Stress fracture of the hip and pubic rami after fusion to the sacrum in an adult with scoliosis: a case report

J A Morcuende; S Arauz; S L Weinstein

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$Stress fracture of the hip and pubic rami after fusion to the sacrum in an adult with scoliosis: a case report$

Journal article

Open access

Peer reviewed

Stress fracture of the hip and pubic rami after fusion to the sacrum in an adult with scoliosis: a case report

J A Morcuende, S Arauz and S L Weinstein

The Iowa orthopaedic journal, Vol.20, pp.79-84

2000

PMCID: PMC1888744

PMID: 10934629

Appears in Diamond Open Access

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888744/View

Published (Version of record) Open Access

Abstract

Correction of adult scoliosis frequently involves long segmental fusions, but controversy still exists whether these fusions should include the sacrum. It has been suggested that forces associated with activities of daily living transfer the stresses to the remaining levels of the spine and to the pelvis. The case described here was a 43-year-old woman with scoliosis and chronic back pain refractory to non-surgical modalities. Radiographically, the patient had a 110 degree lumbar curve. An anterior and posterior fusion with Luque-Galveston instrumentation was performed. Six months postoperatively the patient returned with a 2-week history of right hip pain with no history of trauma. There was radiographic evidence of a displaced femoral neck fracture and pubic rami fractures. The femoral neck fracture was treated with a total hip replacement. Further surgeries were required to correct a lumbar pseudoarthrosis and hardware failure. We believe that this case provides evidence that fusion into the lumbosacral junction may distribute forces through the pelvic bones and hip resulting in stress and potential hardware complications, especially in patients at risk due to osteopenic conditions.

Radiography

Fractures, Stress - surgery

Femoral Neck Fractures - surgery

Humans

Pubic Bone - injuries

Spinal Fusion - adverse effects

Activities of Daily Living

Femoral Neck Fractures - etiology

Bone Diseases, Metabolic - complications

Sacrum - surgery

Adult

Female

Fractures, Stress - diagnostic imaging

Marfan Syndrome - complications

Back Pain - etiology

Femoral Neck Fractures - diagnostic imaging

Fractures, Stress - etiology

Spinal Fusion - instrumentation

Pubic Bone - surgery

Scoliosis - surgery

Ehlers-Danlos Syndrome - complications

Biomechanical Phenomena

Scoliosis - complications

Chronic Disease

Equipment Failure

Details

Title: Subtitle: Stress fracture of the hip and pubic rami after fusion to the sacrum in an adult with scoliosis: a case report
Creators: J A Morcuende - Department of Orthopaedic Surgery, University of Iowa, Iowa City, USA
S Arauz
S L Weinstein
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.20, pp.79-84
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 10934629
PMCID: PMC1888744
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2000
Academic Unit: Stead Family Department of Pediatrics; Orthopedics and Rehabilitation
Record Identifier: 9984040336302771

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