Insufficiency fracture of the pubic ramus – „typical“ or „atypical“: a case report

Česká verze

Authors: Jr K Oc Ján ¹; Šteňo Boris ²
Authors place of work: Oddelenie ortopédie, FNsP J. A. Reimana Prešov ¹; II. ortopedicko-traumatologická klinika LF UK a UNB, Bratislava ²
Published in the journal: Clinical Osteology 2022; 27(2-3): 65-68
Category: Kazuistiky

Summary

Insufficiency fractures occur in normal load on pathologically weak bone, as a result of osteoporosis. Atypical femoral fractures are well described complication of long term bisphosphonate use. With a growing geriatric population, the incidence of insufficiency fractures, as well as atypical femoral fractures, has increased. Also their early diagnostics is a problem, because they are often overlooked on first native X-ray. We present a case of patient, longterm treated with denosumab, who developed fracture of the pubic ramus. Because of delayed bone healing with unusual pattern we consider long-term anti-resorption therapy as a potentional cause of the pubic ramus fracture or factor affecting the healing of insufficiency fracture.

Keywords:

bisphosphonates – osteoporosis – atypical fracture – insufficiency fracture

Zdroje

1. Marshall RA, Mandell JC, Weaver MJ et al. Imaging Features and Management of Stress, Atypical, and Pathologic Fractures. Radiographics 2 018; 3 8(7): 2173–2192. Dostupné z DOI: <http://dx.doi.org/10.1148/rg.2018180073>.

2. O‘Connor TJ, Cole PA. Pelvic Insufficiency Fractures. Geriatr Orthop Surg Rehabil 2 014; 5 (4):178–190. D ostupné z DOI: < http://dx.doi.org/10.1177/2151458514548895>.

3. Van Berkel D, Herschkovich O, Taylor Ret al. The truth behind the pubic rami fracture: identification of pelvic fragility fractures at a university teaching hospital. Clin Med (Lond) 2020; 20(Suppl 2): 113. Dostupné z DOI: <http://dx.doi.org/10.7861/clinmed.20–2-s113>.

4. Franekova L. Atypical femoral fractures –⁠ what´s new? Clinic Osteol 2021; 26(4): 191–199.

5. Cabarrus MC, Ambekar A, LuY et al. MRI and CT of insufficiency fractures of the pelvis and the proximal femur. AJR Am J Roentgenol 2008; 191(4): 995–1001. Dostupné z DOI: <http://dx.doi.org/10.2214/AJR.07.3714.>.

6. Patel V, Graves L, Lukert B. Pelvic fractures associated with longterm bisphosphonate therapy –⁠ case report. J Musculoskelet NeuronalInteract 2013; 13(2): 251–254.

7. Studer P, Suhm N, Zappe Bet al. Pubic rami fractures in the elderly –⁠ a neglected injury? Swiss Med Wkly 2013; 143: w13859. Dostupné z DOI: <http://dx.doi.org/10.4414/smw.2013.13859>.

8. Kloc P, Tomcovcik L, Kloc J. Bilateral pathological sub-trochanteric fracture in a long-term biphosphonate user. Acta Chir Orthop Traumatol Cech 2011; 78(1): 77–81.

9. Adams AL, Xue F, Chantra JQ et al. Sensitivity and specificity of radiographic characteristics in atypical femoral fractures. Osteoporos Int 2017; 28(1): 413–417. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–016–3809-y>.

10. LeBlanc ES, Rosales AG, Genant HK et al. Radiological criteria for atypical features of femur fractures: what we can learn when applied in a clinical study setting. Osteoporos Int 2019; 30(6): 1287–1295. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–019–04869-z>.

Štítky

Biochemie Dětská gynekologie Dětská radiologie Dětská revmatologie Endokrinologie Gynekologie a porodnictví Interní lékařství Ortopedie Praktické lékařství pro dospělé Radiodiagnostika Rehabilitační a fyzikální medicína Revmatologie Traumatologie Osteologie

Článek Slovo úvodem

Článek Osteoporóza: štandardný diagnostický a terapeutický postup (špecializačný odbor endokrinológia)

Článek POSTEROVÁ SEKCIA

Článek Suprapatellar plica syndrome of the knee: literature review and case report

Článek Výber z najnovších vedeckých informácií v osteológii

Článek 25. KONGRES SLOVENSKÝCH A ČESKÝCH OSTEOLÓGOV s medzinárodnou účasťou 22.–24. 9. 2022 Hotel Patria | Vysoké Tatry, Štrbské Pleso | Slovensko

Článek ODBORNÝ PROGRAM

Článek PREDNÁŠKOVÁ SEKCIA – ODBORNÉ BLOKY

Článek vyšel v časopise