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Fragility fracture of the fourth rib in a patient with a cardiac pacemaker: an uncommon case.
Köseoglu Tohma, Ebru; Özyemisçi Taskiran, Özden.
  • Köseoglu Tohma E; Department of Physical Medicine and Rehabilitation, Mugla Sitki Koçman University Research and Training Hospital, Mugla, Turkey. ebru_koseoglu@hotmail.com.
  • Özyemisçi Taskiran Ö; Department of Physical Medicine and Rehabilitation, Koç University School of Medicine, Istanbul, Turkey.
Arch Osteoporos ; 16(1): 129, 2021 09 09.
Article in English | MEDLINE | ID: covidwho-1471836
ABSTRACT

PURPOSE:

In patients with a cardiac pacemaker, pocket-related complications such as nerve impairment or bone fractures are infrequent. We present a man with a fracture of the 4th rib several months after pacemaker implantation. CASE PRESENTATION A 74-year-old man, with a left prepectoral pacemaker implanted 13 months ago, presented complaining of chest pain. The pain started after a sudden trunk rotation and right arm flexion movement with a crack. There was tenderness to palpation and crepitation over the left upper ribs. Computed tomography identified a non-displaced fracture line in the anterior aspect of the left 4th rib. After kinesiotaping and activity restriction, pain alleviated.

CONCLUSION:

Pacemaker implantation might have caused shoulder dysfunction and pectoral tightness resulting in reduced flexibility of the trunk. Consequently, a reaching motion of the arm with a trunk rotation might have directed rotational force vectors towards the osteopenic left 4th rib causing a fragility fracture. In elderly with a pacemaker, osteopenia and concomitant sarcopenia may create a predisposition to this atypical complication.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pacemaker, Artificial / Rib Fractures Type of study: Case report Limits: Aged / Humans / Male Language: English Journal: Arch Osteoporos Year: 2021 Document Type: Article Affiliation country: S11657-021-00999-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pacemaker, Artificial / Rib Fractures Type of study: Case report Limits: Aged / Humans / Male Language: English Journal: Arch Osteoporos Year: 2021 Document Type: Article Affiliation country: S11657-021-00999-2