McKenna M J, Kleerekoper M, Ellis B I, Rao D S, Parfitt A M, Frame B
Bone. 1987;8(2):71-8. doi: 10.1016/8756-3282(87)90073-1.
Six women, aged 24-67 years, had osteopenia and insufficiency fractures, which suggested a diagnosis of osteomalacia. The insufficiency fractures occurred at traditional sites for Looser zones, were multiple in number, were symmetrically distributed in three patients, and did not heal promptly. Bone mass was low, as assessed by single-energy photon absorptiometry at the midshaft of the radius. Two postmenopausal women had vertebral compression fractures. Biochemical indices and bone histomorphometric analysis excluded osteomalacia, and in vivo double tetracycline labeling in five patients revealed both high and low bone turnover states. We propose more stringent radiographic criteria for the designation of the term "Looser zone" that retains the customary association between the radiologic event and osteomalacia. This paper also outlines a diagnostic strategy for future cases of atypical insufficiency fractures and proposes reasons for their resemblance to true Looser zones.
6名年龄在24至67岁之间的女性患有骨质减少和不全骨折，提示诊断为骨软化症。不全骨折发生在Looser带的传统部位，数量较多，3例呈对称分布，且愈合缓慢。通过单能光子吸收法评估桡骨中轴的骨量较低。两名绝经后女性有椎体压缩骨折。生化指标和骨组织形态计量学分析排除了骨软化症，5例患者的体内双四环素标记显示出高骨转换和低骨转换状态。我们提出了更严格的影像学标准来定义“Looser带”这一术语，以保留放射学表现与骨软化症之间的传统关联。本文还概述了未来非典型不全骨折病例的诊断策略，并提出了它们与真正的Looser带相似的原因。
