Atypical femoral fractures: Possible association with long-term bisphosphonate usage

Prakash Selvam ； Sivamurugan Soundarapandian ； Ravisubramaniam Soundarapandian ； Cheralathan Senguttuvan

《International Journal of Case Reports and Images (IJCRI)》 7卷8期 (2016/08) Pp. i+488-494

https://doi.org/10.5348/ijcri-201613-CS-10074

並列摘要

Introduction: Atypical femoral fractures are being identified as a specific type of femoral fracture with regards to the anatomical location, fracture pattern, low energy trauma and possible association with long-term usage of bisphosphonates. Though there is no conclusive evidence to suggest a causal association of bisphosphonates with this type of femur fracture, the recent increase in reporting of such fractures in patients under long-term usage of bisphosphonates justifies the need for research into the association between the two. Case Series: We intend to report two such cases that presented to our institution. Both patients presented with the characteristics of atypical femoral fractures which included low energy trauma, anatomical location, transverse or short oblique configuration with a medial spike, no comminution and lateral cortical thickening. Both patients underwent surgical fixation and were followed-up till union of the fracture. Conclusion: Identifying this specific fracture and treating it with caution is necessary as they tend to take more time to heal in comparison with high energy trauma femoral fracture. Educating physicians and surgeons regarding this type of fracture is of prime importance both in prevention as well as treatment of this type of fracture, which contributes to significant reduction of morbidity and mortality to the patient. Careful prescription of bisphosphonates for patients with definite indications and proper monitoring during follow-up would be another justifiable preventive measure.

並列關鍵字

Atypical femoral fracture ； Bisphosphonates ； Stress fracture