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Front Oncol 2019 28;9:183. Epub 2019 Mar 28.

Department of Radiology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, China.

Insufficiency fracture (IF) can show increased uptake on a bone scan (BS). IFs are often misinterpreted as bone metastases if the characteristic "Honda sign" (H-sign) is invisible. The purpose of the present study was to evaluate the utility of magnetic resonance imaging (MRI) alone for the characterization of IF and bone metastasis after radiotherapy in patients with cervical cancer detected by BS. Read More

Cureus 2019 Jan 10;11(1):e3861. Epub 2019 Jan 10.

Neurological Surgery, University of Miami Hospital, Miami, USA.

Iliac wing fractures are under-diagnosed fractures often associated with sacral insufficiency fractures in osteoporotic patients. They are rarely seen alone. Insufficiency fractures of the iliac bone can often be missed on computerized tomography (CT) and magnetic resonance imaging (MRI) yet identified on radioisotope bone scans. Read More

Anticancer Res 2019 Jan;39(1):361-367

Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.

Aim: To evaluate the incidence and risk factors of sacral insufficiency fractures (SIFs), particularly dose-volume histogram (DVH) parameters, in patients with cervical cancer after whole pelvic radiation therapy (WPRT).

Patients And Methods: The medical records of 61 patients with cervical cancer who underwent WPRT were retrospectively reviewed. The cumulative incidence of SIF, as well as the risk factors that could affect its incidence were assessed. Read More

Skeletal Radiol 2018 Nov 28. Epub 2018 Nov 28.

Department of Radiology, University of California San Diego, San Diego, CA, USA.

Stress fractures are a common diagnosis in sports medicine and can result in significant loss of function, athlete playing time, and potentially lead to chronic symptoms. However, unusual locations of stress fractures may present with vague symptoms and a relatively benign physical exam, leading to difficulty in arriving at the correct diagnosis. Pelvic stress fractures are less common than lower-extremity stress fractures in athletes, occurring in only 1-5% of all stress fractures and typically occur in pubic rami. Read More

Eur J Nucl Med Mol Imaging 2019 Apr 19;46(4):1019-1036. Epub 2018 Oct 19.

Department of Radiology and Nuclear Medicine, Cantonal Hospital Lucerne, Lucerne, Switzerland.

Osteoid osteoma is a painful, benign, osteoblastic lesion that occurs in younger patients and affects the extremities or the axial skeleton. While plain film findings may suggest the diagnosis, in complex anatomical regions such as the spine, pelvis, wrist and foot advanced imaging modalities are often required. A typical nidus surrounded by sclerosis or cortical thickening characterizes osteoid osteoma on plain radiography and CT. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(2):85-88

BG Unfallklinik Tuebingen, Eberhard-Karls-Universitaet Tuebingen, Germany.

PURPOSE OF THE STUDY Fragility fractures of the pelvic ring in the elderly population are a serious problem in orthopaedics. The treatment options range from conservative treatment to diverse operative options. We present a balloon guided new technique of implanting cement augmented screws aiming at improved implant anchorage and reduced cement leakage. Read More

PLoS One 2018 16;13(8):e0200952. Epub 2018 Aug 16.

Institute for Biomechanics, ETH Zürich, Zürich, Switzerland.

The majority of hip fractures have been reported to occur as a result of a fall with impact to the greater trochanter of the femur. Recently, we developed a novel cadaveric pendulum-based hip impact model and tested two cadaveric femur-pelvis constructs, embedded in a soft tissue surrogate. The outcome was a femoral neck fracture in a male specimen while a female specimen had no fracture. Read More

Medicine (Baltimore) 2018 Aug;97(32):e11735

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University Hospital, University of Monastir, Tunisia.

Rationale: Stress fractures of the sacrum and mechanical sacroiliac joint disease can occur not only during pregnancy but also postpartum. Mechanical sacroiliac joint disease is common in patients with low back pain but often misdiagnosed by practitioners. The association of the 2 conditions has not been studied yet. Read More

Z Orthop Unfall 2019 Apr 27;157(2):144-153. Epub 2018 Jul 27.

Unfallchirurgie, Universität Halle.

Fractures of the os sacrum without relevant trauma history are defined as stress or insufficiency fractures and often affect the anterior pelvis. Sacral insufficiency fractures are associated with osteoporosis and occur under physiological load. In contrast, sacral stress fractures are caused by mechanical overloading. Read More

BMC Musculoskelet Disord 2018 Jul 25;19(1):257. Epub 2018 Jul 25.

