Journal of Trauma and Injury最新文献

{"title":"Is dorsal cortex drilling necessary for distal radius fractures treated with a volar locking plate? A comparative study of near-cortex-only and far-cortex drilling.","authors":"Chul Hong Kim, Sung Yoon Jung, Hyeon Jun Kim, Si-Hyun Park","doi":"10.20408/jti.2025.0018","DOIUrl":"10.20408/jti.2025.0018","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare and analyze the effectiveness of near-cortex-only drilling for the surgical treatment of distal radius fractures using a volar locking plate.</p><p><strong>Methods: </strong>From January 2010 to December 2022, a total of 185 patients aged 60 years or older with AO type C distal radius fractures who were treated with a volar locking plate at our hospital were enrolled. Of these, 59 patients were excluded according to the study criteria, resulting in a final cohort of 126 subjects. Without differentiating between left and right sides, group A (n=60) underwent distal locking screw fixation with screws of 12-mm length (except for the most radial screw) using near-cortex-only drilling. In group B (n=66), drilling was performed through to the dorsal cortex, and the length was measured using a depth gauge; distal screws were then fixed at a length 2 mm shorter than the measured depth. The degree of fracture reduction on postoperative radiographs was assessed using the modified Lidstrom scoring system by measuring radial inclination, radial height, and volar tilt. In addition, the visual analog scale, the Korean Disabilities of the Arm, Shoulder, and Hand (DASH) score, and the incidence of extensor tendon rupture and tenosynovitis were evaluated at the final follow-up and compared between groups.</p><p><strong>Results: </strong>Bone union was achieved in all cases, with no significant radiographic differences observed between the two groups (P>0.05). In contrast, two cases of extensor tenosynovitis were noted in group A, whereas group B experienced one extensor tendon rupture and five cases of extensor tenosynovitis, representing a significant difference (P<0.05).</p><p><strong>Conclusions: </strong>In patients aged 60 years or older with AO type C distal radius fractures, the technique of near-cortex-only drilling with short distal locking screws yielded satisfactory results for fracture reduction and clinical indices. This approach may offer a new alternative for preventing extensor tendon rupture or tenosynovitis.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 3","pages":"248-254"},"PeriodicalIF":0.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral artery dissection and homonymous hemianopsia after a cervical spine fracture in a polytrauma patient with hypoplastic contralateral vertebral artery: a case report.","authors":"Josip Lovaković, Dino Bobovec, Ivan Dobrić, Anko Antabak, Goran Milašin, Dino Papeš","doi":"10.20408/jti.2025.0014","DOIUrl":"https://doi.org/10.20408/jti.2025.0014","url":null,"abstract":"<p><p>Despite the increasing incidence of vertebral artery injury (VAI), it can often be overlooked during the management of polytrauma patients. Due to its specific anatomical location, the VA is particularly susceptible to both traumatic and spontaneous injuries. Traumatic VAI can result from blunt or penetrating trauma and is frequently associated with cervical spine injuries. An 18-year-old male patient was brought to the emergency department after being struck by a motor vehicle. The patient exhibited altered mental status while remaining normotensive and tachypneic. Notably, there were no visible injuries to the head or neck, though multiple contusions were present on the chest and abdomen. Radiographic imaging revealed a fracture of the transverse process of the seventh cervical vertebra, which caused dissection, thrombosis, and occlusion of the V1 segment of the left VA. Additionally, hypoplasia of the contralateral VA was observed. Given the presence of ultrasonographically confirmed free intra-abdominal fluid and the patient's newly developed hemodynamic instability, he was urgently transferred to the operating theatre. A grade 3 liver laceration was discovered, and hemostasis was successfully achieved using direct sutures. After regaining consciousness, the patient reported right-sided homonymous hemianopsia accompanied by signs of cerebral ischemia. Following stabilization, he was started on anticoagulant and antiplatelet therapy. Upon discharge and during follow-up, the visual deficit persisted. This case emphasizes the importance of recognizing and managing VAI in polytraumatized patients. Furthermore, the rare combination of contralateral VA hypoplasia and VAI significantly influenced the development of neurological deficits.