Presentation
Patient presented with right ankle pain following a fall while walking. Treated with immobilization for 3 months but no healing callus seen.
Patient Data
Comminuted, posteriorly angulated distal tibia and fibula fractures in bones that are osteopenic. There is mild sclerosis along the fracture lines but no appreciable callus, even 5 months after the original injury. This would constitute delayed union but not non-union.
Horizontal lucent lines with sclerotic borders in the lesser trochanter bilaterally. In addition, there are bilateral inferior pubic rami fractures with sclerosis.
Incidental calcified uterine fibroid in the pelvis noted.
Bilateral proximal ulna fractures, with a wide zone of lucency on the right. Additionally, there is a right radial neck fracture.
Case Discussion
Looser zones are insufficiency fractures associated with osteomalacia. This patient has multiple bones affected.
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