Purpose: There is a high possibility of trauma patients being referred to an unsuitable medical institution for their rehabilitation treatment since the decision is made by them. This study sought to develop a standardized scale to evaluate the need for specialized rehabilitation in patients with multiple traumas and evaluate the effectiveness of the developed scale. Methods: This study employed a systematic review of existing literature to inform the development of a specialized rehabilitation evaluation scale. An expert panel consisting of trauma surgeons, orthopedic surgeons, and rehabilitation medicine physicians collaborated to create a discharge-planning checklist by assessing the need for specialized rehabilitation. The checklist was validated using retrospective data from trauma patients treated at Seoul National University Hospital. Results: We identified 12 studies, providing factors influencing the discharge location and rehabilitation needs of trauma patients. The checklist was developed through expert consensus and comprised 3 criteria: discharge feasibility to specialized rehabilitation facilities, diagnostic eligibility for specialized rehabilitation, and functional assessment. Validation of the checklist demonstrated that the percentage agreement, likelihood ratio of a positive test, and Cohen’s kappa value were 82.1%, 5.21, and 0.375, respectively when comparing whether the checklist was met and the actual discharge location, indicating its effectiveness. Conclusion This study established standardized criteria for assessing the need for specialized rehabilitation in trauma patients, offering a practical tool for clinical use. Implementation of this assessment scale has the potential to improve the trajectory of trauma survivors by facilitating access to appropriate rehabilitation services.

Purpose: There is a high possibility of trauma patients being referred to an unsuitable medical institution for their rehabilitation treatment since the decision is made by them. This study sought to develop a standardized scale to evaluate the need for specialized rehabilitation in patients with multiple traumas and evaluate the effectiveness of the developed scale. Methods: This study employed a systematic review of existing literature to inform the development of a specialized rehabilitation evaluation scale. An expert panel consisting of trauma surgeons, orthopedic surgeons, and rehabilitation medicine physicians collaborated to create a discharge-planning checklist by assessing the need for specialized rehabilitation. The checklist was validated using retrospective data from trauma patients treated at Seoul National University Hospital. Results: We identified 12 studies, providing factors influencing the discharge location and rehabilitation needs of trauma patients. The checklist was developed through expert consensus and comprised 3 criteria: discharge feasibility to specialized rehabilitation facilities, diagnostic eligibility for specialized rehabilitation, and functional assessment. Validation of the checklist demonstrated that the percentage agreement, likelihood ratio of a positive test, and Cohen’s kappa value were 82.1%, 5.21, and 0.375, respectively when comparing whether the checklist was met and the actual discharge location, indicating its effectiveness. Conclusion This study established standardized criteria for assessing the need for specialized rehabilitation in trauma patients, offering a practical tool for clinical use. Implementation of this assessment scale has the potential to improve the trajectory of trauma survivors by facilitating access to appropriate rehabilitation services.

Purpose: There is a high possibility of trauma patients being referred to an unsuitable medical institution for their rehabilitation treatment since the decision is made by them. This study sought to develop a standardized scale to evaluate the need for specialized rehabilitation in patients with multiple traumas and evaluate the effectiveness of the developed scale. Methods: This study employed a systematic review of existing literature to inform the development of a specialized rehabilitation evaluation scale. An expert panel consisting of trauma surgeons, orthopedic surgeons, and rehabilitation medicine physicians collaborated to create a discharge-planning checklist by assessing the need for specialized rehabilitation. The checklist was validated using retrospective data from trauma patients treated at Seoul National University Hospital. Results: We identified 12 studies, providing factors influencing the discharge location and rehabilitation needs of trauma patients. The checklist was developed through expert consensus and comprised 3 criteria: discharge feasibility to specialized rehabilitation facilities, diagnostic eligibility for specialized rehabilitation, and functional assessment. Validation of the checklist demonstrated that the percentage agreement, likelihood ratio of a positive test, and Cohen’s kappa value were 82.1%, 5.21, and 0.375, respectively when comparing whether the checklist was met and the actual discharge location, indicating its effectiveness. Conclusion This study established standardized criteria for assessing the need for specialized rehabilitation in trauma patients, offering a practical tool for clinical use. Implementation of this assessment scale has the potential to improve the trajectory of trauma survivors by facilitating access to appropriate rehabilitation services.

