Atypical Fractures of the Femur: Evaluation and Treatment

Blood, Travis; Feller, Ross; Cohen, Eric; Born, Christopher T.; Hayda, Roman A.

doi:10.2106/jbjs.rvw.n.00062

Cited by 10 publications

(6 citation statements)

References 49 publications

(49 reference statements)

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“…A quantitative bone health assessment along with Vitamin D, parathyroid functions, and calcium levels should also be monitored in these fractures [7,[22][23][24]. When the fracture is complete, Intramedullary nailing is recommended when compared to other fixation techniques because it showed the lowest rate of failure [1].…”

Section: Discussionmentioning

confidence: 99%

Untreated Atypical Left Femoral Shaft Fracture: A Case Report of Its Complication

et al. 2023

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Background: Bisphosphonate therapy is used to manage osteoporosis and decrease the risk of vertebral and hip fractures. These drugs act by suppressing osteoclast activity by inducing the inhibition of bone resorption and increasing bone mineral density. It has been shown that long-term use of bisphosphonate is correlated to a higher incidence of atypical femoral fractures. Case report: This is a case report of an 81-year-old female, on bisphosphonate therapy for 12 years and with chronic left thigh pain for two and a half years who developed an incomplete atypical left femur fracture. What’s special about this case is that the fracture was ignored and then progressed after three months into a complete displaced spiral fracture that required surgical fixation. Conclusion: The benefits of bisphosphonate treatment in preventing osteoporotic fractures outweigh the risk of the occurrence of these atypical fractures. Orthopedic surgeons as well as primary care physicians must keep atypical fractures in their differential diagnosis in patients presenting with prodromal symptoms and who are on long-term bisphosphonate therapy

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Section: Discussionmentioning

confidence: 99%

Untreated Atypical Left Femoral Shaft Fracture: A Case Report of Its Complication

et al. 2023

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“…It has been reported that surgery results in faster bone fusion than conservative treatment [6][7][8]. Blood et al [2] recommended surgery if there is radiographic evidence of AFF and pain. Min et al [9] developed the scoring system to predict the risk of complete fracture in incomplete AFF and reported that prophylactic internal fixation should be performed if the total score is 8 or more, based on a score of 1-3 points each for the following four items: fracture height, pain intensity, contralateral status, and degree of the insufficiency fracture line.…”

Section: Tka: Total Knee Arthroplastymentioning

confidence: 99%

Incomplete Atypical Femoral Fracture With Severe Bowing Treated by Intramedullary Nail and Corrective Osteotomy

Sato¹,

Kitamura²,

Murase³

et al. 2023

Cureus

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We present the case of an 82-year-old female who had difficulty walking due to right thigh pain caused by incomplete atypical femoral fracture (AFF). The femoral bowing was so severe that intramedullary nail insertion was impossible, so we performed a corrective osteotomy of the femur and inserted the intramedullary nail. Postoperatively, the femoral pain disappeared, and bone fusion was achieved at one year and two months postoperatively. In cases of incomplete AFF with very severe femoral bowing, internal fixation with an intramedullary nail combined with corrective osteotomy of the femur is useful.

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“…Thus, even a year of taking these medications can lead to long-term trabecular network changes. In one study, atypical femur fractures were noted to occur approximately 5 years after taking bisphosphonates and commonly occurred in the subtrochanteric region or femoral diaphysis [ 38 ]. These authors recommend a drug holiday after this time to prevent the occurrence of atypical femur fractures with bisphosphonate use.…”

Section: Risks Of Bisphosphonates In Tjamentioning

confidence: 99%

“…This risk may be additionally elevated in younger patients, and surgeons should be judicious in their use in this cohort. Additionally, osteoporosis is a common problem prior to TJA, with up to 25% of individuals being qualified to receive bisphosphonate medication prior to TJA based on osteoporosis criteria alone [ 38 ]. It is imperative that arthroplasty surgeons screen for osteoporosis and consider bisphosphonate therapy both for osteoporosis and for implant survival to decrease revisions.…”

Section: Summary and Recommendationsmentioning

confidence: 99%

Bisphosphonates in Total Joint Arthroplasty: A Review of Their Use and Complications

et al. 2022

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Atypical Fractures of the Femur: Evaluation and Treatment

Cited by 10 publications

References 49 publications

Untreated Atypical Left Femoral Shaft Fracture: A Case Report of Its Complication

Untreated Atypical Left Femoral Shaft Fracture: A Case Report of Its Complication

Incomplete Atypical Femoral Fracture With Severe Bowing Treated by Intramedullary Nail and Corrective Osteotomy

Bisphosphonates in Total Joint Arthroplasty: A Review of Their Use and Complications

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