencies ; Emergency Medical Services ; Fractures, Cartilage ; Fractures, Comminuted ; Humans ; Larynx ; Male ; Methods ; Subcutaneous Emphysema ; Tracheotomy

Laryngeal trauma is rare compared to other head and neck traumas, but it occurs, it can be life threatening. As for treatment, a laryngeal fracture that involves displacement of cartilage or extensive injury requires appropriate surgical treatments. For severe laryngeal fractures, conservative management is usually preferred with placing a stent to prevent laryngeal stenosis. But the downside of placing stents in the larynx includes the risk of granulation and infection. In this report, the authors describe a 35-year-old patient, who was diagnosed with blunt laryngeal trauma and treated by Horizontal partial laryngectomy. The patient's post-operative breathing and voice were fair, and airway stenosis did not occur afterwards.
Adult ; Cartilage ; Constriction, Pathologic ; Fractures, Cartilage ; Head ; Humans ; Laryngeal Cartilages ; Laryngectomy* ; Laryngostenosis ; Larynx ; Neck ; Respiration ; Stents ; Voice

PURPOSE: This study compared the value of ultrasonography(US) in the diagnosis of sternal fractures with those of conventional radiography and bone scan. MATERIAL AND METHOD: From March 2000 to March 2001, in Gil Medical Center, Gachon Medical College, 44 patients(22 women and 22 men, mean age 46 years, range 5~81 years) complained of tenderness in the sternal area. The cases histories of these patients with clinically suspected sternal fracture due to blunt trauma were prospectively studied. At the time of admission, conventional radiography(sternal view) was done. At one day after admission, sternal ultrasonography was obtained, and after 4~5 days, a bone scan was done. Sternal ultrasonographic findings, conventional radiographic findings, and bone-scan findings were compared. In addition, a 12-lead ECG was done. When it was necessary, cardiac enzyme was checked and echocardiography was performed. RESULT: In 21 of 44 patients(48%), a sternal fracture was found by sternal US. Only 9 of 21 patients (43%) were diagnosed as having a sternal fracture by using conventional radiography. 23 of 44 patients (52%) have negative findings on sternal US; they also had negative findings on conventional radiography. Except for 7 unchecked patients, 13 of 21 patients(62%) were diagnosed as having a sternal fracture by bone scan, and among the 23 patients who had negative findings on sternal US, the 19 patients checked with a bone scan also had negative findings. CONCLUSION: Sternal US can find sternal fractures that are difficult to find on conventional radiography. Compared with bone scan, sternal US takes a shorter time and sternal US is not difficult. Additionally, combined lesions with sternal fractures(peristernal hematoma, soft tissue swelling) and costal cartilage fractures are diagnosed more easily when using sternal US.
Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Fractures, Cartilage ; Hematoma ; Humans ; Male ; Prospective Studies ; Radiography ; Ultrasonography*

PURPOSE: We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. MATERIALS AND METHODS: Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. RESULTS: Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. CONCLUSION: Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries.
Cartilage ; Humans ; Incidence ; Radiography* ; Rib Fractures* ; Ribs* ; Thoracic Injuries* ; Thoracic Wall ; Thorax* ; Ultrasonography*

The introduction of Multidetector-row CT (MDCT) has revolutionized the diagnostic strategy of multitrauma patients. The rapid acquisition of a large scanning volume with a thin slice collimation allows for motion-free images of high spatial resolution, and this enables the application of the multiplanar reformat (MPR) and 3D volume-rendering (VR) images. The MPR images more accurately demonstrate aortic rupture or dissection, diaphragmatic injuries and fracture of vertebrae, sternum and costal cartilages. Diagnosing vascular injuries can be aided by using the MIP images. Rib fracture, trachea and bronchial laceration are more easily detected by the 3D images, while airway and vascular injuries can be detected from performing virtual endoscopy. We introduce our current CT imaging protocol and we present our clinical experience with using MDCT in the assessment of patients with blunt thoracic trauma
Aortic Rupture ; Cartilage ; Endoscopy ; Humans ; Lacerations ; Rib Fractures ; Spine ; Sternum ; Thoracic Injuries* ; Trachea ; Vascular System Injuries