Insufficiency fracture of the sternum report of a case

Benbouazza, K.; Harzy, Taoufik; Guedira, N.; Hajja-Hassouni, Najia

doi:10.1016/s1297-319x(02)00022-2

Cited by 3 publications

(1 citation statement)

References 2 publications

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“…The spine, pelvis, and lower extremities are commonly affected by these fractures, whereas insufficiency fracture of the sternum is rare. Approximately 40 cases with sternal insufficiency fractures have been reported in the literature (Itani et al 1982;Cooper 1988;Chen et al 1990;Sapherson and Mitchell 1990;Schapia et al 1995;Benbouazza et al 2003;Min and Sung 2003;Soubrier et al 2003;Ragucci and Vainrib 2005;Lin and Ponampalam 2006) and the fracture was classified as either the buckling type or nonbuckling type as suggested by Chen et al (1990). A buckling sternal fracture was defined as a sternal deformity in which the upper portion of the sternum was located posterior to the lower portion, and in which there was no tion.…”

confidence: 99%

Insufficiency Fracture of the Sternum Simulating Myocardial Infarction: Case Report and Review of the Literature

Horikawa¹,

Miyakoshi

Kodama³

et al. 2007

Tohoku J. Exp. Med.

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Insufficiency fracture is a type of stress fracture that occurs when stress is applied to the bone with less than the normal elastic resistance, as in osteoporosis. Insufficiency fracture of the sternum is rare among all kinds of fractures. We describe two cases with insufficiency fractures of the sternum secondary to osteoporosis and thoracic kyphotic deformity. Both of the present cases, a 76-year-old woman and a 65-year-old woman, presented with severe anterior chest pain simulating myocardial infarction. However, cardiopulmonary examinations including chest radiographs, electrocardiograms, and laboratory tests were normal. Lateral radiographs of the sternum in both patients showed insufficiency fractures of the sternum. Conservative treatment with rib bandaging/bracing and analgesics relieved their symptoms. Clinical behavior, type of sternal insufficiency fractures, and mechanism of the fracture are reviewed from perusal of the literature. We emphasize that sternal insufficiency fracture should be considered in the differential diagnosis of acute chest pain in the elderly along with myocardial infarction or pulmonary embolism. insufficiency fracture; sternum; osteoporosis; myocardial infarction

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confidence: 99%

Insufficiency Fracture of the Sternum Simulating Myocardial Infarction: Case Report and Review of the Literature

Horikawa¹,

Miyakoshi

Kodama³

et al. 2007

Tohoku J. Exp. Med.

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Looking beyond low bone mineral density: Multiple insufficiency fractures in a woman with post-menopausal osteoporosis on alendronate therapy

Lee

Wall

Seibel

2007

J Endocrinol Invest

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Insufficiency fractures occur most commonly in the pelvic girdle and in the sacrum, followed by the tibia and the femoral neck. Insufficiency fractures of the femoral diaphyses are rare, with only few reported cases in the literature. The strongest associations exist with untreated osteoporosis. We describe an unusual case of multiple insufficiency fractures in a 73-yr-old Chinese woman who presented with a 10-month history of bilateral groin pain and difficulty with walking in the absence of trauma, diagnosed 18 months following the commencement of anti-resorptive therapy with alendronate. The pathogenesis of such insufficiency fractures is poorly understood, but next to low bone mineral density and micro-architectural damage likely involves other components such as changes in bone turnover and patient-related factors (e.g. non-compliance). This case report and review of the literature draws attention to some of the challenges in the diagnosis and management of such rare insufficiency fractures.

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