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Postpartum sacral stress fracture: a case report.

Nadeen Hilal1,2, Anwar H Nassar3

  • 1Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

BMC Pregnancy and Childbirth
|May 4, 2016
PubMed
Summary

This case report highlights postpartum bilateral sacral fractures, a type of fatigue fracture, in a woman without osteoporosis. It emphasizes considering sacral fractures in postpartum patients with back and pelvic pain.

Keywords:
Back painPostpartumPregnancySacrumStress fracture

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Area of Science:

  • Orthopedics
  • Radiology
  • Obstetrics

Background:

  • Stress fractures are categorized as insufficiency or fatigue fractures based on bone quality and applied forces.
  • Insufficiency fractures result from normal stress on weakened bone, while fatigue fractures stem from abnormal forces on healthy bone.

Observation:

  • A case of postpartum bilateral sacral fracture is presented in a 30-year-old female without diagnosed osteoporosis.
  • This presentation aligns with the classification of fatigue fractures due to abnormal biomechanical forces during the postpartum period.
  • Clinical symptoms included low back pain, pelvic pain, and an abnormal gait.

Findings:

  • The patient experienced bilateral sacral fractures, a rare occurrence, particularly in the postpartum period without underlying bone density issues.
  • Diagnostic imaging and clinical evaluation confirmed the sacral fractures as fatigue-induced.

Implications:

  • Sacral fractures should be considered in the differential diagnosis for postpartum women presenting with low back and pelvic pain.
  • Early recognition and diagnosis of sacral fractures are crucial for appropriate management and to prevent complications.
  • This case underscores the biomechanical stresses that can lead to fractures even in the absence of osteoporosis.