Department of Radiology, Veterans Health Service Medical Center, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea.

Background: Sacral insufficiency fractures (SIFs) are a common cause of lower back pain in the elderly. However, because clinical symptoms are frequently vague and nonspecific and can mimic lumbar spine pathologies, initial imaging in SIF patients is frequently targeted at the lumbar spine rather than the sacrum, resulting in delayed diagnosis. The purpose of this study is to show the proportions of modalities used in diagnosing SIF in practice and to compare the clinical and imaging features of SIF diagnosed by lumbar spine MRI (L-spine MRI) with those diagnosed by non-lumbar imaging modalities (bone scan, pelvic bone CT, pelvis MRI). Read More

J Orthop Sci 2018 Sep 14;23(5):825-833. Epub 2018 Jun 14.

Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.

Background: Supra-acetabular insufficiency fractures (SAIFs) occur in the upper acetabulum and are rare compared with insufficiency sacral, femoral head, or ischial fractures. However, SAIFs are known to occur in low grade trauma, and the underlying mechanism is still remained unclear.

Methods: We performed biomechanical analysis using finite element analysis to clarify the mechanisms underlying the development of SAIFs. Read More

J Orthop Surg Res 2018 May 9;13(1):108. Epub 2018 May 9.

Regensburg Center of Biomedical Engineering, Ostbayerische Technische Hochschule, Galgenbergstrasse 30, D-93053, Regensburg, Germany.

Background: Iliac crest bone harvesting is a frequently performed surgical procedure widely used to treat bone defects. The objective of this study is to assess the biomechanical quantities related to risk for pelvic fracture after harvesting an autologous bone graft at the anterior iliac crest.

Methods: Finite element models with a simulated harvest site (sized 15 × 20 mm, 15 × 35 mm, 30 × 20 mm and 30 × 35 mm) in the iliac wing are created. Read More

Arch Orthop Trauma Surg 2018 Jul 26;138(7):971-977. Epub 2018 Apr 26.

Department of Orthopaedics and Traumatology, University Medical Center Mainz, Johannes Gutenberg-University, Langenbeckstr. 1, 55131, Mainz, Germany.

Introduction: Patients suffering from osteoporosis-associated fragility fractures of the sacrum (FFS; also termed sacral insufficiency fractures) are increasingly observed. They have typical fracture patterns with fracture lines located in the sacral ala. When treating these patients operatively, iliosacral screw loosening is not uncommon. Read More

Cochrane Database Syst Rev 2018 04 23;4:CD010604. Epub 2018 Apr 23.

Radiotherapy-related Research, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, Greater Manchester, UK, M20 4BX.

Background: Pelvic radiotherapy is a treatment delivered to an estimated 150,000 to 300,000 people annually across high-income countries. Fractures due to normal stresses on weakened bone due to radiotherapy are termed insufficiency fractures. Pelvic radiotherapy-related interruption of the blood supply to the hip is termed avascular necrosis and is another recognised complication. Read More

J Orthop 2018 Mar 16;15(1):122-127. Epub 2018 Jan 16.

Department of Orthopaedic Surgery, Kyorin University, 5-4-1 Mitaka, Shimorenjaku, 181-8612, Tokyo, Japan.

Background: We noticed that most of active sports children with low back pain (LBP) have muscle tightness around the pelvis and reduced trunk flexibility. Abnormalities in short-time inversion recovery (STIR) images on magnetic resonance imaging (MRI) can show stress fracture. Therefore, we investigated the associations among LBP, trunk flexibility, and lumbar stress fractures. Read More

J Korean Neurosurg Soc 2018 Mar 28;61(2):258-266. Epub 2018 Feb 28.

Department of Traumatology and Orthopedics, KRH Nordstadt, Hannover, Germany.

Objective: The diagnosis of insufficiency fractures of the sacrum in an elder population increases annually. Fractures show very different morphology. We aimed to classify sacral insufficiency fractures according to the position of cortical break and possible need for intervention. Read More

Eur Radiol 2018 Aug 23;28(8):3550-3559. Epub 2018 Feb 23.

Department of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.

