scholarly journals Bilateral Insufficiency Fracture of the Pelvis Following THA: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Shinya Hayashi ◽  
Takayuki Nishiyama ◽  
Takaaki Fujishiro ◽  
Shingo Hashimoto ◽  
Masahiro Kurosaka
Keyword(s):  
Groin Pain ◽  
Insufficiency Fracture ◽  
Stress Fractures ◽  
Insufficiency Fractures ◽  
Pubic Rami ◽  
First Case ◽  
Fragile Bone ◽  
Repetitive Stress ◽  
Postoperative Stress ◽  
Pelvic Insufficiency Fracture

Insufficiency fracture is of the stress fractures and is caused by repetitive stress on fragile bone. Insufficiency fractures of pubic rami are rare occurrences in association with total hip arthroplasty (THA). Postoperative stress fractures occur due to increase of patients activity following years of disability. The physician should consider the possibility of a pelvic insufficiency fracture in patients with RA after THA, if the patients present with groin pain. We demonstrate here the first case of bilateral insufficiency fracture of pubic rami and iliac bone following THA.

Bilateral Tibial Stress Fractures and Osteoporosis in a Young Patient

2021 ◽  
pp. 194173812110321
Author(s):  
Ali Gürbüz ◽  
Mustafa Gür
Keyword(s):  
Case Report ◽  
Young Patient ◽  
Insufficiency Fracture ◽  
The Elderly ◽  
Stress Fractures ◽  
The Other ◽  
Insufficiency Fractures ◽  
Normal Loading ◽  
Bone Injury ◽  
Fatigue Fractures

Stress fractures result from microscopic bone injury due to repetitive submaximal stress and include fatigue and insufficiency fracture components. Fatigue fractures generally occur in runners and athletes and are caused by abnormal physical load on the bone. On the other hand, insufficiency fractures are generally seen in the elderly secondary to osteoporosis, typically involving the pelvis and surrounding bones. Insufficiency fracture occurs as a result of normal loading in the abnormal bone. In this case report, we describe a young patient with bilateral tibial stress fractures with both fatigue and insufficiency components.

scholarly journals Bilateral subtrochanteric insufficiency fracture following mini-gastric bypass. A case report

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 32
Author(s):  
Jad Mansour ◽  
Kaissar Yammine ◽  
Anthony El Alam ◽  
George Al-Hajj ◽  
Chahine Assi
Keyword(s):  
Gastric Bypass ◽  
Bypass Surgery ◽  
Groin Pain ◽  
Gastric Bypass Surgery ◽  
Insufficiency Fracture ◽  
Fracture Pattern ◽  
Mini Gastric Bypass ◽  
Insufficiency Fractures ◽  
Common Complication ◽  
Rule Out

Insufficiency fractures are a common complication of bisphosphonate use and have recently been reported in association with Roux-en-Y Gastric Bypass Surgery (RYGB). This study reports a case of a 62-year-old female, 6 years status post Mini Gastric Bypass – One Anastomosis Gastric Bypass (MGB-OAGB), presenting to our institution with bilateral groin pain of 8 months duration unresponsive to conservative management. Diagnostic workup revealed bilateral medial sub-trochanteric insufficiency fractures. She underwent bilateral intramedullary fixation with satisfactory results. This case might suggest a particular fracture pattern in patients undergoing MGB-OAGB, and raises awareness to screen patients with such presentation to rule out a fracture or to prevent the extension of an existing one.

scholarly journals A Dual Biomechanical Failure: Exeter Stem and Pubic Rami Insufficiency Fracture, following Hybrid Total Hip Arthroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Inderpaul Samra ◽  
Christos Paliobeis
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Insufficiency Fracture ◽  
Femoral Stem ◽  
Insufficiency Fractures ◽  
Total Hip ◽  
Pubic Rami ◽  
Spontaneous Fracture ◽  
Stem Fracture ◽  
Stem Failure

Introduction. Incidence of Exeter stem fracture is extremely uncommon. Pubic rami insufficiency fractures following arthroplasty are also rare. To our knowledge no cases of spontaneous stem failure with previous insufficiency fractures have yet been reported.Case Presentation. This report describes a case of spontaneous fracture through a cemented Exeter stem in a 66-year-old patient who had previously undergone a hybrid total hip replacement and was found to have bifocal pubic rami insufficiency fractures. The patient presented 18-year postprimary surgery with spontaneous fracture of the middle third of the cemented femoral stem and adjacent proximal femur.Conclusion. This report demonstrates a unique case of Exeter stem fracture with previous pelvic insufficiency fractures. The case adds to the rare occurrences of Exeter stem failure in the literature and highlights the risk of potential insufficiency fractures in patients undergoing total hip replacement.

