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Atypical femur fracture

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https://www.readbyqxmd.com/read/28632656/intramedullary-nail-fixation-of-atypical-femur-fractures-with-bone-marrow-aspirate-concentrate-leads-to-faster-union-a-case-control-study
#1
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: To evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective case control. SETTING: Level 1 trauma center. PATIENTS: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1-year follow-up. INTERVENTION: Operative treatment with antegrade intramedullary nails...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28612307/atypical-subtrochanteric-fractures-in-korean-hip-fracture-study
#2
Y-K Lee, T-Y Kim, Y-C Ha, S-H Song, J W Kim, H C Shon, J S Chang, K-H Koo
In Korean, atypical subtrochanteric fractures (ASF) were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF. INTRODUCTION: Recently, ASF have been reported to increase among patients on bisphosphonate. However, the incidence of ASF and the association between ASF and bisphosphonate use have not been well defined in Asian population. Our purposes are (1) to estimate the proportion of ASF among Korean patients with proximal femur fracture and (2) to determine the associated risk factors of ASF in the Korean patients...
June 14, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28535898/treatment-of-postmenopausal-osteoporosis-a-literature-based-algorithm-for-use-in-the-public-health-care-system
#3
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...
May 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28487299/the-first-reported-case-of-atypical-femoral-fracture-caused-by-daily-ibandronate-prescribed-for-bone-metastases-in-breast-cancer
#4
Robert Espey, Stephanie Grimes, Gary Heyburn, William David Kealey
A 55-year-old woman with bony metastatic breast cancer was commenced on daily ibandronic acid to prevent skeletal related events (SREs). Four years later, she began to experience new lower limb and groin pain with investigations leading to the suspicion of further metastatic spread to her left femur. While awaiting radiotherapy for this, she unfortunately tripped and fell sustaining a fracture to the proximal third of her left femur. Radiographic findings of her femur from both before and after the fall were suggestive of an atypical femoral fracture, presumed secondary to her bisphosphonate therapy rather than metastatic spread...
May 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28476576/non-bmd-dxa-measurements-of-the-hip
#5
Clinten P Edmondson, Elliott N Schwartz
Hip fracture is one of the most serious complications of osteoporosis. More than 50% of hip and other fractures occur in patients without densitometric osteoporosis. Therefore, areal bone mineral density (aBMD) may not be the best way to assess fracture risk. In order to improve assessment of fracture risk, many other approaches have been taken. At the present time, the Fracture Risk Algorithm (FRAX©) is one of the most notable ways to improve assessment of fracture risk. However, since early in the initiation of the dual energy x-ray absorptiometry (DXA) era, several non-BMD DXA approaches to the assessment of hip fracture risk have been proposed...
May 2, 2017: Bone
https://www.readbyqxmd.com/read/28467663/screening-for-atypical-femur-fractures-using-extended-femur-scans-by-dxa
#6
Denise M van de Laarschot, Alexandra A A Smits, Sanne K C Buitendijk, Merel T Stegenga, M Carola Zillikens
Atypical femur fractures (AFFs) are a rare but serious complication associated with the use of antiresorptive drugs such as bisphosphonates. Assessment of incomplete AFFs on extended femur scans by Dual X-ray Absorptiometry (DXA) may prevent the development of complete fractures. The aim of this study was to evaluate the potential of extended femur scans by DXA as a screening tool for incomplete AFFs. From June 2014 until September 2016 extended femur scans were routinely performed in all consecutive patients undergoing DXA scanning who had used bisphosphonates or denosumab at any given moment in the previous year...
