| Autor: |
Begkas, D., Geogrgiadis, G., Chatzopoulos, S. T., Balanika, A., Pastroudis, A. |
| Předmět: |
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| Zdroj: |
Geriatric Orthopaedic Surgery & Rehabilitation; 12/21/2021, p47-47, 1/2p |
| Abstrakt: |
Introduction: Atypical femoral fractures (AFFs) have been associated in the literature with the use of BPs. Long-term use or high dose of BPs inhibit osteoclast function and cause a reduction of bone turnover and alterations of bone structure and biomechanics. Microcracks within the lateral femoral cortex are not adequately repaired due to severe bone suppression, they accumulate and over the time they can cause a fracture. The purpose of this study was to report the clinical and radiological features and to evaluate the results of the surgical treatment of AFFs associated with long-term use of BPs. Methods: During the period 2006-2016, we retrospectively examined 31 patients with a mean age of 71.2 (60-83) years, who were diagnosed with AFFs (N = 34, 3 patients with bilateral fractures) associated with long-term use of BPs. The fractures were selected according to the criteria of the American Society for Bone and Mineral Research. All cases were treated surgically with antegrade intramedullary nailing (AIN). The duration of treatment with BPs, the preoperative and postoperative clinical and radiological findings and the occurrence of complications were evaluated. Results: The average follow-up duration was 32.3 (12-72) months. The mean duration of BPs treatment was 7.2 (4-10) years. Twelve (35.3%) fractures were subtrochanteric and 22 (64.7%) were fractures of the femoral diaphysis. The average fracture healing time was 4.8 (2-9) months. In 8 (23.5%) cases of fractures there was a failure of healing and revision of AIN with a larger diameter nail, resulting in their healing within 4 months postoperatively. Twenty-six patients (76.5%) returned to their preoperative motor and functional status, while 8 (23.5%) patients presented with varying degrees of motor and functional disorders. No other complications occurred. Conclusion: Long-term use of BPs is directly related to the cause of AFFs. Their surgical treatment is demanding and is associated with an increased rate of fracture healing failure and reduced motor and functional capacity of patients postoperatively. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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