高齢者の足部に発生する脆弱性骨折の特徴

Clinical Characteristics of Insufficiency Fractures in the Feet of Elderly Patients

　高齢者の足部に発生する脆弱性骨折は，早期診断が難しく見逃されることが多い．われわれは，足部の脆弱性骨折8人，10例の臨床像をまとめた．

　1）全例女性で，平均年齢72.8歳であった．

　2）10例の内訳は，踵骨5例，中間楔状骨2例，立方骨1例，舟状骨1例，外側楔状骨1例であった．

　3）病歴および理学所見には，本骨折を疑わせる重要な特徴があった．

　4）全例に原発性骨粗鬆症の合併を認めた．

　MRIは，本骨折の早期診断に非常に有力であった．高齢者が原因不明の足部痛を訴えた場合，脆弱性骨折は鑑別診断の1つとして重要である．

　We retrospectively reviewed clinical findings from 8 patients with 10 insufficiency fractures of the foot.

　All were elderly women (average age, 72.8 years). Insufficiency-fracture sites were：5 calcaneus, 2 tarsal middle cuneiform 1 cuboid, 1 tarsal navicular, and 1 tarsal lateral cuneiform. All had unique clinical features, which were useful in directing attention toward fractures. All 8 patients had osteoporosis. Magnetic resonance imaging was helpful in early confirmation of insufficiency fractures in which radiographic findings were equivocal. Insufficiency fractures should be considered in the differential diagnosis of elderly patients with osteoporosis with spontaneous pain in the middle and/or hind part of the foot.