Insufficiency Fractures vs. Low-Energy Pelvic Ring Fractures – Epidemiological, Diagnostic and Therapeutic Characteristics of Fragility Fractures of the Pelvic Ring

2021 ◽  
Author(s):  
Manuel Sterneder ◽  
Patricia Lang ◽  
Hans-Joachim Riesner ◽  
Carsten Hackenbroch ◽  
Benedikt Friemert ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Diagnostic Testing ◽  
Insufficiency Fracture ◽  
Fragility Fractures ◽  
Relative Increase ◽  
Trauma Centre ◽  
Low Energy ◽  
Insufficiency Fractures ◽  
Type Iv ◽  
Pelvic Ring Fractures

Abstract Background Fragility fractures of the pelvis (FFP) encompass two fracture entities: fracture after low-energy trauma and insufficiency fracture without trauma. It is unclear whether the two subgroups differ in terms of diagnosis and therapy. The aim of this retrospective study was to evaluate insufficiency fractures with regard to defined parameters and to compare specific parameters with the fractures after low-energy trauma. Patients and Methods In the period from 2008 to 2017, 203 patients with FFP were recorded at our clinic (Level 1 Trauma Centre DGU, SAV approval). Of these, 25 had an insufficiency fracture and 178 had a pelvic ring fracture after low-energy trauma. Epidemiological, diagnostic and therapeutic parameters were examined. Results There was a relative increase in the insufficiency fracture within the FFP (2008 – 2009: 5.0% vs. 2015 – 2017: 17.8%). In these patients, osteoporosis tended to be more pronounced than in patients after low-energy trauma (t-value: − 3.66 vs. − 3.13). The diagnosis of insufficiency fractures showed increased use of MRI and DECT (60.9% vs. 26.0%) and a high proportion of type IV fractures after FFP (40.0% vs. 7.9%). In terms of therapy, surgical treatment of the insufficiency fracture was sought more often (68,2% vs. 52,1%), with a tendency towards increased use of combined osteosynthesis procedures (14.3% vs. 7.6%). Conclusion We were able to show that as the number of cases increases, the insufficiency fracture becomes more important within FFP. If these patients tend to have more pronounced osteoporosis, particular attention should be paid to the diagnosis and adequate therapy of the osteoporosis, especially in the case of an insufficiency fracture. In addition to the increased diagnostic testing using MRI and DECT to detect oedema and the increased surgical therapy for this type of fracture, it is also noteworthy that the insufficiency fracture can cause higher-grade fractures after FFP.

scholarly journals Insufficiency Fracture in the Para-Acetabulum, with Features Mimicking those of a Malignant Bone Tumor

2008 ◽  
Vol 1 ◽  
pp. CCRep.S803
Author(s):  
Akio Sakamoto ◽  
Takuaki Yamamoto ◽  
Kazuhiro Tanaka ◽  
Shuichi Matsuda ◽  
Tatsuya Yoshida ◽  
...  
Keyword(s):  
Bone Tumor ◽  
Signal Intensity ◽  
Insufficiency Fracture ◽  
Hip Pain ◽  
Pelvic Bone ◽  
High Signal ◽  
Insufficiency Fractures ◽  
Mineral Density ◽  
Abnormal Signal ◽  
High Index Of Suspicion