Objective: To investigate the incidence rate, time-to-onset and recovery, MRI morphology and occurrence of insufficiency fractures in radiation-induced changes in the sacrum following pelvic radiotherapy.

Material And Methods: 410 patients with pelvic malignancies treated with radiotherapy were reviewed. Follow-up was 1-124 months (mean 22 months). Read More

Sports Health 2018 Jul/Aug;10(4):340-344. Epub 2017 Dec 14.

The Ohio State University Wexner Medical Center, Columbus, Ohio.

Background: Few studies have documented expected time to return to athletic participation after stress fractures in elite athletes.

Hypothesis: Time to return to athletic participation after stress fractures would vary by site and severity of stress fracture.

Study Design: Retrospective cohort study. Read More

Arthroplast Today 2017 Dec 10;3(4):247-250. Epub 2017 Jul 10.

The Anderson Orthopaedic Clinic, Joint Replacement, Arlington, VA, USA.

This report describes a patient with ankylosing spondylitis (AS) who underwent total hip arthroplasty (THA) by the direct anterior approach and sustained a L4-5 extension fracture dislocation with neural deficits. A magnetic resonance imaging revealed an epidural hematoma at the site of the fracture causing critical stenosis. The patient was taken to the operating room for a L3-S1 posterior decompression with L2-pelvis posterior spinal fusion. Read More

Urology 2018 Apr 27;114:188-192. Epub 2017 Nov 27.

Department of Urology, University of Washington Medical Center, Seattle, WA.

Objective: To identify the frequency of de novo stress urinary incontinence (SUI) after posterior excision and primary anastomotic (EPA) urethroplasty in patients with radiation-induced urethral strictures (RIUS) and compare with patients with pelvic fracture urethral injuries (PFUIs).

Materials And Methods: A retrospective review was conducted among patients who underwent successful posterior EPA urethroplasty between 2008 and 2016 for RIUS from prostate cancer or PFUI from blunt trauma. Only patients with an intact bladder neck on imaging were included. Read More

J Orthop Case Rep 2017 Jul-Aug;7(4):76-79

Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi, India.

Introduction: Insufficiency fractures (IFs) are a subtype of stress fractures commonly associated with osteoporosis and Vitamin D deficiency. These nontraumatic fractures often occur in the pelvis and spine, but the involvement of other unusual sites is also not very uncommon. Plain radiographs and magnetic resonance imaging scan are the most commonly used imaging modalities for the diagnosis of IF. Read More

Injury 2017 Dec 4;48(12):2717-2723. Epub 2017 Nov 4.

Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland.

Background: Low energy pelvic ring fractures in the elderly have traditionally been treated conservatively, a treatment with potential long-term complications and loss of self-independence. Percutaneous screw stabilisation of the posterior pelvic ring is a new treatment modality that enables immediate mobilisation. The aim of this study was to assess the functional outcome after sacroiliac stabilisation in the elderly. Read More

Gynecol Oncol 2017 12 18;147(3):585-588. Epub 2017 Oct 18.

Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi-city, Hyogo 673-8558, Japan.

Objectives: This study clarified the incidence of and identified the risk factors for post-radiation pelvic insufficiency fractures (PIFs) in women who received postoperative definitive or adjuvant radiotherapy (RT) for cervical cancer.

Patients And Methods: The medical records and data of imaging studies, including computed tomography scan and magnetic resonance imaging, of women with cervical cancer who received external-beam RT for the entire pelvic area between January 2003 and December 2012 at our institution were reviewed.

Results: A total of 533 patients with histologically diagnosed cervical cancer who received RT (298: definitive RT, 235: adjuvant RT) were included in this study. Read More

BMJ Case Rep 2017 Sep 23;2017. Epub 2017 Sep 23.

Department of Endocrinology, University Hospital of Birmingham, Birmingham, UK.

A 35-year-old female renal transplant recipient was referred to the metabolic bone clinic because of a 15 cm loss of height. She was noted to have thoracic kyphosis and vertebral X-ray confirmed a wedge fracture of the eighth thoracic vertebra. She was managed accordingly but on subsequent follow-up mentioned in passing that her gynaecologist had been unable to obtain a cervical smear for routine screening. Read More

Unfallchirurg 2017 Oct;120(10):890-895

Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinikum Bergmannstrost gGmbH, Merseburger Straße 165, 06112, Halle (Saale), Deutschland.

