Infographic: Mid-term outcomes after the surgical treatment of atypical femoral fractures

2021 ◽  
Vol 103-B (11) ◽  
pp. 1646-1647
Author(s):  
S-Y. Jeong ◽  
K-T. Hwang ◽  
C-W. Oh ◽  
J-W. Kim ◽  
O. J. Sohn ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Fractures ◽  
Atypical Femoral Fractures

scholarly journals ¿Tardan más en consolidar las fracturas asociadas a bifosfonatos? [Is the time for consolidation of fractures associated with bisphosphonates higher?]

2019 ◽  
Vol 84 (4) ◽  
pp. 320-327
Author(s):  
Fernando Vanoli ◽  
Luciano Gentile ◽  
Alejandra Beatriz Juarez ◽  
Marcos Sahid Eluani ◽  
Ignacio Pioli ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Fractures ◽  
Healing Time ◽  
Low Energy ◽  
Control Group ◽  
Cephalomedullary Nail ◽  
Atypical Femoral Fractures ◽  
Treatment Of Osteoporosis ◽  
Femur Fractures ◽  
Atypical Femur Fractures

Introducción: Los bifosfonatos evolucionaron como el pilar para el tratamiento de la osteoporosis, reduciendo la incidencia de fracturas. Recientemente, varias publicaciones describieron la aparición de fracturas atípicas de fémur de baja energía asociadas con el uso de bifosfonatos. El objetivo de este estudio fue evaluar el tiempo promedio de consolidación de las fracturas atípicas de fémur asociadas al tratamiento con bifosfonatos comparado con el de un grupo de control. Materiales y Métodos: Se evaluó, en forma retrospectiva, a 34 mujeres (edad promedio 74 años) con fracturas atípicas; 16 de ellas habían recibido bifosfonatos, al menos, por cinco años. Fueron tratadas entre 2006 y 2017, y estabilizadas con un clavo cefalomedular. Este grupo fue comparado con un grupo de control de similares características. Resultados: Veintidós tenían fracturas subtrocantéricas y 12, diafisarias. El 14% de las que tomaron bifosfonatos y fueron operadas requirió una revisión frente al 5,5% del grupo de control. El tiempo promedio de consolidación fue mayor en las tratadas con bifosfonatos (8.5 vs. 6 meses), con una diferencia estadísticamente significativa (p <0,001).Conclusiones: El beneficio del tratamiento con bifosfonatos en la prevención de fracturas es superior al riesgo de fracturas atípicas; sin embargo, es importante evaluar la relación riesgo-beneficio en cada paciente al comienzo y durante el tratamiento, teniendo en cuenta que, pese a esto, el tiempo de curación es más largo. AbstractIntroduction: Bisphosphonates evolved as the mainstay for the treatment of osteoporosis, reducing the incidence of fractures. Recently, several publications described the occurrence of low-energy atypical femur fractures associated with the use of bisphosphonates. The objective of this work was to study the average time of consolidation of the atypical femoral fractures caused by the consumption of bisphosphonates compared with a control group.Materials and Methods: We retrospectively evaluated 34 patients with atypical femoral fractures of which 16 patients had undergone treatment with bisphosphonates for at least 5 years, treated between 2006 and 2017, and stabilized with a cephalomedullary nail, and were compared with a control group of similar characteristics.Results: All the patients were female. The average age was 74 years. 22 presented subtrochanteric fractures while 12 were diaphyseal. 14% of the subjects who took bisphosphonates and received surgical treatment, required a revision versus 5.5% of the control group. The average time of consolidation was higher in those treated with bisphosphonates (8.5 months vs. 6 months), this being statistically significant (p <0.001).Conclusions: The benefit of treatment with bisphosphonates in the prevention of fractures is greater than the risk of atypical fractures. However, it is important to evaluate the risk-benefit in each patient at the beginning and the duration of the treatment, taking into account that despite this, the healing time is longer.   

Bilateral atypical femoral fractures after only 4-years of bisphosphonate therapy

2017 ◽  
Author(s):  
Edouard Mills ◽  
Pat Forbes ◽  
Michael Yee ◽  
Jeremy Cox ◽  
Alexander N Comninos
Keyword(s):  
Femoral Fractures ◽  
Bisphosphonate Therapy ◽  
Atypical Femoral Fractures

scholarly journals Evaluation of the nature and etiologies of risk factors for diaphyseal atypical femoral fractures

2021 ◽  
Author(s):  
Hiroyuki Tsuchie ◽  
Naohisa Miyakoshi ◽  
Yuji Kasukawa ◽  
Koji Nozaka ◽  
Kimio Saito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analyses ◽  
Femoral Fractures ◽  
Japanese Patients ◽  
High Serum ◽  
Control Group ◽  
Atypical Femoral Fractures ◽  
Factors Affecting ◽  
Lateral Curvature ◽  
Low Serum

