Sasaki Daizo, Hatori Masahito, Kotajima Satoru, Kokubun Shoichi
Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, 980-8574, Sendai, Miyagi , Japan.
Arch Orthop Trauma Surg. 2005 Jul;125(6):422-5. doi: 10.1007/s00402-005-0804-8. Epub 2005 Jun 14.
Fatigue fractures most frequently involve the tibia and metatarsal bones in the young. We report a very unusual case of fatigue fracture in the distal femur of a 62-year-old man. The differential diagnosis was a pathological fracture due to a metastatic bone tumor. The diagnosis of fatigue fracture was based on the fact that the patient walked every day for a long time, together with the following radiological features: no definite cortical destruction, a radiolucent area surrounded by sclerosis on CT, no extraskeletal mass, and sharp linear low signal intensities in the center of the lesion on MR images. Rest and restricted walking improved his symptoms and fracture healing. Fatigue fracture should be ruled out even in the elderly, especially those who engage in sports activities for long periods.
疲劳性骨折在年轻人中最常累及胫骨和跖骨。我们报告了一例62岁男性股骨远端疲劳性骨折的非常罕见病例。鉴别诊断为转移性骨肿瘤所致的病理性骨折。疲劳性骨折的诊断基于患者每天长时间行走这一事实，以及以下影像学特征：无明确的皮质破坏，CT上可见硬化环绕的透亮区，无骨外肿块，磁共振成像（MR）图像上病变中心有清晰的线性低信号强度。休息和限制行走改善了他的症状并促进了骨折愈合。即使在老年人中，尤其是那些长期从事体育活动的人，也应排除疲劳性骨折。
