Is It a Simple Stress Fracture or Bisphosphonate-related Atypical Fracture?
Journal of Bone Metabolism
;
: 129-132, 2012.
Article
in English
| WPRIM
| ID: wpr-174458
ABSTRACT
A number of reports regarding atypical fractures of the femur have raised questions concerning the possible correlation between long-term bisphosphonate treatment and the occurrence of insufficiency fractures in the proximal femur. However, clinically, it is often confused whether is it a fatigue fracture because of implant induced stress concentration or a bisphosphonate-related atypical fracture, especially in a patient with a subtrochanteric fracture who receive bisphosphonate therapy after open reduction and internal fixation, such as dynamic hip screw (DHS) fixation for previous ipsilateral femoral neck or intertrochanteric fracture. The authors experienced a case of a progressive femoral insufficiency fracture in a woman who had been on Fosamax (Alendronic acid with Vitamin D; Merck & Co. Inc, NJ, USA) therapy for four years after ipsilateral femoral neck fracture treated with a two hole DHS system. Despite a high suspicion of an insufficiency femoral subtrochanteric fracture by bone scan, the occult fracture progressed to a displaced femoral subtrochanteric fracture one year after. The fracture site was fixed with a 6 hole DHS plate, and six months after reoperation the patient had no symptoms and the fracture site had united without any complication.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Osteoporosis
/
Reoperation
/
Vitamins
/
Fractures, Stress
/
Alendronate
/
Early Diagnosis
/
Femoral Fractures
/
Femoral Neck Fractures
/
Femur
/
Femur Neck
Type of study:
Diagnostic study
/
Screening study
Limits:
Female
/
Humans
Language:
English
Journal:
Journal of Bone Metabolism
Year:
2012
Type:
Article
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