Newhouse K E, el-Khoury G Y, Buckwalter J A
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242-1088.
J Bone Joint Surg Am. 1992 Dec;74(10):1472-7.
The presentation, diagnosis, and treatment of occult sacral fractures in seventeen osteopenic patients were reviewed. Sixteen of the seventeen patients were elderly women, and the fracture usually occurred without trauma (fourteen patients). In ten patients, the sacral fracture was associated with a fracture of the pubic ramus. The sacral fractures were difficult to diagnose because nine patients also had a history of a malignant lesion of the pelvis with or without radiation treatment. Computed tomography and bone-scanning were diagnostic in all patients, but magnetic resonance imaging was not specific. Use of crutches or a walker, a reduction in activity, and use of non-narcotic analgesics allowed for the resolution of symptoms in all twelve patients who did not have mitigating conditions and permitted these patients to walk independently.
回顾了17例骨质疏松患者隐匿性骶骨骨折的临床表现、诊断及治疗情况。17例患者中有16例为老年女性，且骨折通常在无外伤情况下发生（14例患者）。10例患者的骶骨骨折合并耻骨支骨折。骶骨骨折难以诊断，因为9例患者既往有骨盆恶性病变史，无论是否接受过放射治疗。计算机断层扫描和骨扫描对所有患者均有诊断价值，但磁共振成像不具有特异性。对于12例无缓解因素的患者，使用拐杖或助行器、减少活动量以及使用非麻醉性镇痛药可使症状缓解，并使这些患者能够独立行走。