PURPOSE: Meningitis is an acute childhood infection caused by viral or bacterial infection. The purpose of the present study is to analyze the differences between enteroviral meningitis and non-enteroviral aseptic meningitis. METHODS: From January 2013 to December 2016, we retrospectively reviewed the medical records of a total of 303 aseptic meningitis patients who visited Wonju Severance Christian Hospital. We examined demographics of all patients and analyzed serologic and cerebrospinal fluid tests, clinical symptoms, and outcomes. RESULTS: Of a total of 303 patients, 197(65.0%) were male, and the most cases occurred from June to November (91.8%). The most common pathogen of meningitis was found to be enterovirus (65.0%). According to the etiology, the enteroviral meningitis group had significantly more headache and enteric symptoms (P=0.0003 and P=0.0013, respectively). Furthermore, the non-enteroviral meningitis group showed pleocytosis in the cerebrospinal fluid and a significantly higher rate of seizure at 1 to 4 years (P=0.0360 and P=0.0002, respectively). CONCLUSION: In this study, enteroviral meningitis was the most common and the prognosis was good. When compared between two groups, neurological symptoms were frequent in patients with non-enteroviral meningitis in groups 1 to 4 years.
Bacterial Infections ; Cerebrospinal Fluid ; Child ; Demography ; Enterovirus* ; Gangwon-do ; Headache ; Humans ; Leukocytosis ; Male ; Medical Records ; Meningitis* ; Meningitis, Aseptic ; Prognosis ; Retrospective Studies ; Seizures

BACKGROUND: Few studies have investigated the effects of sarcopenia on postoperative outcomes including mortality rates following surgery for osteoporotic hip fractures. The purpose of the present study was to determine the prevalence of sarcopenia and the relationship between sarcopenia and 1- and 5-year mortality rates in a consecutive series of patients with osteoporotic hip fractures. METHODS: Among patients who underwent hip surgery for osteoporotic hip fractures, this study included 91 patients subjected to abdominal computed tomography within 1 year of hip surgery. We defined sarcopenia using sex-specific cut-off points for the skeletal muscle index at the level of the third lumbar vertebra. All patients were divided into 2 groups according to the presence or absence of sarcopenia and the 1- and 5-year mortality rates were compared. To confirm factors affecting mortality in addition to sarcopenia, we examined patient age, sex, American Society of Anesthesiologists grade, location of fracture, type of surgery, and bone mineral density. RESULTS: The 1- and 5-year mortality rates were 20.9% and 67.2%, respectively. Among the 45 patients with sarcopenia, the 1- and 5-year mortality rates were 22.2% and 82.7%, respectively. Of the 46 patients without sarcopenia, the 1- and 5-year mortality rates were 19.6% and 52.7%, respectively. Results of the Kaplan-Meier analysis showed that sarcopenia did not affect the 1-year mortality rate (P=0.793), but had a significant effect on the 5-year mortality rate (P=0.028). Both perioperative sarcopenia (P=0.018) and osteoporosis (P=0.000) affected the 5-year mortality rate. CONCLUSIONS: Sarcopenia increases the risk of 5-year mortality in patients with osteoporotic hip fractures.
Bone Density ; Hip Fractures ; Hip* ; Humans ; Kaplan-Meier Estimate ; Mortality* ; Muscle, Skeletal ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Sarcopenia* ; Spine

PURPOSE: To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-Schönlein purpura (HSP). METHODS: A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. RESULTS: The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5%), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. CONCLUSION: In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome.
Adult* ; Anemia ; Antistreptolysin ; C-Reactive Protein ; Child* ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Mycoplasma pneumoniae ; Nephrotic Syndrome ; Pneumonia, Mycoplasma ; Prognosis* ; Proteinuria ; Purpura* ; Renal Insufficiency, Chronic ; Retrospective Studies* ; Risk Factors ; Uric Acid

PURPOSE: To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-Schönlein purpura (HSP). METHODS: A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. RESULTS: The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5%), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. CONCLUSION: In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome.
Adult* ; Anemia ; Antistreptolysin ; C-Reactive Protein ; Child* ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Mycoplasma pneumoniae ; Nephrotic Syndrome ; Pneumonia, Mycoplasma ; Prognosis* ; Proteinuria ; Purpura* ; Renal Insufficiency, Chronic ; Retrospective Studies* ; Risk Factors ; Uric Acid

