Sintering fracture
| Classification according to ICD-10 | |
|---|---|
| M80.9 | Unspecified osteoporosis with pathological fracture |
| M48.5 | Vertebral Compression, not elsewhere classified |
| ICD-10 online (WHO version 2019) | |
Sintering fractures or sintering are vertebral fractures that occur in severely osteoporotic bone. They often cause the vertebra to collapse.
Symptoms
The course of the injury is usually much less dramatic than in younger people's vertebral fractures that are not due to osteoporosis. While a healthy vertebra bursts or splinters in the event of an accident-related force, the fragile substance of an osteoporotically altered vertebra collapses. After a loss of bone substance, the resulting material defect causes the vertebra to lose height, usually without fragments getting into the vertebral canal. A wedge-shaped vertebra forms , the trailing edge is retained, the vertebral canal is not injured, so there is normally no risk of a cross-sectional syndrome .
Often such a wedge vortex does not occur individually, but the same fractures occur several times in a row. The spine curves forward ( hyperkyphosis ), the body size decreases, the ratio of trunk length to the length of the arms and legs becomes disproportionate. The thoracic spine curves, the abdomen arches forward, with slimmer people, skin folds occur on the flanks due to the decreasing trunk length, which run from back-top to front-bottom. This final state is popularly known as the "widow's hump". The resulting pain, the physical limitations and the change in appearance are largely accepted as "normal" signs of age. This late state of an essentially untreated osteoporosis can be seen quite frequently, both doctors and patients still have to do a lot of educational work.
Emergence
While in young people considerable force is required to break a vertebra, in the case of damaged bones, slight mechanical forces are sufficient to trigger material failure. In individual cases it can be difficult to decide in retrospect whether the violence corresponded to the trauma or not.
A sintering fracture is to be regarded as a pathological fracture ; a healthy bone does not give way in this form in the event of mechanical overload.
therapy
If there is a sintering fracture on the basis of osteoporosis , an attempt should definitely be made to put the patient in bed for as short a time as possible. It makes sense to ensure an adequate supply of painkillers and to stabilize the spine with an orthopedic support device that is adapted to the type of injury and the physical conditions of the patient. With prolonged bed rest, the loss of calcium from the bones continues quickly, the next vertebral fracture follows soon.
Another option is vertebroplasty and kyphoplasty : the material defect in the broken vertebra is filled with bone cement under X-ray control . If this procedure can be used, painless remobilization is possible very soon after the surgical treatment.
In addition to the immediate treatment of the fracture, drug treatment of osteoporosis is important in the long term in order to prevent further fractures as a result.
