Malleolar fracture in pregnancy and lactation-associated osteoporosis: a case report and literature review



The incidence of fractures in pregnancy and lactation-associated osteoporosis (PLO) is very low. Some fracture cases of PLO are associated with vertebral compression fractures, while malleolar fractures in patients with PLO are rarely reported before.

Case report

A 31-year-old Han Chinese patient presented with a malleolar fracture 3 months after delivery, while she was still breastfeeding. Temporary closed reduction and plaster external fixation were performed in the emergency room. Then the patient was admitted to the orthopedic trauma ward for surgery and diagnosed as PLO by dual-energy X-ray absorptiometry (DEXA). After preoperative evaluation, the patient underwent open reduction and internal fixation. With the diagnosis of PLO, the patient was treated with weaning, bisphosphonate, and supplementation of calcium carbonate and vitamin D. During the 12-month follow-up period, the results of DEXA and laboratory examination improved gradually, and the internal fixation was removed 12 months after surgery.


Orthopedic doctors should not ignore the possibility of PLO to avoid misdiagnosis of perinatal women with fractures. Improvement of functional recovery of fractures can be achieved with accurate diagnosis and individual treatment.

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Pregnancy and lactation-associated osteoporosis


Bone mineral density


Dual-energy X-ray absorptiometry


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All the data supporting our findings are contained within the manuscript.

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XDB and BJW joined the surgery, GW and GQX were involved in information collection of the patient, XDB and GQX reviewed the literature and contributed to manuscript drafting, and GQX and BJW were responsible for the revision of the manuscript. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Baojun Wang.

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Informed written consent was obtained from the patient for publication of this report and any accompanying images. A copy of the written consent is available for review by the editor of this journal.

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Bai, X., Wang, G., Xu, G. et al. Malleolar fracture in pregnancy and lactation-associated osteoporosis: a case report and literature review. Arch Osteoporos 16, 36 (2021).

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  • Malleolar fracture
  • Pregnancy and lactation-associated osteoporosis (PLO)
  • Dual-energy X-ray absorptiometry (DEXA)
  • Bone mineral density (BMD)