Fukunishi Shigeo, Fukui Tomokazu, Nishio Shoji, Imamura Fumiaki, Yoshiya Shinichi
Department of Orthopaedic Surgery Hyogo College of Medicine, Nishinomiya City, Hyogo, Japan.
Orthop Rev (Pavia). 2009 Oct 10;1(2):e23. doi: 10.4081/or.2009.e23.
Multiple insufficiency fractures occurred in two patients with mutilating rheumatoid arthritis (RA), leading to substantial disabilities. Both patients received long-term oral glucocorticoid therapy and underwent multiple lower-extremity surgeries such as total hip arthroplasty (THA) or Total knee arthroplasty (TKA). The multiple fractures were located in the pelvis and lumbosacral region. Fractures in both patients were treated conservatively. Although bony union and resumption of activities were achieved in one patient, the other patient was not able to resume ambulation. For RA patients with combined risk factors for insufficiency fractures, aggressive preventive intervention and careful clinical assessment for early detection and management are warranted.
两名患有毁损性类风湿关节炎（RA）的患者发生了多处不全骨折，导致严重残疾。两名患者均接受了长期口服糖皮质激素治疗，并接受了多次下肢手术，如全髋关节置换术（THA）或全膝关节置换术（TKA）。多处骨折位于骨盆和腰骶部。两名患者的骨折均采用保守治疗。尽管其中一名患者实现了骨愈合并恢复了活动能力，但另一名患者仍无法恢复行走。对于存在不全骨折合并危险因素的RA患者，有必要进行积极的预防性干预，并进行仔细的临床评估以早期发现和处理。
