Search
pelvic insufficiency fracture
Etiology:
- minimal trauma in a patient with osteoporosis
Epidemiology: most common in elderly women
Pathology:
1) incomplete, non-displaced fracture of the pelvis
2) may occur in sacrum, coccyx, pubic rami, or acetabulum
Clinical manifestations:
1) pain in buttocks & hips after minor trauma (fall)
2) peristent pain (> 1 week) with inability to bear weight
3) tenderness in buttocks region
4) range of motion in hips is not affected
Radiology:
1) fracture is frequently not visible on initial radiograph
2) bone scan may detect fracture (> 1 week after initial injury)
Management:
1) analgesia
2) weight-bearing as tolerated, using cane or walker
3) foam rings or pads can be helpful if there is pain on sitting
4) prophylaxis for DVT if inactivity is likely to persist for weeks
5) nasal calcitonin 100 units QD (analgesic effects)
6) treat osteoporosis
Related
osteoporosis
General
pelvic fracture
References
- UCLA Intensive Course in Geriatric Medicine & Board Review,
Marina Del Ray, CA, Sept 12-15, 2001
- UCLA Intensive Course in Geriatric Medicine & Board Review,
Marina Del Ray, CA, Sept 25-28, 2002
Graland A et al Arch Int Med 156:668, 1996
Saraux A et al, Rev Rheum Engl Ed 62:582, 1995