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Atypical femur fracture

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https://www.readbyqxmd.com/read/28228783/-atypical-atypical-femur-fractures-and-use-of-bisphosphonates
#1
Denise M van de Laarschot, Matthijs P Somford, Agnes Jager, Edwin H Oei, P Koen Bos, M Carola Zillikens
BACKGROUND: Atypical femur fractures (AFFs) present a rare but serious condition associated with use of bisphosphonates. Underlying mechanisms and clinical risk factors remain unclear. According to the diagnostic criteria formulated by the ASBMR, a lateral localization of an AFF is required. CASE HISTORY: We present a patient who developed bilateral leg pain while using an oral bisphosphonate and aromatase inhibitor in the course of adjuvant treatment for breast cancer...
September 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28208867/osseous-hydatidosis-of-femur-in-a-patient-with-fracture-non-union-an-uncommon-entity
#2
Kiruthiga Kala Gnanasekaran, Anne Jennifer Prabhu, Shyjumon George
Hydatid disease caused by the larval form of the parasitic tapeworm, Echinococcus granulosus, commonly affects the liver and lungs. Bone involvement by Hydatid is extremely uncommon and is reported in 1-3% of cases. It is often a dormant disease, presenting at a late stage with non-specific clinical and radiological findings. Usually they occur as an isolated entity without liver/lung involvement and a clinical suspicion of this disease is not possible. We report a rare case of Hydatid cyst of femur in a 25-year-old female, with unresolving non-union of fracture for five years...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203048/atypical-femoral-shaft-fractures-secondary-to-long-term-bisphosphonate-therapy
#3
Cemil Kayali, Taskin Altay, Firat Ozan, Serkan Sozkesen, Kamil Yamak
BACKGROUND: Bisphosphonates (BPs) are one of the most commonly used agents in the treatment of post-menopausal osteoporosis and other metabolic bone diseases. METHODS: Between 2010 and 2015, data of 22 osteoporotic women with femoral fractures due to low-energy trauma who received BPs previously were analysed. RESULTS: The mean duration of BP therapy was 7.6 years. The mean duration of union was 7.4 months. Five patients had non-union. Stress reaction was observed in the contralateral femur in 11 patients...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28169041/treatment-of-postmenopausal-osteoporosis-a-literature-based-algorithm-for-use-in-the-public-health-care-system
#4
Ellen Luz Pereira Caires, Mailze Campos Bezerra, Ana Flávia Torquato de Araújo Junqueira, Sheila Márcia de Araújo Fontenele, Silvana Cristina de Albuquerque Andrade, Catarina Brasil d'Alva
Bisphosphonates are considered first-line agents in the treatment of postmenopausal osteoporosis based on extensive experience of use, safety, and proven efficacy in reducing vertebral, non-vertebral and femur fractures. However, post-marketing reports based on the treatment of millions of patients/year over lengthy periods of time have revealed the occurrence of initially unexpected adverse effects, such as osteonecrosis of the jaw and atypical femoral fracture, leading to the restriction of treatment duration with bisphosphonates by global regulatory agencies...
December 27, 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28164053/long-term-bisphosphonate-therapy-induced-periprosthetic-femoral-stress-fracture-in-a-sliding-hip-screw-implant-a-unique-case-report
#5
Mark R Adams, Conor Dunn, Michael S Sirkin, Mark C Reilly
INTRODUCTION: Long-term bisphosphonate therapy for osteoporosis is associated with an increased risk of low-to-no energy atypical subtrochanteric and femoral shaft fractures with characteristic radiologic findings. There are few reports of patients with long-term bisphosphonate-induced periprosthetic fractures, all of them had a hip arthroplasty prosthesis. In this report, we present a unique case of a 90-year-old Caucasian female on long-term bisphosphonate therapy with a sliding hip screw implant who sustained a periprosthetic fracture of the femoral shaft at the distal aspect of the plate...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28157080/atypical-fractures-of-the-femur-associated-with-chronic-treatment-with-bisphosphonates
#6
Grzegorz Fijewski, Bartłomiej Szostakowski, Radosław Górski, Piotr Modzelewski, Piotr Dudek, Paweł Małdyk
BACKGROUND: The problem of atypical fractures, such as subtrochanteric or diaphyseal femoral fractures, associated with long-term treatment with bisphosphonates (BPs) has recently been given increasingly more attention. These fractures develop as stress fractures and are characterised by diaphyseal cortical thickening and a transverse or slightly oblique fracture line. The use of bisphosphonates has been documented to reduce the risk of osteoporotic fractures. However, an increasing number of papers verify the safety and benefits of the administration of these drugs over more than 3-5 years...