A monolateral sacrum fracture was primarily diagnosed with a CT and treated with PMMA augmented SI screw fixation. The following CT showed an unexpected contralateral fracture which led to the need for a lumbopelvic stabilization. In the course of 6 months, successively occurring adjacent fractures required recurrent vertebroplasty. Read More

J Orthop Case Rep 2017 Mar-Apr;7(2):87-89

Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA.

Introduction: Acute hip pain following total hip arthroplasty (THA) could have numerous causes to include stress fracture of the pelvis. Stress fractures of the pelvis are rare and have been reported to involve the medial wall and the pubic ramus. A unique case is presented demonstrating the clinical presentation and management of an acute stress fracture of ilium and anterior column following a THA. Read More

Oper Orthop Traumatol 2017 Aug 19;29(4):360-372. Epub 2017 Jun 19.

Spine Department, RKU - Universitäts- und Rehabilitationskliniken Ulm, Oberer Eselsberg 45, 89081, Ulm, Deutschland.

Objective: To reduce the rate of implant failures at the lumbosacral junction in polysegmental lumbar fusions.

Indications: Spinal fusion with deformity correction including L5/S1, revision surgery for pseudoarthrosis L5/S1, screw pull-out and pedicle fractures in S1, and S1/S2 fractures after polysegmental fusions.

Contraindications: Osteosynthesis of complex pelvic ring fractures, tumors of the ilium. Read More

Hip Pelvis 2017 Jun 2;29(2):120-126. Epub 2017 Jun 2.

Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea.

Purpose: To evaluate clinical features and the effect of parathyroid hormone (PTH) on treatment outcomes of patients with pelvic insufficiency fractures.

Materials And Methods: Fifteen patients diagnosed with pelvic insufficiency fractures were evaluated retrospectively. All patients had osteoporosis with mean lumbar T score of -3. Read More

J Am Acad Orthop Surg 2017 Jul;25(7):509-517

From the Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL (Dr. Stover and Dr. Edelstein) and the Hip and Pelvis Institute, St. John's Health Center, Santa Monica, CA (Dr. Matta).

Chronic anterior pelvic ring instability can cause pain and disability. Pain typically is localized to the suprapubic area or inner thigh; often is associated with lower back or buttock pain; and may be exacerbated by activity, direct impact, or pelvic ring compression. Known etiologies of chronic anterior pelvic ring instability include pregnancy, parturition, trauma, insufficiency fractures, athletics, prior surgery, and osteitis pubis. Read More

Oper Neurosurg (Hagerstown) 2017 Jun;13(3):E4-E7

Background And Importance: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Read More

Acta Ortop Mex 2016 Sep-Oct;30(5):256-258

Centro Médico ABC (The American British Cowdray Medical Center), Avenida Carlos Fernández Graef 154, Tlaxala, 05300 Cuajimalpa, Ciudad de México, México.

Introduction: The suspected diagnosis of a Toddler's fracture can often be complicated by an unclear history, the lack of specific clinical findings and the absence of obvious changes in the initial radiographs. We present the case of an infant of 3 years and 7 months old with a history of falling from her own height with a rotation mechanism of the left pelvic limb. The purpose of this paper is to describe the etiopathology, diagnosis and therapeutic management of these fractures. Read More

Am J Emerg Med 2017 Sep 18;35(9):1314-1316. Epub 2017 Mar 18.

Department of Orthopedics, Mitoyo General Hospital, 708 Himehama, Kanonji, Kagawa 769-1695, Japan.

Introduction: A sacral insufficiency fracture (SIF) often manifests as low back pain or sciatica in the absence of any antecedent trauma. These fractures may be missed because of lack of appropriate imaging. The purpose of this study was to clarify the incidence and clinical features of SIF as well as the characteristic findings on magnetic resonance imaging (MRI) of the lumbar spine. Read More

Int J Radiat Oncol Biol Phys 2017 04 15;97(5):1032-1039. Epub 2017 Mar 15.

Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Medical Physics, Aarhus University Hospital, Aarhus, Denmark.

Purpose: To investigate the incidence of and risk factors for pelvic insufficiency fracture (PIF) after definitive chemoradiation therapy for locally advanced cervical cancer (LACC).