Para-acetabular insufficiency fractures are rare and exceedingly difficult to diagnose without a high index of suspicion, since the images mimic those of bone tumors. We herein present the case of a 55-year-old woman who suffered from hip pain with subacute onset. She had undergone a hysterectomy-ovariectomy due to endometriosis when she was 41 years old. Her bone mineral density was normal due to supplemental treatment with female hormones. About 3 months after onset, she was referred to our institute with a diagnosis of pelvic bone tumor. Plain radiographs and computed tomography showed irregular osteosclerosis in the para-acetabulum. Bone scintigraphy demonstrated uptake in the para-acetabulum. Magnetic resonance imaging showed abnormal signal with low-signal intensity on T1-weighted images and high-signal intensity on T2-weighted images throughout the entire hemipelvic bone. Since the pain continued for more than 3 months, open biopsy was undertaken and the lesion was found to be non-neoplastic. Six months after onset, the pain disappeared. The clinical course suggested a diagnosis of insufficiency fracture in the para-acetabulum. Para-acetabular insufficiency fractures should always be considered in cases of hip pain, even in patients with prolonged symptoms.

Pelvic insufficiency fracture associated with severe suppression of bone turnover by alendronate therapy

2007 ◽  
Vol 25 (5) ◽  
pp. 333-336 ◽  
Author(s):  
Kazuhiro Imai ◽  
Seizo Yamamoto ◽  
Yorito Anamizu ◽  
Toshiyuki Horiuchi
Keyword(s):  
Bone Turnover ◽  
Insufficiency Fracture ◽  
Pelvic Insufficiency Fracture

scholarly journals Joint Space Injection for Osteitis Pubis in an Airborne Jump Injury: A Case Report

2019 ◽  
Vol 185 (7-8) ◽  
pp. e1298-e1299
Author(s):  
Jackson P Beall ◽  
Joshua J Oliver ◽  
Rachel E Bridwell ◽  
Scott E Young
Keyword(s):  
Sports Medicine ◽  
Groin Pain ◽  
Pubic Symphysis ◽  
Joint Space ◽  
Treatment Modalities ◽  
Osteitis Pubis ◽  
Jump Exercise ◽  
Repetitive Stress ◽  
First Time

Abstract Osteitis Pubis (OP) is groin pain caused by overloading stresses on the pubic symphysis. This is often caused by the repetitive stress seen in competitive sports, but can also be caused by rapid acceleration or deceleration. It is a diagnosis of exclusion made after other entities such as fracture or infection are ruled out. It is often treated conservatively with rest, Non-Steroidal Anti-inflammatories (NSAIDS), and Physical Therapy (PT). After these treatment modalities have failed, intra-articular injection with local anesthetics and steroids can be considered. We report a case of a 22-year-old Male Active Duty Army Soldier who presented with OP immediately after landing during a routine Airborne Jump exercise. The Soldier reported landing in such a way that his feet did not impact the ground at the same time, creating a sheering force on his pelvis. Following two months of failed treatment involving NSAIDS and PT, the patient was referred to Sports Medicine where he received an injection of 1 mL of 1% lidocaine and 40 mg of triamcinolone into the pubic symphysis joint space. Shortly afterward the patient endorses complete resolution of his symptoms without return of symptoms at 1-month follow-up. Although injection of the pubic symphysis with local anesthetic and steroids has been previously described, this is the first time it has been described in a jump injury.

scholarly journals Fractured Inferior Pubic Ramus with Ipsilateral Total Hip Replacement: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Sarkhell Radha ◽  
Michael Shenouda ◽  
Alexandra Hazlerigg ◽  
Sujith Konan ◽  
Alison Hulme
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Groin Pain ◽  
Occupational Therapists ◽  
Early Mobilisation ◽  
Review Of The Literature ◽  
Pubic Ramus ◽  
Total Hip ◽  
Pubic Rami ◽  
Fracture Of The Acetabulum

Pubic rami fractures are common. They are associated with significant morbidity and mortality. These fractures are usually classified as stable injuries and traditionally receive limited orthopaedic input. Management typically involves hospital admission and early input from physiotherapists and occupational therapists. Early mobilisation is advocated as a central part of managing these patients, with emphasis on secondary prevention. We report a case diagnosed as minimally displaced inferior pubic ramus fracture in a patient with an ipsilateral total hip replacement (THR). The patient was mobilised early and despite analgesia continued to complain of groin pain. Repeat radiographs showed a fracture of the acetabulum with displacement of the acetabular component of the hip replacement. We advocate early orthopaedic input for all pubic rami fractures, particularly in patients with hip arthroplasty, and thorough investigation including a CT scan of the pelvis to exclude acetabular extension prior to mobilisation.

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