Soubrier Martin, Dubost Jean-Jacques, Boisgard Stephane, Sauvezie Bernard, Gaillard Pierre, Michel Jean Luc, Ristori Jean Michel
Rheumatology department, CHU Gabriel Montpied, BP 69, 63003 cedex 1, Clermont-Ferrand, France.
Joint Bone Spine. 2003 Jun;70(3):209-18. doi: 10.1016/s1297-319x(03)00024-1.
We report findings on the site, risk factors and imaging of insufficiency fractures (IF) in 60 patients admitted to our department between 1989 and 1997.
Fifty-five women (mean age 72.5 years) and five men (mean age 59 years) had 91 fractures, accounting for 0.32% of admissions. Fractures occurred most commonly in the pelvic girdle (30.7%, 28/91) and in the sacrum (29.6%, 27/91). In eight patients fractures of the sacrum were associated with fractures of the pelvic girdle. The next most common sites of occurrence were the tibia (16.5%, 15/91: 11 transverse, four longitudinal) and the femoral neck (9.9%, 9/91). There were three subchondral fractures of the femoral head, three fractures of the femoral diaphysis (two longitudinal, one transversal), two of the astragalus, and one each of the ilium, perone, calcaneum and sternum. Thirty patients had osteoporosis: six had received fluoride treatment and five had corticosteroids. Other risk factors were rheumatoid arthritis (4), osteomalacia (4), corticosteroid treatment (4), and hyperparathyroidism (1). Radiography showed a fracture line or osteocondensation in 65% (39/60) of cases. Scintigraphy was positive in 87.5% of cases (21/24), showing a fracture line (15) or a callus (6). Bone computed tomography (CT) scan was positive in 98.1% (54/55) of cases. IF occurs in elderly women with osteoporosis and most commonly in the pelvis.
Since radiologic signs are inconstant, scintigraphy is the choice procedure.
我们报告了1989年至1997年间收入我院的60例患者的骨不全性骨折（IF）的部位、危险因素及影像学表现。
55名女性（平均年龄72.5岁）和5名男性（平均年龄59岁）发生了91处骨折，占入院患者的0.32%。骨折最常见于骨盆带（30.7%，28/91）和骶骨（29.6%，27/91）。8例患者骶骨骨折合并骨盆带骨折。其次常见的发生部位是胫骨（16.5%，15/91：11处横行，4处纵行）和股骨颈（9.9%，9/91）。有3例股骨头软骨下骨折，3例股骨干骨折（2例纵行，1例横行），2例距骨骨折，髂骨、腓骨、跟骨和胸骨各1例骨折。30例患者患有骨质疏松症：6例接受过氟化物治疗，5例接受过皮质类固醇治疗。其他危险因素包括类风湿性关节炎（4例）、骨软化症（4例）、皮质类固醇治疗（4例）和甲状旁腺功能亢进（1例）。X线检查显示65%（39/60）的病例有骨折线或骨质增生。骨闪烁显像在87.5%（21/24）的病例中呈阳性，显示骨折线（15例）或骨痂（6例）。骨计算机断层扫描（CT）在98.1%（54/55）的病例中呈阳性。骨不全性骨折发生于患有骨质疏松症的老年女性，最常见于骨盆。
由于放射学征象不恒定，骨闪烁显像是首选的检查方法。