May 3, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28463916/intramedullary-nailing-for-atypical-femoral-fracture-with-excessive-anterolateral-bowing
#7
Young-Chang Park, Hyung-Keun Song, Xuan-Lin Zheng, Kyu-Hyun Yang
BACKGROUND: Intramedullary nailing is the treatment of choice for atypical femoral fractures. However, several problems, such as iatrogenic fracture and medial gap opening, can occur during intramedullary nailing when atypical femoral fractures are associated with excessive anterolateral bowing. To overcome these problems, we have developed a new grading system for anterolateral femoral bowing and a new technique for intramedullary nailing. The core of this new technique is matching the anterior curvature of the femoral nail with the anterolateral bowing of the femur when the nail passes the apex of the curvature, by rotating the nail externally...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28459066/atypical-femoral-shaft-fractures-in-female-bisphosphonate-users-were-associated-with-an-increased-anterolateral-femoral-bow-and-a-thicker-lateral-cortex-a-case-control-study
#8
Seung Pil Jang, Ingwon Yeo, Sang-Yeon So, Keunbyuel Kim, Young-Wan Moon, Youn-Soo Park, Seung-Jae Lim
The purpose of our study was to investigate the radiographic characteristics of atypical femoral shaft fractures (AFSFs) in females with a particular focus on femoral bow and cortical thickness. We performed a fracture location-, age-, gender-, and ethnicity-matched case-control study. Forty-two AFSFs in 29 patients and 22 typical osteoporotic femoral shaft fractures in 22 patients were enrolled in AFSF group and control group, respectively. With comparing demographics between two groups, radiographically measured femoral bow and cortical thicknesses of AFSF group were compared with control group...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28456365/medication-management-after-intramedullary-nailing-of-atypical-fractures
#9
Jean-Marc Feron, Adeline Cambon-Binder
Long term use of bisphosphonates (BPs) in osteoporotic patients may be associated with stress fractures of the sub-trochanteric and shaft area of the femur, so called "atypical" femoral fractures (AFF). Specific diagnosis criteria have been defined with 5 major features; the presence of four of them characterizes the AFF. Once a complete fracture occurred, the best surgical treatment is closed reduction and intra medullary nailing. The BPs treatment should be stopped immediately after an AFF occurred. Dietary calcium and vitamin D status should be assessed, and adequate supplementation prescribed...
April 26, 2017: Injury
https://www.readbyqxmd.com/read/28410753/retrospective-review-of-patients-with-atypical-bisphosphonate-related-proximal-femoral-fractures
#10
H K Phillips, S J Harrison, H Akrawi, S A Sidhom
INTRODUCTION: Patients may be at an increased risk of atypical proximal femoral fractures with prolonged bisphosphonate use. PATIENTS AND METHODS: This was a retrospective review of patients who sustained a subtrochanteric fracture of the femur in our department between April 2009 and March 2014. The radiographs were reviewed for features of atypical femoral fractures as described by the American Society of Bone Mineral Research. RESULTS: 185 patients were coded according to the National Hip Fracture Database as having sustained a subtrochanteric fracture of the femur...
April 4, 2017: Injury
https://www.readbyqxmd.com/read/28394845/im-nail-fixation-of-atypical-femur-fractures-with-bone-marrow-aspirate-concentrate-leads-to-faster-union-a-case-control-study
#11
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: High rates of implant failure and nonunion in atypical femur fractures (AFF) have been reported. The aim of this study was to evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective Case Control SETTING:: Level 1 Trauma Center PATIENTS:: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1 year follow up. INTERVENTION: Operative treatment with anterograde intramedullary (IM) nails...
April 7, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28389970/osteoporosis-a-discussion-on-the-past-5%C3%A2-years
#12
REVIEW
Kyle M Schweser, Brett D Crist
PURPOSE OF THE REVIEW: The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. RECENT FINDINGS: Patient compliance with therapy remains an issue. The effectiveness of Vitamin D and calcium are being called into question Atypical femur fractures have been associated with bisphosphonate and denosumab use. Treatment is both surgical and pharmaceutical. A multidisciplinary approach to osteoporotic fractures is important and having some form of fracture liaison service (FLS) improves the efficacy of osteoporotic care and decreases secondary fractures...
