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ArticleTitle | A Case Report of Insufficiency Fracture of the Fossa Acetabuli in a Patient with Rheumatoid Arthritis |
AuthorList | Daiya Ozaki, Yasumasa Shirai, Yoshihito Nakayama and Shinji Uesaka |
Affiliation | Department of Orthopedic Surgery, Nippon Medical School |
Language | EN |
Volume | 67 |
Issue | 4 |
Year | 2000 |
Page | 267-270 |
Received | January 18, 2000 |
Accepted | March 8, 2000 |
Keywords | insufficiency fracture, rheumatoid arthritis, acetabulum |
Abstract | Aside from vertebral compression fractures, the most common site of insufficiency fractures is the pelvis and lower extremities. In the pelvis, the fractures usually occur in the ilium, the pubis and the ischium, but rarely in the fossa acetabuli. We report a severe insufficiency fracture of the fossa acetabuli in a 78-year-old woman with rheumatoid arthritis (RA). She had associated insufficiency fractures of the rib, the thoracic spine and the sacrum. In our case, senile osteoporosis was present before the onset of the fracture was recognized on radiographs, and RA and corticosteroid therapy might have further aggravated the porosis, resulting in the destruction of the fossa acetabuli. Regarding treatment for the fracture, a cemented total hip replacement without bone graft was attempted for several reasons such as the patient's activities, postoperative rehabilitaion and the bone mass of the acetabulum. The postoperative course was satisfactory during study period. However, further follow-up is needed to monitor carefully how the patient will be in the future. |
Correspondence to | Daiya Ozaki, MD, Department of Orthopedic Surgery, Nippon Medical School 2nd Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki-shi, Kanagawa 211-8533, Japan daiya@nms.ac.jp |
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