Barton Fracture of the Distal Radius in Pregnancy and Lactation-Associated Osteoporosis: A Case Report and Literature Review

Gang Wang, Xiaodong Bai

Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of China

Correspondence: Xiaodong Bai
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of China
Tel +86-10-63138753
Fax +86-10-63138353
Email orthopedics_bxd@163.com

Objective: Pregnancy and lactation-associated osteoporosis (PLO) is very rare, which typically occurs during the third trimester or during lactation. Many cases of PLO are associated with vertebral compression fractures or hip fractures, while distal radius fractures in patients with PLO are rarely reported.
Case Report: A 36-year-old patient presented with Barton fracture at 37 weeks of gestation. Temporary closed reduction and plaster external fixation were performed in emergency room. At 38 weeks of gestation, she gave birth to a healthy boy and began breastfeeding after delivery. Three days after delivery, the patient was admitted to the orthopedic ward for surgery and was diagnosed as PLO. The patient underwent open reduction and internal fixation and treated with weaning and supplementation of calcium carbonate and vitamin D. During the 1-year follow-up period, the results of laboratory tests and bone mineral density gradually returned to normal.
Conclusion: Clinicians should be alert to the possibility of PLO to avoid missed diagnosis. Accurate diagnosis and individualized treatment are of great significance for relieving pain and functional recovery of patients.

Keywords: pregnancy and lactation-associated osteoporosis, PLO, Barton fracture, bone mineral density, BMD, calcium, vitamin D, dual-energy X-ray absorptiometry, DEXA