Methods And Materials: We analyzed 101 patients with LACC treated from 2008-2014. Patients received weekly cisplatin and underwent external beam radiation therapy with 45 Gy in 25 fractions (node-negative patients) or 50 Gy in 25 fractions with a simultaneous integrated boost of 60 Gy in 30 fractions (node-positive patients). Read More

Br J Radiol 2017 May 14;90(1073):20160885. Epub 2017 Mar 14.

Department of Radiation Oncology, Institut Curie, Paris, France.

Objective: To summarize the results of pelvic insufficiency fracture (PIF) incidence in patients with anal or gynaecological cancer treated by pelvic intensity-modulated radiation therapy (IMRT).

Methods: The clinical and morphological (CT and/or pelvic MRI) characteristics of patients treated by IMRT at our institution between 2007 and 2014 were analyzed. The global incidence of PIF after external beam radiotherapy and the impact of tumour site (gynaecological or anal cancer) were determined. Read More

Comput Math Methods Med 2017 1;2017:9403821. Epub 2017 Feb 1.

Department of Trauma, Plastic and Reconstructive Surgery, University of Leipzig, Liebigstr. 20, 04103 Leipzig, Germany.

The main purpose of this study is to develop an efficient technique for generating FE models of pelvic ring fractures that is capable of predicting possible failure regions of osteosynthesis with acceptable accuracy. Patient-specific FE models of two patients with osteoporotic pelvic fractures were generated. A validated FE model of an uninjured pelvis from our previous study was used as a master model. Read More

Osteoporos Int 2017 06 27;28(6):1915-1923. Epub 2017 Feb 27.

Unit of Radiation Oncology, University Hospital of Siena, Viale Bracci, 53100, Siena, Italy.

This study deals with the role of texture analysis as a predictive factor of radiation-induced insufficiency fractures in patients undergoing pelvic radiation.

Introduction: This study aims to assess the texture analysis (TA) of computed tomography (CT) simulation scans as a predictive factor of insufficiency fractures (IFs) in patients with pelvic malignancies undergoing radiation therapy (RT).

Methods: We performed an analysis of patients undergoing pelvic RT from January 2010 to December 2014, 24 of whom had developed pelvic bone IFs. Read More

Praxis (Bern 1994) 2017 Jan;106(2):97-102

2 Exercise Physiology Laboratory, Nikaia, Greece.

J Clin Endocrinol Metab 2017 02;102(2):560-565

Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Sungnam 03080, Korea; and.

Context And Objective: Pain-related immobility because of insufficiency fractures may result in serious complications and a high mortality rate in senile patients with preexisting comorbidities. This study aimed to evaluate the efficacy of teriparatide in patients with sacral insufficiency fractures.

Design, Setting, And Participants: This retrospective, case-controlled, single center study, performed from 2009 to 2014, included 41 patients who underwent radiographs, magnetic resonance imaging, and/or bone scans to document sacral insufficiency fractures. Read More

Clujul Med 2016 20;89(4):559-564. Epub 2016 Oct 20.

Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

McCune-Albright syndrome is a rare sporadic disease characterized by bone fibrous dysplasia, café-au-lait skin spots and a variable association of hyperfunctional endocrine disorders. Fibrous dysplasia (FD), which can involve the craniofacial, axial, and appendicular skeleton, may range from an isolated, asymptomatic monostotic lesion to a severe disabling polyostotic disease involving the entire skeleton. A twenty-five-year old male patient presented to our clinic with recently developed heart palpitations. Read More

Spine J 2017 May 14;17(5):615-621. Epub 2016 Nov 14.

Department of Orthopedic Surgery, National University Health System, Singapore.

Background Context: Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage. Read More

Semin Musculoskelet Radiol 2016 Sep 14;20(4):330-344. Epub 2016 Nov 14.

Department of Radiology, Auckland District Health Board, Auckland City Hospital, Greenlane Clinical Center, National Women's Hospital, Auckland, New Zealand.

This article focuses on nonspinal fragility or insufficiency fractures. Fragility fractures occur when normal levels of energy are applied to weakened bone, and they normally represent spontaneous fractures or traumatic fractures from minimal energy trauma that would not normally result in fracture in healthy people. This is the case in osteoporosis, where there is reduction of bone mass as well as loss of normal trabecular architecture leading to changes in structural characteristics that compromise biomechanics. Read More

Injury 2016 Dec 18;47(12):2789-2794. Epub 2016 Oct 18.

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address:

Purpose: The purpose of this study is to report the clinical course of fatigue-type subchondral fractures of the femoral head in young healthy adults.