June 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28328823/a-case-report-of-pycnodysostosis-with-atypical-femur-fracture-diagnosed-by-next-generation-sequencing-of-candidate-genes
#13
Hyung Keun Song, Young Bae Sohn, Yong Jun Choi, Yoon-Sok Chung, Ja-Hyun Jang
RATIONALE: Pycnodysostosis is a rare autosomal recessive skeletal dysplasia characterized by short stature, craniofacial dysmorphism, acro-osteolysis, osteosclerosis, and brittle bone with poor healing. Pycnodysostosis results from the deficient activity of cathepsin K, a lysosomal cysteine protease that is encoded by CTSK. PATIENT CONCERNS: We report a Korean adult patient with pycnodysostosis and atypical femur fracture whose diagnosis was confirmed by next-generation sequencing (NGS) of candidate genes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28288986/bisphosphonates-and-atypical-subtrochanteric-fractures-of-the-femur
#14
N Kharwadkar, B Mayne, J E Lawrence, V Khanduja
OBJECTIVES: Bisphosphonates are widely used as first-line treatment for primary and secondary prevention of fragility fractures. Whilst they have proved effective in this role, there is growing concern over their long-term use, with much evidence linking bisphosphonate-related suppression of bone remodelling to an increased risk of atypical subtrochanteric fractures of the femur (AFFs). The objective of this article is to review this evidence, while presenting the current available strategies for the management of AFFs...
March 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28275116/retrospective-review-of-atypical-femoral-fracture-in-metastatic-bone-disease-patients-receiving-denosumab-therapy
#15
Samantha Peiling Yang, Tae Won B Kim, Patrick J Boland, Azeez Farooki
BACKGROUND: Denosumab therapy is used to reduce skeletal-related events in metastatic bone disease (MBD). There have been reports of atypical femoral fracture (AFF) in osteoporotic patients treated with denosumab but none in the context of higher dose and more frequent denosumab therapy for MBD. The goal of this study was to assess the incidence of AFF in MBD. PATIENTS AND METHODS: We conducted a retrospective review of 253 patients who received a minimum of 12 doses of denosumab at 120 mg each for MBD...
April 2017: Oncologist
https://www.readbyqxmd.com/read/28249966/clinical-management-and-pathogenesis-of-atypical-fractures-of-the-femur
#16
EDITORIAL
M K Javaid, R Handley, M L Costa
No abstract text is available yet for this article.
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28247363/atypical-fracture-of-the-sternum-after-long-term-alendronate-plus-cholecalciferol-treatment-a-case-report
#17
Luis H Martín Arias, Pilar García Ortega, María Sáinz Gil, Ester Navarro García, Carlos Treceño Lobato, Virginia Delgado Armas
A 55-year-old woman developed an atraumatic sternum fracture during treatment with alendronate for osteoporosis. The woman received alendronate 70 mg in combination with cholecalciferol 5600 IU once weekly, as well as nonsteroidal anti-inflammatory drugs. After 4 years of treatment, following a dorsal flexion with no direct thoracic trauma, the patient suffered a fracture of the sternum, with an X-ray revealing sternal body fracture. This fracture was seen to be transverse, noncomminuted and without displacement...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28240655/impending-atypical-femoral-fracture-in-patients-with-medullary-thyroid-cancer-with-skeletal-metastasis-treated-with-long-term-bisphosphonate-and-denosumab
#18
Mitsuru Koizumi, Tabu Gokita, Kazuhisa Toda
Atypical femoral fractures (AFFs) occur in osteoporosis patients receiving long-term bisphosphonate. Atypical femoral fractures also occur in cancer patients receiving long-term bisphosphonate or denosumab, but the prevalence is low. We describe a 53-year-old woman with a history of medullary thyroid cancer and skull metastasis who was prescribed bisphosphonate for 6 years and denosumab for 1.5 years, consecutively. Bone scintigraphy performed because of spontaneous groin pain showed uptake in the lateral aspect of the left femur, which was confirmed as impending AFF...
June 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28228783/-atypical-atypical-femur-fractures-and-use-of-bisphosphonates
#19
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
#20
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
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