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex soft tissue injuries associated with portable charger detonation: four case reports from the war in Ukraine.","authors":"Eduard Mykolaiovych Khoroshun, Vitaliy Volodymyrovych Makarov, Volodymyr Volodymyrovych Nehoduiko, Maksym Olegovych Malimonenko, Hannah B H Wild, Serhii V Tertyshnyi","doi":"10.20408/jti.2025.0042","DOIUrl":"https://doi.org/10.20408/jti.2025.0042","url":null,"abstract":"<p><p>This article describes the characteristics and management of injuries associated with ricochet effects due to portable charger detonation. We present a case series of four military personnel who sustained complex soft tissue injuries when portable chargers detonated after being struck by projectiles during combat. All patients were treated by an advanced surgical team at the Military Medical Clinical Center of the Northern Region in Kharkiv, Ukraine, over a 9-month period in 2023. Patient history, physical examination findings, laboratory studies, radiographic imaging, treatment approaches, and early outcomes were examined. All patients were male, with a mean age of 33±0.3 years. Complex soft tissue injury patterns arose when a projectile (such as a bullet or shrapnel) struck the charger, causing ricochet effects while damaging the battery housing and triggering detonation. The anatomical region of injury corresponded to the charger's placement in the patients' pockets, namely the thigh or buttock. Characteristic findings included local chemical burns of the skin and subcutaneous tissue, with surrounding ecchymosis. Surgical teams identified three zones of damage associated with this injury pattern: (1) a central zone with the most pronounced burn related changes, covering the smallest area of the three zones; (2) an intermediate zone of soft tissue damage from thermochemical reactions extending beyond the charger's profile; and (3) an outer zone of ecchymosis. Risks associated with carrying portable chargers during combat have not been well documented. These findings may inform injury prevention strategies for military personnel.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual plating in the management of nonunion complex distal femur fractures following lateral locked plate fixation: radiological and functional outcomes of a prospective study.","authors":"Nilesh Barwar, Gypsy Gargi, Ankit Rai, Abhay Elhence, Sumit Banerjee, Nitesh Gahlot","doi":"10.20408/jti.2024.0054","DOIUrl":"10.20408/jti.2024.0054","url":null,"abstract":"<p><strong>Purpose: </strong>Managing complex distal femur fractures presents technical challenges. Although the lateral locked plate has become standard for these fractures, failures are not uncommon when this device is used alone. Patients with nonunion of distal femur fractures following treatment with a single lateral locked plate were examined. Revision surgery was performed by applying dual plates, and their efficiency was evaluated.</p><p><strong>Methods: </strong>This study investigated 24 aseptic and 3 septic nonunions of distal femur fractures, classified as AO/OTA type C, that were previously managed with open reduction and internal fixation using only a lateral locked plate. Revision surgery involved replacing the broken 5.0-mm lateral locked plate, supplementing the medial side with a 4.5-mm T-plate, and applying bone grafting at the fracture site. Septic cases were managed using a staged approach with dual implant application.</p><p><strong>Results: </strong>Following revision surgery, bony union was achieved in 83.3% of aseptic nonunions, with a mean bone healing time of 22.5 weeks (range, 15-27 weeks). Additional surgery was required for the remaining 16.6%. Using staged management, the septic nonunions were united in a mean of 30.25 weeks (range, 27-32 weeks). Significant improvements were noted in the Tegner Lysholm Knee Scoring Scale, with median preoperative and postoperative scores of 30 (range, 12-67) and 80 (range, 66-90), respectively (P<0.001). Limb pain, as measured by the visual analog scale for knee pain, improved significantly from a preoperative median of 6 (range, 4-8) to 3 (range, 1-6) postoperatively (P<0.001). All patients were ambulatory without supportive devices. However, the mean knee range of motion was 80° (range, 40°-120°). Limb shortening was observed in six cases (22.2%; average shortening, 2.3±1.0 cm).</p><p><strong>Conclusions: </strong>Dual plating appears to be an effective approach for managing failed complex distal femur fractures following initial treatment with a single lateral locked plate.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"125-136"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical site infections: a comprehensive review.","authors":"Ahmad Reza Rezaei, Damian Zienkiewicz, Amir Reza Rezaei","doi":"10.20408/jti.2025.0019","DOIUrl":"10.20408/jti.2025.0019","url":null,"abstract":"<p><p>Surgical site infections (SSIs) represent a major public health challenge, contributing to increased morbidity, mortality, and healthcare costs worldwide. This paper presents a comprehensive review of the epidemiology, classification, risk factors, microbiological aspects, treatment modalities, and prevention strategies for SSIs, based on contemporary research and evidence-based practice protocols. An extensive literature review was conducted, synthesizing existing studies on SSIs. A comprehensive search was performed in PubMed, Embase, Cochrane Library, and guidelines from leading organizations such as the American College of Surgeons, the US Centers for Disease Control and Prevention, the World Health Organization, and the Infectious Diseases Society of America. Inclusion criteria encompassed peer-reviewed articles as well as American and European medical guidelines focusing on the epidemiology, risk factors, microbiology, treatment, and prevention of SSIs. The review adhered to the PECO (population, exposure, comparator, outcome) framework. Some of the most significant global concerns related to SSIs include antibiotic resistance and the contamination of surgical instruments, particularly in resource-poor settings. Trauma patients, especially those undergoing emergency procedures or sustaining open fractures, are at increased risk for SSIs due to the severity of their injuries and higher contamination risks. These findings underscore the importance of preventive measures, such as appropriate preoperative interventions, strict aseptic techniques, and proper antibiotic prophylaxis, in reducing SSI incidence and improving patient outcomes.