Retrospective Radiological Approach to Pathological Fractures of the Extremities in Chinese Population

中國人四肢病理性骨折之放射線學探討

盧業球(Gilbert Y. C. Loo) ； 施焄鏻(Shih-Lin Shin) ； 李宗憲(Jack Lee) ； 林清澤(Jackson C. T. Lin)

《中華放射線醫學雜誌》 16卷2期 (1991/06) Pp. 169-174

摘要

本文收集46例發生在中國人之四肢病理性骨折，依X光素片的變化，對臨床及放射線學上的表徵，作了回溯性的分析。
轉移性病灶(67.39%)是最常見的原因，而其中最主要的是由乳癌轉移，佔38.7%。最常見的轉移位置是近端股骨(68.2%)，特別是股骨頸部(65.2%)。
發生在管狀骨的轉移性病例，其橫徑與管狀骨徑之比，大多數大於0.7。顯示出，若是一個轉移性病灶，其橫徑與管狀骨徑比達到0.7，極易發生病理性骨折。
良性骨瘤造成的病理性骨折，常發生在移轉區(transitional zone)。
在本文病例中，骨折的發生並沒有明顯的外力造成，除了一例有副甲狀腺機能亢進併發痙攣而間接造成骨折。另外在極少數的例子，有輕微的傷害而併發骨折，特別是在良性的病例。
當碰到一個病理性骨折的病例，吾人首要考慮惡性病灶的可能，特別是在我們系列裹佔了82.61%。

關鍵字

骨折、骨癌 ； 骨轉移病灶

並列摘要

The clinicoradiological behaviors of 46 cases of pathological fratures of the extremities were reviewed through the study of their plain X-ray films. Metastatic lesions (67.39%) were the most common causes with lytic type of destruction (87%). Breast carcinoma was the main entity (38.7%). The most common site of metastatic fractures was the proximal part of the femoral bone (68.2%), esp. the neck (65.2%). Most of the metastatic cases had a ratio of 0.7 between the transverse diameter of the metastatic lesions and that of the tubular bones, indicating that the pathological fractures would likely to occur if the size of the metastases reaches the ratio of 0.7. Pathological fractures due to benign bone tumor were usually located at the transitional zone. These fractures never necessitate violent traumatic events except in one case of hyperparathyroidism presenting with seizure, and only a few cases were due to trivial injuries, esp., in benign lesions. Whenever a pathological fracture is seen, malignancy should be considered as it was 82.61% in our series.

並列關鍵字

bone, fracture ； bone, neoplasm ； bone neoplasm, metastatic