Karataş Metin, Başaran Ceyla, Ozgül Esra, Tarhan Cağla, Ağildere A Muhteşem
Department of Physical Medicine and Rehabilitation, Başkent University School of Medicine, Ankara, Turkey.
Am J Phys Med Rehabil. 2008 May;87(5):418-22. doi: 10.1097/PHM.0b013e318164a8e6.
Low-back and buttock pain is a common complaint during pregnancy and the postpartum period and is usually attributable to mechanical lesions of the pelvis. Sacral stress fractures are unusual but important causes that should be considered in differential diagnosis. To date, only eight postpartum sacral stress fractures have been reported in the literature. A 32-yr-old woman presented with low-back and right buttock pain that started 15 days after uneventful cesarean section delivery. Imaging studies revealed a right sacral stress fracture. Lumbar spine and femoral neck bone mineral density were normal and, except for pregnancy and lactation, no risk factors for osteoporosis were identified. There was no history of trauma, excessive weight gain, strenuous physical activity, or contribution of mechanical factors. The question remains whether this is an insufficiency fracture or a fatigue fracture. Clinicians should consider sacral fracture during pregnancy and the postpartum period as a diagnostic possibility in patients with low-back and/or buttock pain.
腰背部和臀部疼痛是孕期及产后常见的主诉，通常归因于骨盆的机械性损伤。骶骨应力性骨折虽不常见，但却是鉴别诊断中应考虑的重要病因。迄今为止，文献中仅报道过8例产后骶骨应力性骨折。一名32岁女性在剖宫产顺利分娩15天后出现腰背部及右侧臀部疼痛。影像学检查显示右侧骶骨应力性骨折。腰椎和股骨颈骨密度正常，除妊娠和哺乳外，未发现骨质疏松的危险因素。无外伤史、体重过度增加、剧烈体力活动或机械因素影响。问题仍然是这是一次骨质疏松性骨折还是疲劳性骨折。临床医生应将孕期及产后出现腰背部和/或臀部疼痛的患者骶骨骨折列为一种诊断可能。
