REVIEW - Insufficiency fracture. Survey of 60 cases and review of the literature.

September 27, 2006

Joint Bone Spine. 2003 Jun;70(3):209-18.

Insufficiency fracture. A survey of 60 cases and review of the literature.

Rheumatology department, CHU Montpied, BP 69, 63003 cedex 1,

Clermont-Ferrand, France. msoubrier@...

We report findings on the site, risk factors and imaging of insufficiency

fractures (IF) in 60 patients admitted to our department between 1989 and

1997. RESULTS: Fifty-five women (mean age 72.5 years) and five men (mean age

59 years) had 91 fractures, accounting for 0.32% of admissions. Fractures

occurred most commonly in the pelvic girdle (30.7%, 28/91) and in the sacrum

(29.6%, 27/91). In eight patients fractures of the sacrum were associated

with fractures of the pelvic girdle. The next most common sites of

occurrence were the tibia (16.5%, 15/91: 11 transverse, four longitudinal)

and the femoral neck (9.9%, 9/91). There were three subchondral fractures of

the femoral head, three fractures of the femoral diaphysis (two

longitudinal, one transversal), two of the astragalus, and one each of the

ilium, perone, calcaneum and sternum. Thirty patients had osteoporosis: six

had received fluoride treatment and five had corticosteroids. Other risk

factors were rheumatoid arthritis (4), osteomalacia (4), corticosteroid

treatment (4), and hyperparathyroidism (1). Radiography showed a fracture

line or osteocondensation in 65% (39/60) of cases. Scintigraphy was positive

in 87.5% of cases (21/24), showing a fracture line (15) or a callus (6).

Bone computed tomography (CT) scan was positive in 98.1% (54/55) of cases.

IF occurs in elderly women with osteoporosis and most commonly in the

pelvis.

CONCLUSIONS: Since radiologic signs are inconstant, scintigraphy is the

choice procedure.

PMID: 12814764

ctPlus & list_uids=12814764

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

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