Subchondral fatigue fracture of the femoral head in military recruits
Subchondral fatigue fracture of the femoral head in military recruits
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DOI：
10.2106/00004623-200409000-00009
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发表时间：
2004-09-01
影响因子：
5.3
通讯作者：
Kim, HJ
中科院分区：
文献类型：
--
作者：
Song, WS;Yoo, JJ;Kim, HJ
背景资料：股骨头软骨下应力性骨折是一种罕见的情况，通常发生在骨质差的人中。我们评估的临床特点发生在年轻，健康的军事increment.Methods：1998年1月至2001年11月，7股骨头软骨下疲劳骨折的股骨头进行了治疗的5例患者。这种情况的特点进行了评估的临床过程，以及X光片，骨密度，和磁共振images.Results：所有患者都是男性新兵在他们的二十出头的疼痛在招募后五个月内开发。在3例患者的4个髋关节的初始X线片上观察到明确的异常结果，其中2个髋关节的股骨头明显塌陷。4例患者的5个髋关节的骨密度图均显示股骨头放射性核素摄取增加。在所有受影响的髋关节，磁共振图像显示股骨头和/或颈部局部或弥漫性骨髓水肿模式。在所有髋关节中发现了软骨下骨折线（磁共振新月征）。在没有股骨头塌陷的患者中，疼痛逐渐减轻，并在6个月内完全消失，序列磁共振成像的结果也相应改善。股骨头塌陷的患者进行了全髋关节置换术或髂骨strut grafts.Conclusions：当新兵或运动员报告髋关节疼痛，诊断为股骨头软骨下疲劳骨折应考虑。证据等级：预后研究，I级（病例系列）。证据等级的完整描述见作者说明。
Background: Subchondral stress fracture of the femoral head is a rare condition that usually occurs as an insufficiency fracture in people with poor bone quality. We evaluated the clinical characteristics of subchondral fatigue fractures of the femoral head that occurred in young, healthy military recruits.Methods: Between January 1998 and November 2001, seven subchondral fatigue fractures of the femoral head were treated in five patients. The characteristics of this condition were ascertained by assessing the clinical course as well as radiographs, bone scintigrams, and magnetic resonance images.Results: All patients were male military recruits in their early twenties in whom pain had developed within five months after recruitment. Definite abnormal findings were observed on the initial radiographs of four hips in three patients, and the femoral head was markedly collapsed in two of these four hips. Bone scintigrams were made of five hips in four patients, and all of them showed increased radionuclide uptake in the femoral head. In all affected hips, magnetic resonance images demonstrated a localized or diffuse bone-marrow-edema pattern in the femoral head and/or neck. A subchondral fracture line (a magnetic resonance crescent sign) was identified in all hips. In the patients who did not have collapse of the femoral head, the pain decreased gradually and disappeared completely within six months, with correspondingly improved findings on sequential magnetic resonance images. The patients with femoral head collapse were treated with total hip arthroplasty or an iliac bone strut graft.Conclusions: When a military recruit or an athlete reports hip pain, a diagnosis of subchondral fatigue fracture of the femoral head should be considered.Level of Evidence: Prognostic study, Level I (case series). See Instructions to Authors for a complete description of levels of evidence.