Objectives: Differences in the mechanisms of subtrochanteric and diaphyseal atypical femoral fractures (AFFs) have been speculated in studies that have analyzed differences in the patients’ backgrounds. However, the etiologies of each type of AFF have not been investigated in detail. Therefore, this study aimed to investigate the nature and etiologies of the risk factors for diaphyseal AFFs. Materials and Methods: Eighty consecutive Japanese patients with 91 diaphyseal AFFs (the AFF group) and 110 age-matched female patients with osteoporosis (the non-AFF control group) were included. Their clinical data were compared and the factors affecting AFFs were investigated. Furthermore, the etiologies of the risk factors for diaphyseal AFFs were examined. Results: Multivariate analysis revealed that femoral serrated changes, bisphosphonate or denosumab usage, and lateral and anterior femoral curvatures were the risk factors for diaphyseal AFFs (p<0.0011, p=0.0137, and p<0.0001, respectively). Multivariate analyses also revealed that serrated changes and low serum 25(OH)D levels affected the lateral curvature (p=0.0088 and 0.0205, respectively), while serrated changes affected the anterior curvature (p=0.0006); each significantly affected the femoral curvature. In addition, a high serum calcium (Ca) level, lateral femoral curvature, and anterior femoral curvature were the predictors of serrated changes (p=0.0146, 0.0002, and 0.0098, respectively). Conclusion: The risk factors for diaphyseal AFFs were bone resorption inhibitor usage, a strong femoral curvature, and serrated changes. A low serum 25(OH)D level and serrated changes are the risk factors for lateral curvature, while a high serum Ca level is a risk factor for serrated changes.

scholarly journals Early Surgery Does Not Improve Outcomes for Patients with Periprosthetic Femoral Fractures—Results from the Registry for Geriatric Trauma of the German Trauma Society

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 517
Author(s):  
Christopher Bliemel ◽  
Katherine Rascher ◽  
Tom Knauf ◽  
Juliana Hack ◽  
Daphne Eschbach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Mortality Rate ◽  
Femoral Fractures ◽  
Geriatric Trauma ◽  
Outcome Parameters ◽  
Periprosthetic Femoral Fractures ◽  
Trauma Society ◽  
Eq5d Index ◽  
Early Surgical Treatment

Background and Objectives: Appropriate timing of surgery for periprosthetic femoral fractures (PFFs) in geriatric patients remains unclear. Data from a large international geriatric trauma register were analyzed to examine the outcome of patients with PFF with respect to the timing of surgical stabilization. Materials and Methods: The Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie (DGU)) (ATR-DGU) was analyzed. Patients treated surgically for PFF were included in this analysis. As outcome parameters, in-house mortality rate and mortality at the 120-day follow-up as well as mobility, the EQ5D index score and reoperation rate were analyzed in relation to early (<48 h) or delayed (≥48 h) surgical stabilization. Results: A total of 1178 datasets met the inclusion criteria; 665 fractures were treated with osteosynthesis (56.4%), and 513 fractures were treated by implant change (43.5%). In contrast to the osteosynthesis group, the group with implant changes underwent delayed surgical treatment more often. Multivariate logistic regression analysis of mortality rate (p = 0.310), walking ability (p = 0.239) and EQ5D index after seven days (p = 0.812) revealed no significant differences between early (<48 h) and delayed (≥48 h) surgical stabilization. These items remained insignificant at the follow-up as well. However, the odds of requiring a reoperation within 120 days were significantly higher for delayed surgical treatment (OR: 1.86; p = 0.003). Conclusions: Early surgical treatment did not lead to decreased mortality rates in the acute phase or in the midterm. Except for the rate of reoperation, all other outcome parameters remained unaffected. Nevertheless, for most patients, early surgical treatment should be the goal, so as to achieve early mobilization and avoid secondary nonsurgical complications. If early stabilization is not possible, it can be assumed that orthogeriatric co-management will help protect these patients from further harm.

scholarly journals Incidence of Atypical Femoral Fractures and its Mortality in a Single Centre in Singapore

JBMR Plus ◽  
2021 ◽  
Author(s):  
LU Gani ◽  
NF Anthony ◽  
LM Dacay ◽  
PT Tan ◽  
LR Chong ◽  
...  
Keyword(s):  
Femoral Fractures ◽  
Single Centre ◽  
Atypical Femoral Fractures

scholarly journals Sequential treatment with teriparatide and strontium ranelate in a postmenopausal woman with atypical femoral fractures after long-term bisphosphonate administration

HORMONES ◽  
2013 ◽  
Vol 12 (4) ◽  
pp. 591-597 ◽  
Author(s):  
Kalliopi Lampropoulou-Adamidou ◽  
Symeon Tournis ◽  
Alexia Balanika ◽  
Ioulia Antoniou ◽  
Ioannis Stathopoulos ◽  
...  
Keyword(s):  
Postmenopausal Woman ◽  
Strontium Ranelate ◽  
Femoral Fractures ◽  
Sequential Treatment ◽  
Atypical Femoral Fractures

Atypical femoral fractures and bisphosphonate treatment

2012 ◽  
Vol 94-B (3) ◽  
pp. 385-390 ◽  
Author(s):  
R. N. Thompson ◽  
J. R. A. Phillips ◽  
S. H. J. McCauley ◽  
J. R. M. Elliott ◽  
C. G. Moran
Keyword(s):  
Femoral Fractures ◽  
Bisphosphonate Treatment ◽  
Atypical Femoral Fractures
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