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Sequential Sacral Insufficiency Fracture After Unilateral Pubic Fractures - A Case Report -

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초록

Osteoporotic fractures of the pelvic ring are not uncommon and among them sacral insufficiency fractures (SIFs) are often overlooked in patients with buttock or low back pain following no or minimal trauma, which results in diagnostic delays. SIFs are often bilateral and are commonly associated with other fractures - most frequently with a pubic ramus fracture. However, it remains unclear which fracture (sacral or pubic ramus) occurs first, and the only report on the subject found that the fracture sequence is initiated by a sacral fracture. The authors describe a case of sequential bilateral SIFs in a 74-year old woman following superior and inferior pubic rami fractures on one side. In conclusion we suggested that SIFs can occur after pelvic ring injury in any side because biomechanical disruption of the pelvic ring can induce the sacral fracture in patients with severe osteoporosis.

Abstract

Osteoporotic fractures of the pelvic ring are not uncommon and among them sacral insufficiency fractures (SIFs) are often overlooked in patients with buttock or low back pain following no or minimal trauma, which results in diagnostic delays. SIFs are often bilateral and are commonly associated with other fractures - most frequently with a pubic ramus fracture. However, it remains unclear which fracture (sacral or pubic ramus) occurs first, and the only report on the subject found that the fracture sequence is initiated by a sacral fracture. The authors describe a case of sequential bilateral SIFs in a 74-year old woman following superior and inferior pubic rami fractures on one side. In conclusion we suggested that SIFs can occur after pelvic ring injury in any side because biomechanical disruption of the pelvic ring can induce the sacral fracture in patients with severe osteoporosis.

참고문헌 (10)

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  7. Schindler OS, "Sacral insufficiency fractures", J Orthop Surg (Hong Kong), 15, pp.339~346 (2007)
  8. Linstrom NJ, "Anatomical and biomechanical analyses of the unique and consistent locations of sacral insufficiency fractures", Spine (Phila Pa 1976), 34, pp.309~315 (2009)
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  10. Tsiridis E, "Percutaneous screw fixation for sacral insufficiency fractures: a review of three cases", J Bone Joint Surg Br, 89, pp.1650~1653 (2007)

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