May 5, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28114975/incidence-and-medical-management-of-bisphosphonate-associated-atypical-femoral-fractures-in-a-major-trauma-centre-a-retrospective-observational-study
#7
Neil Eisenstein, Ganesh Kasavkar, Dhruva Bhavsar, Faisal Shehzaad Khan, Zoe Paskins
BACKGROUND: Atypical femoral fractures (AFFs) are rare events associated with increased duration of bisphosphonate exposure. Recommended management of AFFs include cessation of bisphosphonates and imaging of the contralateral femur. The aims of this study were to identify the local incidence of AFFs in bisphosphonate users and to audit the medical management of AFFs against published recommendations. METHODS: A retrospective analysis of the admissions database for a major trauma centre identified all femoral fractures (3150) in a five-year period (July 2009 to June 2014)...
January 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28099754/addressing-the-crisis-in-the-treatment-of-osteoporosis-a-path-forward
#8
Sundeep Khosla, Jane A Cauley, Juliet Compston, Douglas P Kiel, Clifford Rosen, Kenneth G Saag, Elizabeth Shane
Considerable data and media attention have highlighted a potential "crisis" in the treatment of osteoporosis. Specifically, despite the availability of several effective drugs to prevent fractures, many patients who need pharmacological therapy are either not being prescribed these medications or if prescribed a medication, are simply not taking it. Although there are many reasons for this "gap" in the treatment of osteoporosis, a major factor is physician and patient concerns over the risk of side effects, especially atypical femur fractures (AFFs) related to bisphosphonate (and perhaps other antiresorptive) drug therapy...
December 29, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28071822/responses-to-treatment-with-teriparatide-in-patients-with-atypical-femur-fractures-previously-treated-with-bisphosphonates
#9
Nelson B Watts, Deborah Aggers, Edward F McCarthy, Tina Savage, Stephanie Martinez, Rachel Patterson, Erin Carrithers, Paul D Miller
If over-suppression of bone turnover explained the association between bisphosphonate use and atypical subtrochanteric femur fractures (AFF), this could be reversed with anabolic treatment such as teriparatide. We conducted a prospective, open label study in patients previously treated with bisphosphonates who sustained AFF, examining the response to 24 months treatment with teriparatide on bone mineral density (BMD), trabecular bone score (TBS), bone turnover markers (BTM) and fracture healing as well as quantitative histomorphometry...
January 10, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28032660/addressing-the-crisis-in-the-treatment-of-osteoporosis-a-path-forward
#10
Sundeep Khosla, Jane A Cauley, Juliet Compston, Douglas P Kiel, Clifford Rosen, Kenneth G Saag, Elizabeth Shane
Considerable data and media attention have highlighted a potential "crisis" in the treatment of osteoporosis. Specifically, despite the availability of several effective drugs to prevent fractures, many patients who need pharmacological therapy are either not being prescribed these medications or if prescribed a medication, are simply not taking it. Although there are many reasons for this "gap" in the treatment of osteoporosis, a major factor is physician and patient concerns over the risk of side effects, especially atypical femur fractures (AFFs) related to bisphosphonate (and perhaps other anti-resorptive) drug therapy...
December 29, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28019684/diaphyseal-femur-fractures-in-osteogenesis-imperfecta-characteristics-and-relationship-with-bisphosphonate-treatment
#11
Pamela Trejo, François Fassier, Francis H Glorieux, Frank Rauch
Several recent case reports have suggested that bisphosphonate treatment in individuals with osteogenesis imperfecta (OI) is causally related to atypical femur fractures. However, it is not known whether atypical femur fractures are actually more frequent in patients who have received bisphosphonates. In the present study, we retrospectively analyzed 166 femur fractures in 119 children with a diagnosis of OI that had not undergone intramedullary rodding procedures. A total of 130 fractures in 90 patients occurred in femurs with pre-existing deformities (age at fracture between 1 month and 19...
December 26, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28013363/bone-structure-and-turnover-status-in-postmenopausal-women-with-atypical-femur-fracture-after-prolonged-bisphosphonate-therapy
#12
Shijing Qiu, George W Divine, Saroj Palnitkar, Pooja Kulkarni, Trent S Guthrie, Mahalakshmi Honasoge, Sudhaker D Rao
Atypical femur fracture (AFF), a serious complication of long-term bisphosphonate therapy, is usually preceded by an incomplete fracture appearing on the lateral femur. AFF is most likely the result of severely suppressed bone turnover (SSBT). However, the differences in bone structure and turnover between patients with incomplete and complete AFF remain unknown. We examined trans-iliac bone biopsies from 12 white postmenopausal women with AFF (incomplete = 5; complete = 7) on BP therapy of >5 years and 43 healthy white premenopausal women...
March 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28009615/healing-of-atypical-subtrochanteric-femur-fractures-after-cephalomedullary-nailing-which-factors-predict-union
#13
Jae-Woo Cho, Chang-Wug Oh, Frankie Leung, Ki-Chul Park, Merng Koon Wong, Ernest Kwek, Han-Ju Kim, Jong-Keon Oh
OBJECTIVES: The purpose of this study was to determine the healing rate and time to union of atypical subtrochanteric fractures treated with cephalomedullary nailing. DESIGN: Retrospective review, descriptive, and analytic study. SETTING: Six level 1 trauma centers. PATIENTS/PARTICIPANTS: The study included 42 patients with 48 displaced, atypical, bisphosphonate-associated subtrochanteric femur fractures who underwent surgical intervention...