Materials/methods: We retrospectively reviewed 28 consecutive patients (34 hips) who had a clear history of a sudden increase in physical activity without trauma on the hip and pelvis, and were diagnosed as having a fatigue-type subchondral fracture of the femoral head. The diagnosis was made primarily on the basis of sequential plain radiographs and magnetic resonance images. Read More

Medicine (Baltimore) 2016 Oct;95(40):e5026

aDepartment of Orthopedic Surgery, Provincial Hospital Affiliated to Shandong University, Ji'nan, Shandong bDepartment of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng District, Beijing, People's Republic of China.

Background: The aim of this study was to compare the biomechanical characteristics between bilateral and unilateral lumbo-iliac fixation in unilateral comminuted sacral fractures (USF) by finite element analysis.

Methods: A 3-dimensional finite element model of unilateral sacral fractures was simulated. Three kinds of implants were instrumented into the model, including the unilateral lumbopelvic fixation (ULF), bilateral lumbopelvic fixation (BLF), and unilateral iliac fixation with bilateral lumbar pedicle screws (UBF). Read More

Z Orthop Unfall 2016 Dec 6;154(6):560-570. Epub 2016 Oct 6.

Klinik für Unfall- und Wiederherstellungschirurgie, BG-Unfallklinik Tübingen.

In contrast to periprosthetic fractures of the femur, periprosthetic fractures of the acetabulum are rare complications - both primary fractures and fractures in revision surgery. This topic is largely under-reported in the literature; there are a few case reports and no long term results. Due to an increase in life expectancy, the level of patients' activity and the number of primary joint replacements, one has to expect a rise in periprosthetic complications in general and periprosthetic acetabular fractures in particular. Read More

J Korean Med Sci 2016 Oct;31(10):1650-5

Department of Orthopaedic Surgery, Seoul national University Bundang Hospital, Seongnam, Korea.

Subchondral insufficiency fracture (SIF) of the femoral head occurs in the elderly and recipients of organ transplantation. Osteoporosis and deficient lateral coverage of the acetabulum are known risk factors for SIF. There has been no study about relation between spinopelvic alignment and anterior acetabular coverage with SIF. Read More

Ann Palliat Med 2016 Jul 27;5(3):233-7. Epub 2016 May 27.

Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.

Insufficiency fractures are stress fractures that occur from normal weight-bearing on weakened bone. Radiation treatment to malignancies in the prostate, rectum, anus, or cervix may increase the risk of insufficiency fractures in the pelvic region by damaging osteoblasts that are essential to bone formation. In elderly women with cancer, this risk is greater due to their susceptibility to developing osteoporosis. Read More

Clin Orthop Relat Res 2016 Nov 22;474(11):2522-2530. Epub 2016 Jun 22.

Division of Orthopaedic Trauma, Department of Orthopaedics, University of British Columbia, 3114-910 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.

Background: Sacroiliac screw fixation in elderly patients with pelvic fractures is prone to failure owing to impaired bone quality. Cement augmentation has been proposed as a possible solution, because in other anatomic areas this has been shown to reduce screw loosening. However, to our knowledge, this has not been evaluated for sacroiliac screws. Read More

Cardiovasc Intervent Radiol 2016 Oct 2;39(10):1455-63. Epub 2016 Jun 2.

Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS, 1, place de l' Hôpital, 67000, Strasbourg, France.

Aim: To review outcomes and local evolution of treated lesions following percutaneous image-guided screw fixation (PIGSF) of pathological/insufficiency fractures (PF/InF) and impeding fractures (ImF) in cancer patients at two tertiary centres.

Materials And Methods: Thirty-two consecutive patients (mean age 67.5 years; range 33-86 years) with a range of tumours and prognoses underwent PIGSF for non/minimally displaced PF/InF and ImF. Read More

Emerg Radiol 2016 Aug 22;23(4):365-75. Epub 2016 Mar 22.

Department of Radiology, New York University, Langone Medical Center, New York, NY, 10016, USA.

Stress fracture, in its most inclusive description, includes both fatigue and insufficiency fracture. Fatigue fractures, sometimes equated with the term "stress fractures," are most common in runners and other athletes and typically occur in the lower extremities. These fractures are the result of abnormal, cyclical loading on normal bone leading to local cortical resorption and fracture. Read More