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"71-81"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and outcomes of open and endovascular aortic repair with blunt traumatic aortic injuries in Western Australia.","authors":"Amyna Jiwani, Warren D Raymond, Fernando Picazo-Pineda, Sudhakar Rao, Kishore Sieunarine","doi":"10.20408/jti.2024.0101","DOIUrl":"10.20408/jti.2024.0101","url":null,"abstract":"<p><strong>Purpose: </strong>Blunt traumatic aortic injuries (TAIs) require timely surgical intervention to prevent death. We described the management and outcomes of polytrauma patients with TAI after open and endovascular repair in Western Australia.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients with TAI admitted to the State Trauma Unit, Royal Perth Hospital from 2008 to 2018. Patient data were obtained from the Trauma Database and supplemented with chart review.</p><p><strong>Results: </strong>Among 57 patients with TAI, 45 (78.9%) were male, with a mean age of 41 years, and were mainly involved in motor vehicle crashes (89.5%). They had a median Injury Severity Score of 34 (interquartile range [IQR], 21-45) and a median length of stay of 18 days. Concurrent injuries occurred in nearly all patients, including musculoskeletal (56 patients, 98.2%; mainly fractures, 91.2%), central nervous system (33 patients, 57.9%; mostly hemorrhage), injury to the chest cavity (46 patients, 80.7%), and abdominal organs (32 patients, 56.1%). The most common TAI grade was III (56.1%), followed by grade I (22.8%) and grade II (21.1%); all grade IV patients died before vascular consultation. TAI was managed with endovascular surgery (thoracic endovascular aortic repair, TEVAR) in 37 (64.9%, of which early TEVAR was performed in 29 [78.4%]), open surgery in 4 (7.0%), and conservative management in 16 (28.1%). Vascular procedures had a median duration of 81 minutes (IQR, 60-97 minutes). Acute vascular surgery-related complications were infrequent (5.3%), and all occurred post-TEVAR, mainly involving upper limb ischemia that required bypass or stenting within 72 hours of the index procedure. After discharge (52 patients), 3 patients were lost to follow-up regarding surgical survival, and late complications occurred in 6 of 48 vascular surgery patients (12.5%), who all underwent TEVAR.</p><p><strong>Conclusions: </strong>TAI patients who received a vascular surgery review and were managed either conservatively or surgically showed favorable postdischarge survival rates and surgical results. Patients with grade II or III TAI who underwent endovascular repair had favorable short- and long-term outcomes.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 2","pages":"111-124"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolution is not the end: The Macklin effect after chest tube removal in a trauma patient with aging and comorbidities: a case report.","authors":"Faye Abdulkareem, Fayez G Aldarsouni, Sahar Alomar, Zisis Touloumis, Hussain M AlHassan, Ghassan Z Al Ramahi, Tareq Alsabahi, Khaled Twier, Mohammad Alsenani, Emad Alamoudi","doi":"10.20408/jti.2024.0090","DOIUrl":"10.20408/jti.2024.0090","url":null,"abstract":"<p><p>Pneumomediastinum is an uncommon complication in cases of blunt chest trauma but can signal severe underlying issues. This report discusses a 69-year-old male patient with preexisting conditions of obesity, sleep apnea, and asthma, who experienced delayed pneumomediastinum and pneumopericardium following the removal of a chest tube. This tube had been placed to address a traumatic hemopneumothorax, which had resolved. The removal of the chest tube triggered a series of events, exacerbated by the patient's chronic health conditions. The patient was managed conservatively with close monitoring and physiotherapy, which successfully resolved the condition without the need for further invasive procedures. The multifactorial nature of the Macklin effect illustrates that even routine procedures such as chest tube removal can trigger a chain reaction in susceptible patients. The choice of conservative management, rather than immediate invasive interventions, underscores the delicate balance necessary in trauma care.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons from foreign military surgeons in the Korean War: advancing trauma surgery and preparing for future conflicts.","authors":"Kun Hwang, Chan Yong Park","doi":"10.20408/jti.2025.0041","DOIUrl":"10.20408/jti.2025.0041","url":null,"abstract":"<p><strong>Purpose: </strong>The Korean War (1950-1953) significantly advanced military medicine, with foreign military surgeons playing a pivotal role in transforming trauma care under extreme conditions.</p><p><strong>Methods: </strong>Resources such as PubMed, JSTOR, and reports from participating nations formed the basis of this study. A thorough comparative analysis was performed to examine the similarities and differences in medical practices between the United Nations Command and North Korean forces.