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产后非创伤性双侧股骨颈骨折

Non-traumatic, bilateral subcapital femoral fractures postpartum.

作者信息

Yassin Anhar, Jawad Issrah, Coomber Ross, Gonzalez-Castro Aurora

机构信息

Department of Trauma and Orthopaedics, Luton & Dunstable Hospital, Luton, UK.

出版信息

BMJ Case Rep. 2014 Jan 20;2014:bcr2013201625. doi: 10.1136/bcr-2013-201625.

Abstract

A 28-year-old Romanian woman, presented 2 weeks postnatally with pain in her left hip. Plain radiography suggested a left intracapsular, subcapital hip fracture. A CT scan of the pelvis showed diffuse osteopaenia with bilateral subcapital fractures of both femurs. From this imaging and subsequent investigation, a diagnosis of transient osteoporosis of pregnancy was made. The patient was treated with a closed reduction and cannulated screw fixation. Rehabilitative treatment, vitamin D, calcium and bisphosphonate therapy were initiated. She remains under close follow-up from orthopaedic, rheumatological and endocrine teams. Multiple opportunities were missed to identify the source of the patient's pain and inability to weight bear. Early detection and management of this condition is crucial because of the associated morbidity, including debilitating pain, reduced mobility, fractures and avascular necrosis. Cessation of breastfeeding, adequate pain relief, early use of bisphosphonates and rehabilitative treatment are essential.

摘要

一名28岁的罗马尼亚女性,产后2周出现左髋部疼痛。X线平片提示左髋关节囊内、股骨头下骨折。骨盆CT扫描显示弥漫性骨质疏松,双侧股骨均有股骨头下骨折。根据这些影像学检查及后续检查,诊断为妊娠性短暂性骨质疏松症。患者接受了闭合复位和空心螺钉内固定治疗。开始了康复治疗、补充维生素D、钙剂及双膦酸盐治疗。她仍在接受骨科、风湿科和内分泌科团队的密切随访。多次错失了找出患者疼痛及无法负重原因的机会。由于该病会引发包括疼痛难忍、活动能力下降、骨折和缺血性坏死等相关并发症,因此早期发现和处理至关重要。停止母乳喂养、充分缓解疼痛、早期使用双膦酸盐及康复治疗必不可少。

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