Wang Gang, Bai Xiaodong
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People's Republic of China.
Int J Gen Med. 2020 Nov 6;13:1043-1049. doi: 10.2147/IJGM.S278536. eCollection 2020.
Pregnancy and lactation-associated osteoporosis (PLO) is very rare, which typically occurs during the third trimester or during lactation. Many cases of PLO are associated with vertebral compression fractures or hip fractures, while distal radius fractures in patients with PLO are rarely reported.
A 36-year-old patient presented with Barton fracture at 37 weeks of gestation. Temporary closed reduction and plaster external fixation were performed in emergency room. At 38 weeks of gestation, she gave birth to a healthy boy and began breastfeeding after delivery. Three days after delivery, the patient was admitted to the orthopedic ward for surgery and was diagnosed as PLO. The patient underwent open reduction and internal fixation and treated with weaning and supplementation of calcium carbonate and vitamin D. During the 1-year follow-up period, the results of laboratory tests and bone mineral density gradually returned to normal.
Clinicians should be alert to the possibility of PLO to avoid missed diagnosis. Accurate diagnosis and individualized treatment are of great significance for relieving pain and functional recovery of patients.
妊娠和哺乳期相关骨质疏松症(PLO)非常罕见,通常发生在妊娠晚期或哺乳期。许多PLO病例与椎体压缩骨折或髋部骨折有关,而PLO患者的桡骨远端骨折很少被报道。
一名36岁患者在妊娠37周时出现巴顿骨折。在急诊室进行了临时闭合复位和石膏外固定。妊娠38周时,她生下一名健康男婴,产后开始母乳喂养。产后三天,患者因手术入住骨科病房,被诊断为PLO。患者接受了切开复位内固定,并进行了断奶及补充碳酸钙和维生素D治疗。在1年的随访期内,实验室检查结果和骨密度逐渐恢复正常。
临床医生应警惕PLO的可能性,避免漏诊。准确诊断和个体化治疗对缓解患者疼痛和功能恢复具有重要意义。