Journal of Musculoskeletal Trauma

Diastasis of the Symphysis Pubis During Vaginal Delivery: Woo Nam Moon, Kwan Young Joo, Seung Woo Suh; J Korean Soc Fract 2001;14(1):37-43. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.37

Abstract PDF: PURPOSE
The objectives of this study are to observe the clinical characteristics and incidence of diastasis of symphysis pubis during vaginal delivery and to evaluate the risk factors of the lesion.
METHODS
AND MATERIALS: 16,000 vaginal delivery cases of our center from 1997 to 1999 were reviewed. The severe pain in symphysis pubis and walking difficulty after delivery were used as a diagnostic criterion. Several factors that increase the risk of this lesion during delivery were reviewed and analyzed by t-test between diastasis group (n=55) and normal group (n=100).
RESULTS
Fifty-five diastasis of symphysis pubis were diagnosed out of 16,000 normal vaginal delivery cases during that period. The widening of the joint ranged from 4mm to 34mm. Sixteen cases accompanied vertical mobility. No factor was proved to increase the risk of the lesion. Initial body weight of infant had suggestive significance (P=0.051).
CONCLUSION
We couldn't prove any risk factors that increased the risk of diastasis of symphysis pubis during vaginal delivery in this study. Further prospective studies with more cases would be needed to disclose the risk factors.

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Analysis of cause of collapse and Non-union After Internal Fixation of Intertrochanteric Fracture: Seung Woo Suh, Chang Ryong Hur, Jung Ho Park, Jun Seok Hong, Woo Nam Moon; J Korean Soc Fract 1999;12(4):812-817. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.812

Abstract PDF: Sixty-five Intertrochanteric hip fractures were analyzed radiologically to study the factors affecting postoperati ye stability. Fractures were evaluated by measuring shortening and angulation, collapse of telescoping device when utilized, and migration of the fixation device within the femoral head. Fractures were classified according to their stability preoperatively and the reduction of lessor trochanteric fracture fragment postoperatively. The failure rate and postoperative stability were then compared on terms of severity of osteoporosis, type of fracture, existence of reduction of lestor trochanter fragment.
Results
indicated that the severity of osteoporosis was not related to the group of fracture, which determines stability of fracture. Regarding the rate of bone union, anatomically reduced groups showed similar rates of bone union(73.8% in average) and degree of sliding of lag screw (4.13mm in average) regardless of fixation of lesser trochanter fragment. On the other hand, malreduced group which failed to obtain anatomical reduction had 26.1% of bone union rates and 10.95mm of sliding of lag screw representing importance of anatomical reduction rather than fixation of lesser trochanteric fracture. In conclusion, there was no correlationthip between severity of oLteoporosis and type of fracture. And it is suggested that unstabae intertrochanteric fractures accompanied by large lesser trochanteric fracture fragment can be provided stability avoiding major complications such as loosening of implant or collapse of fracture fragment if it is fixed with anatomical reduction of fracture even without the fixation of lesser trochanteric fragment.

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Seidel Interlocking Intramedullary Nailing for Humerus Fractures: Woo Nam Moon, Jae Yong Ahn; J Korean Soc Fract 1998;11(1):16-21. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.16

Abstract PDF: From retrospective review of 26 humerus fractures treated by Seidel interlocking intramedullary nailing, 17 complications in nine patients(35%) were occurred: two delayed unions, three malunions, two infections, one distraction of fracture gap, two additional fragmentations, two failures in proximal interlocking screw insertion, three distal locking mechanism failures and two proximal protrusions of nail. Functional assessment was carried out an all patients at a mean follow up 13 months(9-23 months). The results were ten excellent, twelve good, two fair and two poor. These results show that there are considerable problems at present in the use of the seidel interlocking nail.

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Treatment of Tibial Shaft Fractures Using Interlocking Intramedullary Comparison of Reamed and Unlearned Methods: Woo Nam Moon; J Korean Soc Fract 1997;10(3):562-568. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.562

Abstract PDF: Sixty-four closed or Gustilo type I open fractures of the tibial shaft were treated with interlocking intramedullary nailing with(n=38) or without(n=26) reaming and were followed for an average of 13 months. The time to bony union ranged from twelve to twenty-five weeks with an average of 16.4 weeks in reamed method and from thirteen to twenty-seven weeks with an average of 15.9 weeks in unlearned method. The complications of reamed method were seen in 4 cases(11%) (two stiffness of ankle joint, one malunion and one distal screw breakage) whereas complications of unlearned method were seen in 7 cases(27%) (one stiffness of ankle joint, two malunions and four distal screw breakages). There was no significant difference in the union time of reamed and unlearned interlocking intramedullary nailing. But complications of fracture healing were less frequently seen on reamed interlocking intramedullary nailing.

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Effect of Unreduced Lesser Trochanteric Fracture on Stability in Intertrochanteric Fracture of Femur: Seung Woo Suh, Jeong Ho Park, Jong Kun Oh, Kyung Wook Nah, Tae Hyeon Kim, Woo Nam Moon; J Korean Soc Fract 1997;10(3):529-533. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.529

Abstract PDF: Unstable intertrochanteric hip fractures are characterized by comminution of the posteromedial cortex, resulting in a fragment of variable size containing the lesser trochanter. Stability can be provided by transfixion of the lesser trochanteric fracture fragment with a screw. However, fixation of lesser trochanteric fragment is difficult, time-consuming, and often unsuccessful. Controversy exists as to whether it is necessary to perform reduction and fixation of this fragment. A radiological review of 61 intertrochanteric fractures treated with compression screw was made to study the effect of unreduced lesser trochanteric fracture on fracture healing and stability in unstable intertrochanteric fractures accompanied by lessor trochanteric fracture. Analysis were made on terms of rate of bone union, maintenance of reduction by comparing between anatomically reduced group with/without lesser trochanteric fracture and malreduced group with lesser trochanteric fracture. Anatomically reduced groups with/without lessel trochanteric fracture showed similar rates of bone union(88.3% in average) and degree of sliding of lag screw(3.74mm in average) regardless of fixation of lesser trochanter. On the other hand, unreduced group had 33.3% of bone union rates and 9.80mm of sliding of lag screw representing importance of anatomical reduction rather than fixation of lesser trochanteric fracture. In conclusion, it is suggested that unstable intertrochanteric fractures accompanied by large lesser trochanteric fracture fragment can be treated without fixation of lesser trochanteric fragment avoiding major complicatioins such as loosening of implant or collapse of fracture fragment.

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Operative Treatment of Intraarticular Fractures of the Distal Raidus: Jong Keon Oh, Seung Woo Suh, Woo Nam Moon, Sung Joon Hong; J Korean Soc Fract 1996;9(1):1-7. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.1

Abstract PDF: The intraarticular fracture of the distal radius is one of the most common fractures in the orthopaedic field and physicians have considered the results of the treatment to be favorable. But recently investigations into the pathomechanics of these injuries highlight the peoblems of arthritis, pain, swelling, weakness, limited ranges of motion and instability associated with nonanatomic reduction of both intraaetocular fragments and their associated ligaments. So the treatment of intraarticular fractures of the distal radius has been altered into more aggressive pattern using the open reduction and internal fixation, open reduction or closed reduction and internal fixation, closed reduction and percutaneous pinning. The authors reviewed 37 cases(34 patients)of intraarticular fractures of the distal radius treated using operative methods from February 1989 to May 1994 in the department of orthopaedic surgery, Ansan Hospital, Korea University: We analyzed the correlation between the radiologic parameters(articular conguity, radial height loss, adial angulation, palmar angulation)and the end results.

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