Avhad Tanmay Anil, Bhangde Saurabh
Department of Orthopaedics, TNMC and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2024 Aug;14(8):174-178. doi: 10.13107/jocr.2024.v14.i08.4690.
The increasing incidence of atraumatic neck of femur (NOF) fractures, often linked to age-related bone weakening, is a notable clinical trend. This case report highlights a 72-year-old male presenting with NOF and proximal humerus fractures post-trivial fall, revealing lytic lesions suggestive of multiple myeloma (MM). Despite inconclusive skeletal and metabolic evaluations, a comprehensive surgical approach confirmed MM, emphasizing the importance of thorough diagnostic and therapeutic management in complex cases.
A 72-year-old male presented with a trivial fall resulting in hip and shoulder trauma, revealing right transcervical NOF and proximal humerus fractures on X-rays, alongside multiple lytic lesions suggesting MM. Despite inconclusive metabolic evaluations, conservative management was pursued for the humerus fracture, while a complex surgical approach involving curettage and cemented bipolar hemiarthroplasty was undertaken for the femur fracture, confirming MM on histopathology.
Evaluating atypical MM manifestations in the appendicular skeleton requires comprehensive assessment and diagnostic procedures to influence outcomes and improve quality of life. Managing suspected pathological fractures involves detailed evaluation and surgical planning, highlighting the importance of collaboration among different specialties.
无创伤性股骨颈（NOF）骨折的发病率不断上升，这通常与年龄相关的骨质变弱有关，是一个显著的临床趋势。本病例报告重点介绍了一名72岁男性，在轻微跌倒后出现股骨颈骨折和肱骨近端骨折，显示出提示多发性骨髓瘤（MM）的溶骨性病变。尽管骨骼和代谢评估结果不明确，但综合手术方法确诊为MM，强调了在复杂病例中进行全面诊断和治疗管理的重要性。
一名72岁男性因轻微跌倒导致髋部和肩部受伤，X线检查显示右侧经颈股骨颈骨折和肱骨近端骨折，同时伴有多个提示MM的溶骨性病变。尽管代谢评估结果不明确，但对肱骨骨折采取了保守治疗，而对股骨骨折则采用了包括刮除术和骨水泥双极半关节置换术在内的复杂手术方法，组织病理学检查确诊为MM。
评估四肢骨骼中不典型的MM表现需要进行全面评估和诊断程序，以影响治疗结果并改善生活质量。处理疑似病理性骨折需要详细评估和手术规划，突出了不同专科之间合作的重要性。