March 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27990429/atypical-complete-femoral-fractures-associated-with-bisphosphonate-use-or-not-associated-with-bisphosphonate-use-is-there-a-difference
#14
Sang-Min Kim, Youn-Soo Park, Young-Wan Moon, Seung-Hoon Kang, Ingwon Yeo, Seung-Min Oh, Seung-Jae Lim
The purpose of this study is to compare clinical characteristics and surgical outcome of atypical complete femoral fractures associated with bisphosphonates (BPs) use and those of fractures not associated with BPs use. Seventy-six consecutive patients (81 fractures) who had been operatively treated for a complete atypical femoral fracture were recruited. Of the 81 fractures, 73 occurred after BPs medication of at least 3 years (BP group) while 8 occurred without a history of BP medication (non-BP group). There were no differences in demographic data and fracture- and surgery-associated factors between the two groups...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27926679/factors-associated-with-increased-healing-time-in-complete-femoral-fractures-after-long-term-bisphosphonate-therapy
#15
Hae-Seong Lim, Chong-Kwan Kim, Youn-Soo Park, Young-Wan Moon, Seung-Jae Lim, Sang-Min Kim
BACKGROUND: The purpose of this study was to analyze factors that affect healing time after operative treatment of complete femoral fractures associated with long-term use of bisphosphonates. In particular, we sought to determine surgically controllable factors related to fracture-healing time. METHODS: Ninety-nine consecutive patients (109 fractures) who had been surgically treated for a complete atypical femoral fracture were enrolled. All patients had a documented history of bisphosphonate therapy at the time of presentation, with an average duration of 7...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27900455/bilateral-atypical-femur-fractures-without-bisphosphonate-exposure
#16
Lauren K Szolomayer, Izuchukwu K Ibe, Dieter M Lindskog
Atypical femur fractures have common radiographic features that set them apart from more typical higher-energy subtrochanteric femur fractures. They are noncomminuted, transverse fractures with medial spiking of the femoral cortex and increased lateral cortical thickness. These fractures have been associated in the literature with the use of bisphosphonate medications. This case describes bilateral atypical femur fractures in a patient with a medical history devoid of bisphosphonate use. We present his history, co-morbidities, and subsequent treatment...
February 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/27866217/osteonecrosis-of-the-jaw-onj-and-atypical-femoral-fracture-aff-in-an-osteoporotic-patient-chronically-treated-with-bisphosphonates
#17
A Sánchez, R Blanco
The aim of the study is to report the rare association of two complications of long-term treatment of osteoporosis with bisphosphonates in the same Caucasian elderly patient. A female patient of Italian descent, age 87 years, consulted in February 2013. She had a history of osteoporosis and had taken alendronate weekly for 7 years (1999-2006). Due to low back pain, an orthopedist had indicated i.v. zoledronic acid, 5 mg/year for 3 years (2006-2008). She received occasional supplements of ergocalciferol...
November 20, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27830385/atypical-femoral-fractures-in-italy-a-retrospective-analysis-in-a-large-urban-emergency-department-during-a-7-year-period-2007-2013
#18
Mario Pedrazzoni, Andrea Giusti, Giuseppe Girasole, Barbara Abbate, Ignazio Verzicco, Gianfranco Cervellin
The aim of this study was to determine the incidence of atypical femoral fractures (AFFs) seen in a large emergency department in Italy. It was a retrospective study of all men and women aged 40 years or older admitted to the Emergency Department of Parma University Hospital for a femoral fracture. Cases were identified in the hospital database with use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 820 or 821 or text strings. All the radiographic images of fractures not clearly identified as proximal or condylar were retrieved and evaluated by three independent reviewers...
November 9, 2016: Journal of Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/27824547/atypical-femur-fractures-in-patients-treated-with-bisphosphonates-identification-management-and-prevention
#19
REVIEW
Judith Sarah Bubbear
Osteoporosis is a common condition with significant health care costs. First-line therapy is with bisphosphonates, which have proven anti-fracture efficacy. Around 10 years after the introduction of bisphosphonates reports began to be published of atypical femoral fractures (AFFs) that may be associated with this therapy. These fractures are associated with significant morbidity although lower mortality than the more common osteoporotic neck-of-femur fractures. A case definition has been described to allow identification of this class of fracture...
October 31, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27812727/-atypical-subtrochanteric-femur-fracture-under-alendronate-therapy-in-spite-of-an-intramedullar-implant
#20
H-P Sobotta, T Gösling
There are a number of case reports about women undergoing long-term bisphosphonate therapy who have suffered an atypical subtrochanteric or femoral shaft fracture due to an inadequate trauma.The present case reports on a patient who underwent a subtrochanteric femur fracture with the inserted AO femur interlocking nail.
November 3, 2016: Der Unfallchirurg
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