J Korean Fract Soc.  2004 Jan;17(1):19-24. 10.12671/jkfs.2004.17.1.19.

Insufficiency Fractures of the Femoral Shaft Associated with Osteoporosis

• Koh HS
• Kang YK
• Lee HY
• Rhyu KW
• Song JH
• Jeong JY
• Song ES

• KMID: 2043947
• DOI: http://doi.org/10.12671/jkfs.2004.17.1.19

Abstract

PURPOSE: To present a clinical experience of the insufficiency fractures of the femoral shaft associated with osteoporosis
MATERIALS AND METHODS
From January 1995 to December 2002, four patients (8 cases, four females) more than 1-year follow up were reviewed retrospectively. The mean age was 61 years (range, 55 to 73). Medical records and roentgenograms were reviewed.
RESULTS
The fractures were bilateral. Plain film revealed fracture line in six among seven cases excluding 1 displaced fracture at initial presentation. All cases presented osteoporosis, anterolateral bowing of the femur, and hot spot in bone scan. Five cases (four displaced, one impending displaced fracture) underwent interlocking intramedullary nailing and all five of them manifested no evidence of delayed union. The preoperative thigh and knee joint pain improved postoperatively.
CONCLUSION
Femoral shaft insufficiency fracture could occur rarely in patients with anterolateral bowing of the femur and postmenopausal osteoporosis. Careful history taking, radiography and bone scan are necessary, and bone scan is helpful for early diagnosis. Once diagnosed as the insufficiency fracture with fracture-related symptoms, prophylactic nailing may be necessary lest complete displaced fracture should occur.

Keyword

Femoral shaft; Insufficiency fracture; Osteoporosis

MeSH Terms

Early Diagnosis
Female
Femur
Follow-Up Studies
Fracture Fixation, Intramedullary
Fractures, Stress*
Humans
Knee Joint
Medical Records
Osteoporosis*
Osteoporosis, Postmenopausal
Radiography
Retrospective Studies
Thigh