Insufficiency fractures of the sternum

Jk, Min; Ms, Sung

doi:10.1080/03009740310002533

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…Chronic obstructive pulmonary disease was the most commonly associated disease condition in a study of 15 patients identified with sternum insufficiency fracture described by Min and Sung [1]; five out of these 15 patients in that study had chronic obstructive pulmonary disease and two had rheumatoid arthritis. One out of five patients with chronic obstructive pulmonary disease and both patients with rheumatoid arthritis were on corticosteroid therapy.…”

Section: -9546 C 2006 Lippincott Williams and Wilkinsmentioning

confidence: 98%

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Sternum insufficiency fracture presenting as acute chest pain: a case report and review of the literature

Lin¹,

Ponampalam²

2006

European Journal of Emergency Medicine

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The spine, pelvic bones and long bones of the lower extremities are common sites for insufficiency fractures. Cases of sternum insufficiency fractures have been rarely reported in an elderly patient. Insufficiency fracture tends to occur in bones with decreased mechanical strength. It tends to occur in elderly patients, especially in postmenopausal women, with underlying diseases. We describe a case of sternum insufficiency fracture in a patient with rheumatoid arthritis and systemic lupus erythematosus on long-term corticosteroid therapy diagnosed in an emergency setting. Sternum insufficiency fracture is a rare cause of chest pain. This case serves to remind the emergency physician to remain vigilant for other noncardiac and nontraumatic causes of chest pain. If diagnosed accurately, these patients can be discharged and treated as outpatients.

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Section: -9546 C 2006 Lippincott Williams and Wilkinsmentioning

confidence: 98%

“…Insufficiency fracture tends to occur in bones with decreased mechanical strength. It tends to occur in elderly patients, especially in postmenopausal women, with underlying diseases [1].…”

Section: Introductionmentioning

confidence: 99%

Sternum insufficiency fracture presenting as acute chest pain: a case report and review of the literature

Lin¹,

Ponampalam²

2006

European Journal of Emergency Medicine

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“…All diseases that induce osteoporosis are prone to develop insufficiency fractures. Min and Sung found that chronic obstructive pulmonary disease was the most commonly associated disease condition in a study of 15 patients identified with sternal insufficiency fracture (5 of 15) 12. Two of these patients had rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 99%

Atraumatic sternum fracture

Abrahamsen¹,

Madsen

2014

BMJ Case Reports

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SUMMARYThe spine, pelvic bones and long bones of the lower extremities are common sites for insufficiency fractures. Cases of sternum insufficiency fractures have rarely been reported among elderly patients. Insufficiency fractures tend to occur in bones with decreased mechanical strength especially among elderly patients, in postmenopausal women and patients with underlying diseases. We describe a case of spontaneous sternum insufficiency fracture in a healthy man, with no known risk factors to fracture, or previous history of fractures. Sternum insufficiency fracture is a rare cause of chest pain. This case serves to remind the emergency physician to remain vigilant for other non-cardiac, non-pulmonary and non-traumatic causes of chest pain, especially among patients with known risk factors such as osteoporosis, chronic obstructive pulmonary disease, rheumatoid arthritis, systemic lupus erythematosus and patients on long-term steroid treatment. If diagnosed correctly, these patients can be discharged and treated as outpatients as this case emphasises. BACKGROUND

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“…Chen et al (1990) reported that in their 7 patient series with sternal insufficiency fracture, patients with nonbuckling sternal fractures (5 patients) reported pain, while buckling fractures (2 patients) were asymptomatic. On the other hand, Min and Sung (2003) reported that 5 of the 7 patients in their series with the buckling type of fracture had chest pain. The discrepancy might be attributed to the small number of cases.…”

Section: Discussionmentioning

confidence: 99%

“…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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Insufficiency fractures of the sternum

Cited by 6 publications

References 5 publications

Sternum insufficiency fracture presenting as acute chest pain: a case report and review of the literature

Sternum insufficiency fracture presenting as acute chest pain: a case report and review of the literature

Atraumatic sternum fracture

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

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