중증 골다공증에 동반되는 골반골 부전 골절

Abstract

Purpose: As severe osteoporotic elderly patients increase, rate of pelvis insufficiency fracture in sacrum and pubis has also risen. The aim of our study is to report type of fracture, therapeutic outcome and complication in the patients with pelvis insufficiency fracture resulting from no trauma or minor trauma. Materials and Methods: Fifteen patients with insufficiency fracture in sacrum and pubis during recent 3 years were included. Patients complained of difficulty in walking due to pelvic bone area tenderness or discomfort. The insufficiency fracture was diagnosed by simple x-ray or by abdomen and pelvis computed tomography(CT). Clinical evaluation evaluating clinical symptoms such as tenderness, the presence of spine fracture, ambulation etc., were performed. Results: All but one patients were accompanied by vertebra compression fracture. In 11 patients, there was multiple vertebra compression fracture involving more than two vertebras. The type of fractures include 4 sacrum fractures, 2 pubis fractures, and 9 fractures involving both sacrum and pubis. The average osteosyntesis time was 26.67 weeks (±8.07weeks). Four out of 5 patients who applied human recombinant parathyroid hormone(rhPTH) showed complete bone union at average of 21.5 weeks. One patient with delayed union used rhPTH underwent internal fixation of sacrum with cannulated screw. Conclusion: The patients with severe osteoporosis accompany multiple vertebral fracture should be carefully monitored of insufficient fracture, if pelvic region tenderness is noted without obvious trauma history.