抄録
Insufficiency fracture, which occurs without any apparent accident due to increased bone fragility, has been highlighted in recent years. We conducted bone histomorphometry with respect to 5 insufficiency fractures of the femoral neck in 4 hemodialysis patients, l male and 3 females aged between 55 and 71 years (mean age: 63.8) at the time of fracture. Patients had undergone dialysis before fracture for a period of from 11 months to 18 years and 10 months (mean: 9.1 years) . Prosthesis replacement was conducted for 2 fractures, hemorrhagic redress-ment/internal fixation using a dynamic hip screw for 2, and conservative therapy for one. Bone histomorphometry showed adynamic bone disease (ABD) in 2 patients, osteomalacia (OM) in one, and ostitis fibrosa (OF) in the other. Osteosynthesis conducted in one ABD patient was failure due to marked loosening and nonunion. A cautious approach is necessary, taking the possibility of ABD into account, when considering osteosynthesis for insufficiency fracture in hemodialysis patients.
