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- Title
Accumulation of microdamage and low bone mass in the femoral head as a cause of subchondral insufficiency fracture in a patient with osteogenesis imperfecta.
- Authors
Iwata, Ken; Mashiba, Tasuku; Shimamura, Masashi; Miki, Takanori; Yamamoto, Tetsuji
- Abstract
Subchondral insufficiency fractures of the femoral head are generally considered to be osteoporosis-related fragility fractures. There have been reports of microfractures being found in subchondral bone on pathological examination. However, the mechanism of these microfractures is not known. In this report, we describe a patient with osteogenesis imperfecta who developed a subchondral insufficiency fracture of the femoral head after a fall that had resulted in a subcapital femoral neck fracture. Bipolar hemiarthroplasty was performed, and bone at the femoral head and neck was sampled for pathophysiological examination. Hematoxylin and eosin staining revealed microfractures and microcallus in the subchondral bone in the femoral head, indicating healing of a subchondral insufficiency fracture before the subcapital femoral neck fracture. Moreover, decreased bone volume and accumulated microdamage were observed in the subchondral bone but not in the cancellous bone in the femoral neck. These findings suggest that subchondral insufficiency fracture of the femoral head is a stress fracture caused by accumulation of microdamage in fragile subchondral bone.
- Subjects
BONE density; BONE growth; BONE fractures; FEMUR neck; OSTEOGENESIS imperfecta
- Publication
Journal of Bone & Mineral Metabolism, 2019, Vol 37, Issue 5, p768
- ISSN
0914-8779
- Publication type
journal article
- DOI
10.1007/s00774-019-01006-y