Humeral shaft fracture sustaining arm wrestling is rare, but occurs intermittently. We treated 15 cases of humeral shaft spiral fractures occurred during arm wrestling for fun since 2007. Average age was 22.47±2.69 years, average body mass index was 22.67±2.06 kg/m2. There was no prominent tendency for the fractures to occur at a certain phase of the match. Fractured level and length of each case were measured in the plain radiographs and compared with those of previous reports. Eight cases (53.3%) had an associating medial butterfly fragment, and the time taken until the fracture occurred was longer than that of simple spiral fracture (15.62±9.03 seconds vs. 7.85±2.67 seconds, p=0.048). Fractures were distributed mid to distal one third of humerus, the length of fracture was 7.93±2.69 cm and involved 25.43%±8.24% of humeral length. All cases except one treated surgically using plate and screws and returned their full activities within postoperative 3 months. Although arm wrestling is a simple and joyful sport, participants should be aware of the risks of injury during arm wrestling, especially for the amateur players.
Arm* ; Body Mass Index ; Butterflies ; Humans ; Humeral Fractures ; Humerus ; Male* ; Sports ; Wrestling*

PURPOSE: The purpose of this study was to compare the clinical results between the subacromial injection of the ketorolac and that of the corticosteroid in patients with subacromial shoulder impingement syndrome. MATERIALS AND METHODS: Twenty patients with shoulder impingement syndrome received an injection of 60 mg ketorolac and were evaluated in terms of visual analogue scale (VAS), range of motion (ROM) and Constant-Murley score. The outcomes are compared with the data of patients treated by 40 mg triamcinolone injection, retrospectively. RESULTS: There was no significant difference in the demographics, VAS, ROM, and Constan-Murley score between the two groups before the injection. At the 4 weeks follow-up, pain improvement was significantly greater in the corticosteroid group (2.7±1.53) than in the ketorolac group (4.9±2.08; p=0.001). However 12 weeks after the injection, there was no significant difference in pain improvement between the two groups (ketorolac: 2.9±2.32, corticosteroid: 2.6±1.82; p=0.707). The Constant-Murley score at the final follow-up improved from 33.5 to 52.1 in the corticosteroid group, and from 39.0 to 56.6 in the ketorolac group (p=0.677). ROM was increased in both groups, and external rotation was significantly greater in the ketorolac group than in the corticosteroid group at the final follow-up (ketorolac: 29.3°±9.90°, corticosteroid: 20.8°±7.99°; p=0.005). CONCLUSION: In this study, ketolorac provided an effect equivalent to triamcinolone in the treatment of subacromial shoulder impingement syndrome at 12 weeks after the injection. This result could offer better opportunities to manage patients with diabetes or local and systemic side effects of repetitive use of corticosteroids.
Adrenal Cortex Hormones ; Anti-Inflammatory Agents, Non-Steroidal ; Demography ; Follow-Up Studies ; Glucocorticoids ; Humans ; Ketorolac* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder Impingement Syndrome* ; Shoulder* ; Triamcinolone

PURPOSE: Anatomical medial knee reconstruction is crucial to the recovery of the knee joint. Our purpose is to determine the location of femoral insertion of the superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) from the attachment site of the adductor magnus and medial gastrocnemius tendon with MRI results. MATERIALS AND METHODS: A total of 200 knee magnetic resonance imaging results were retrospectively measured. The boundary of femoral insertion of sMCL and POL was marked and measured on the sagittal image. The attachment site of the adductor magnus tendon and medial gastrocnemius tendon was identified. The lineal, anterior-posterior and proximal-distal distances were measured from the attachment site to the center of the femoral insertion of sMCL and POL. RESULTS: The average size of sMCL and POL was as follows—sMCL: length of 13.5±1.7 mm, width of 10.9±0.3 mm and POL: length of 9.4±1.3 mm, width of 6.1±0.5 mm. The lineal distances from the insertion of the adductor magnus tendon and medial gastrocnemius tendon to the center of the sMCL and POL were measured—distances to the sMCL: 17.1±3.8 mm, 15.9±3.2 mm; distances to the POL: 11.9±2.9 mm, 8.2±2.7 mm. CONCLUSION: This study will help determine the location of the femoral attachment site of sMCL and POL by identifying the attachment section of the adductor magnus tendon and medial gastrocnemius tendon. Moreover, this study will guide the reconstruction of sMCL and POL when palpation of the bony structures become difficult.
Collateral Ligaments* ; Knee ; Knee Joint ; Ligaments* ; Magnetic Resonance Imaging* ; Palpation ; Retrospective Studies ; Tendons