Clin Orthop Surg.  2012 Sep;4(3):227-233. 10.4055/cios.2012.4.3.227.

Clinical Analysis of Femur Shaft Insufficiency Fractures

• Ko SB
• Lee SW
• Park CM
• Lee SH

• KMID: 1392986
• DOI: http://doi.org/10.4055/cios.2012.4.3.227

Abstract

BACKGROUND
To characterize the recently issued femur shaft insufficiency fracture in terms of a patient's own epidemiological status.
METHODS
Fourteen patients were treated for insufficiency fracture from July 2002 to June 2008, excluding cases including the risk factors of insufficiency fracture. All patients were female, and their mean age was 75.6 years (range, 65 to 89 years). The mean follow-up period was 50.6 months (range, 14 to 86 months).
RESULTS
The mean body weight of the Koreans in the same age group was 58.1 +/- 9.7 kg, and the mean height was 155.5 +/- 8.8 cm. The mean body weight of our insufficiency fracture patients was 45.7 kg and it was statistically significantly lower than that of the Koreans in the same age group (p < 0.001). The mean height was 147.3 cm and it was significantly shorter than the mean height of the Koreans in the same age group (p = 0.002). In regard to menopausal time, the mean menopausal time of the Koreans was 48.0 +/- 4.2 years, it was 44 years in our study, as menopause occurred statistically significantly earlier (p = 0.017). The patients with insufficiency fracture showed statistically lower weight, shorter stature and an earlier menopausal period than that of the general population.
CONCLUSIONS
In early menopausal, underweight, and short patients prescribed osteoporosis medication for an extended period of time, if predromal symptom is present, it is necessary to suspect insufficiency fracture of the femur.

Keyword

Femur shaft; Insufficiency fracture; Epidemiologic status

MeSH Terms

Aged
Aged, 80 and over
Body Height
Female
Femoral Fractures/epidemiology/*pathology/surgery
Femur
Fractures, Stress/epidemiology/*pathology/surgery
Humans
Menopause
Republic of Korea/epidemiology
Risk Factors

Figure

• 

  Fig. 1 An 82-year-old female patient. (A, B) Preoperative and postoperative radiogrpahs showing a left femur shaft insufficiency fracture and operated state with intramedullary (IM) nail. (C) Typical findings in the contralateral femur were missed at emergency room (ER) initially. (D) Radiographs showing a right femur shaft insufficiency fracture at 3 days after ER visit. (E, F) Postoperative radiographs showing the operated state with IM nail and union state.

• 

  Fig. 2 A 67-year-old female patient. (A, B) Radiographs showing an operated state due to a left femur shaft insufficiency fracture and nonunion and a metal failure state. (C, D) Left femur radiographs showing a reported state with a dual plate and union state after 1 year. (E, F) Radiographs showing a contralateral side insufficiency fracture without pseudomotion that was treated conservatively and progressive union status.

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  Fig. 3 A 68-year-old female patient treated conservatively. (A) Post-union state on simple radiographs. (B) Cortical thickening of mid-diaphysis and marrow edema on T2 and enhanced images.

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