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. 2013 Mar;57(1):42-8.

Sternal insufficiency fracture related to steroid-induced osteoporosis: A case report

Jessica J Wong  1 , Brian Drew, Paula Stern
Affiliations

Sternal insufficiency fracture related to steroid-induced osteoporosis: A case report

Jessica J Wong et al. J Can Chiropr Assoc. 2013 Mar.

Abstract
in English, French

Osteoporosis often results in fractures, deformity and disability. A rare but potentially challenging complication of osteoporosis is a sternal insufficiency fracture. This case report details a steroid-induced osteoporotic male who suffered a sternal insufficiency fracture after minimal trauma. Prompt diagnosis and appropriate management resulted in favourable outcome for the fracture, though a sequalae involving a myocardial infarction ensued with his osteoporosis and complex health history. The purpose of this case report is to heighten awareness around distinct characteristics of sternal fractures in osteoporotic patients. Discussion focuses on the incidence, mechanism, associated factors and diagnostic challenge of sternal insufficiency fractures. This case report highlights the role primary contact practitioners can play in recognition and management of sternal insufficiency fractures related to osteoporosis.

L’ostéoporose cause souvent des fractures, des difformités et l’invalidité. Une complication rare, mais potentiellement grave, de l’ostéoporose est la fracture par insuffisance osseuse du sternum. Ce rapport décrit en détail le cas d’un mâle atteint d’ostéoporose causée par les stéroïdes et qui a subi une fracture par insuffisance osseuse du sternum après un traumatisme minime. Grâce à un diagnostic rapide et une gestion appropriée, on a obtenu de bons résultats pour la fracture, mais des séquelles ont été laissées sous forme d’un infarctus du myocarde en raison de ses antécédents médicaux complexes. Le but de cette étude de cas est de sensibiliser sur les caractéristiques distinctes des fractures du sternum chez les patients ostéoporotiques. La discussion porte sur l’incidence, le mécanisme, les facteurs associés et la difficulté de diagnostic des fractures par insuffisance osseuse du sternum. Cette étude de cas met en évidence le rôle que peuvent jouer les chiropraticiens qui offrent des soins primaires dans le diagnostic et la gestion des fractures par insuffisance osseuse du sternum liées à l’ostéoporose.

Keywords: insufficiency fracture; osteoporosis; sternal fracture.

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Figures

Figure 1:
Figure 1:
Lateral spot-view radiograph of the sternum reveals fracture of the sternal body. There is interval development of a new fracture in the proximal portion of the sternal body (arrow).
Figure 2:
Figure 2:
Lateral thoracolumbar radiograph reveals previous kyphoplasty procedures at T9, T10, T11, T12, L1, L2, L3, L4 and L5. Contrast agents are confined to the vertebral bodies with no significant leaks. Old compression fractures suspected at T7 and T8. There is generalized decrease in bone density and multilevel degenerative changes.
See this image and copyright information in PMC

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