Fensky F, Schäffler A, Siebenlist S, König B, Stöckle U
Abteilung für Unfallchirurgie, Klinikum rechts der Isar der TU München, Ismaningerstr. 22, 81675, München, Deutschland.
Unfallchirurg. 2011 Dec;114(12):1115-9. doi: 10.1007/s00113-010-1908-3.
Insufficiency fractures of the sacrum are frequently overlooked injuries especially in postmenopausal women with an osteoporotic bone structure and without a history of significant trauma. Plain radiographs are frequently inadequate in showing insufficiency fractures of the sacrum. Regarding this a fracture of a pubic ramus combined with appropriate clinical symptoms should raise the suspicion of a concomitant sacral injury. Therefore, further investigations including a CT scan are necessary.The case of an osteoporotic female patient with bilateral insufficiency fractures of the sacrum and a fracture of the right superior and inferior pubic ramus 5 weeks after primary total hip arthroplasty and implantation of a pedestal cup due to an intraoperative fracture of the right acetabulum is presented. To ensure early mobilization as well as avoidance of further concomitant morbidities a percutaneous iliosacral screw fixation was performed. This approach has been established as an operative treatment for minimally or non-displaced insufficiency fractures of the sacrum.
骶骨应力性骨折常被忽视，尤其是在骨质疏松骨结构的绝经后女性中，且无明显外伤史。普通X线片常不足以显示骶骨应力性骨折。鉴于此，耻骨支骨折合并适当临床症状时应怀疑伴有骶骨损伤。因此，包括CT扫描在内的进一步检查是必要的。本文介绍了一例骨质疏松女性患者，在初次全髋关节置换术及因右髋臼术中骨折植入基座杯5周后，出现双侧骶骨应力性骨折及右耻骨上下支骨折。为确保早期活动并避免进一步的并发症，进行了经皮髂骶螺钉固定。这种方法已被确立为骶骨轻度或无移位应力性骨折的手术治疗方法。