</p><p><strong>Results: </strong>The United States introduced Mobile Army Surgical Hospitals, revolutionizing trauma care by enabling rapid intervention near combat zones. Innovations such as helicopter evacuation, whole blood transfusions, and antibiotic treatments reduced mortality rates among treated soldiers to as low as 3%. British surgeons excelled in managing abdominal wounds and performing orthopedic surgery, often undertaking limb-saving procedures. Field hospitals provided comprehensive care for combat injuries and infectious diseases-a major concern given the inadequate sanitation. The Indian 60th Parachute Field Ambulance treated over 20,000 casualties, demonstrating adaptability in harsh environments. The Indian Field Hospital not only treated military casualties but also provided care to Korean civilians, offering life-saving medical interventions under challenging conditions. Denmark deployed the hospital ship MS Jutlandia, equipped with advanced surgical facilities, enabling a level of medical care that was not practical on land. The Swedish Red Cross Field Hospital in Busan delivered crucial medical aid to both military personnel and civilians; its staff focused on civilian outreach and controlling epidemics, with treatments targeting diseases such as typhoid and tuberculosis. Norwegian mobile surgical teams specialized in rapid interventions near combat zones, performing life-saving operations within hours of injury and thus minimizing complications and increasing survival rates.</p><p><strong>Conclusions: </strong>The lessons learned from these contributions continue to influence modern military and civilian healthcare systems, highlighting the importance of innovation, collaboration, and resilience in conflict settings.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"103-110"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between bispectral index values and the Glasgow Coma Scale in traumatic brain injury patients: a prospective observational study.","authors":"Anjum H Mujawar, Pradnya M Bhalerao, Sujit J Kshirsagar","doi":"10.20408/jti.2025.0026","DOIUrl":"10.20408/jti.2025.0026","url":null,"abstract":"<p><strong>Purpose: </strong>Traumatic brain injury (TBI) severity is typically assessed using the Glasgow Coma Scale (GCS). In contrast, the bispectral index (BIS) objectively evaluates a patient's level of consciousness in an intensive care unit. The primary objective of this study was to evaluate the correlation between GCS and BIS values in TBI patients. Secondary objectives included determining the range of BIS scores corresponding to different levels of consciousness and assessing the correlation among mild, moderate, and severe TBI.</p><p><strong>Methods: </strong>Sixty patients participated in a prospective observational study conducted at a government tertiary care facility. After obtaining a detailed history and performing a physical examination, each patient's age, sex, intubation status, computed tomography brain findings, and vital signs were recorded. Subsequently, the patients' GCS and BIS values were measured at 0, 6, 12, 18, and 24 hours. Quantitative data are presented as mean±standard deviation, while qualitative data are illustrated using frequency and percentage tables. Spearman correlation analysis was employed to evaluate the association.</p><p><strong>Results: </strong>Spearman correlation analysis demonstrated a strong positive relationship between BIS and GCS at 0 hours (r=0.655, P<0.05), 6 hours (r=0.647, P<0.05), 12 hours (r=0.652, P<0.05), 18 hours (r=0.659, P<0.05), and 24 hours (r=0.648, P<0.05). Moreover, the mean BIS value decreased significantly with increasing severity of head injury.</p><p><strong>Conclusions: </strong>Similar to the GCS, the BIS correlates with head injury severity and may serve as a complementary tool for predicting outcomes in TBI patients.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"38 2","pages":"97-102"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerability of the border area: analysis of the Traffic Accident Analysis System in Korea.","authors":"Doo-Hun Kim, Hangjoo Cho, Sung Yub Jeong, Maru Kim","doi":"10.20408/jti.2024.0100","DOIUrl":"10.20408/jti.2024.0100","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed patient vulnerability following traffic accidents (TAs) in Korea's border area (BA).</p><p><strong>Methods: </strong>The BA includes cities and counties directly adjacent to the demilitarized zone with North Korea. The rear area (RA) is defined as the area immediately adjacent to the BA. TA data from 2017 to 2021 were obtained from the Traffic Accident Analysis System in Korea. Information on road length, population, number of TAs, injured patients, and fatalities was collected. The number of TAs and fatalities per 1 km of road length and per 100,000 people was calculated. Severity (number of fatalities per 100 TA cases) and lethality (number of fatalities divided by the sum of fatalities and injured patients) were used to assess the vulnerability of each area.</p><p><strong>Results: </strong>A total of 55,463 TAs were analyzed. Although the RA exhibited higher numbers of TAs and deceased patients per 1 km of road length and per 100,000 people, the BA showed significantly higher fatalities per 100,000 people as well as increased severity and lethality.</p><p><strong>Conclusions: </strong>The BA is more likely to be associated with death following TAs, despite a lower overall TA incidence compared to the RA. Further analysis is needed to address and mitigate this vulnerability.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}