Wada K, Tominaga A, Naruo M, Okazaki K
Department of Orthopaedics, Spine Center, Tomei Atsugi Hospital, Kanagawa, Japan.
Department of Orthopaedics, Tokyo Women's Medical University, Tokyo, Japan.
Trauma Case Rep. 2025 Apr 15;57:101176. doi: 10.1016/j.tcr.2025.101176. eCollection 2025 May.
Fragility fractures of the pelvis (FFPs) are typically caused by minor trauma or without any trauma in older individuals with osteoporosis. In recent years, FFP incidence has increased considerably owing to the increasing number of individuals in the aging population as well as impaired daily life. Surgeries are the main treatment options for some types of FFPs; however, the potential of the use of romosozumab, an FDA-approved humanized monoclonal antibody that can bind and inhibit sclerostin, is yet to be evaluated. Romosozumab substantially increases bone mineral density (BMD) in the spine and the hip, improves bone strength, and prevents the occurrence of new fractures. Previous studies have demonstrated the efficacy of romosozumab in promoting fracture healing, including the healing of nonunion in some fractures. Herein, we present a case of a 61-year-old woman who had FFP delayed union, after falling 4 months before visiting our hospital. She presented with bilateral buttock and leg pain. Baseline BMD measured using dual-energy X-ray absorptiometry revealed a T-score of -3.8 and -3.2 for the lumbar spine and total hip, respectively. As the patient's BMD indicated a high risk of fractures, romosozumab was administered. Her pain improved 3 months after the medication. Computed tomography taken after 3 months revealed that the fracture had healed, suggesting that romosozumab is an effective medication for treating FFP delayed union and nonunion.
骨盆脆性骨折（FFP）通常由轻微创伤引起，或发生于患有骨质疏松症的老年人且无任何创伤的情况下。近年来，由于老龄人口数量增加以及日常生活受损，FFP的发病率大幅上升。手术是某些类型FFP的主要治疗选择；然而，一种经美国食品药品监督管理局（FDA）批准的可结合并抑制硬化蛋白的人源化单克隆抗体——罗莫单抗的应用潜力尚待评估。罗莫单抗可显著提高脊柱和髋部的骨矿物质密度（BMD），增强骨强度，并预防新骨折的发生。先前的研究已证明罗莫单抗在促进骨折愈合方面的疗效，包括某些骨折不愈合的愈合。在此，我们报告一例61岁女性患者，她在来我院就诊前4个月摔倒后发生FFP延迟愈合。她表现为双侧臀部和腿部疼痛。使用双能X线吸收法测量的基线BMD显示，腰椎和全髋部的T值分别为-3.8和-3.2。由于患者的BMD表明骨折风险高，遂给予罗莫单抗治疗。用药3个月后她的疼痛有所改善。3个月后进行的计算机断层扫描显示骨折已愈合，这表明罗莫单抗是治疗FFP延迟愈合和不愈合的有效药物。
