Atypical diaphyseal femoral fractures: Considerations on surgical technique
| Autor: | Maria Silvia Spinelli, Andrea Piccioli, Primo Andrea Daolio, Eleonora Marini |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Perforation (oil well) Osteoporosis Guidelines as Topic law.invention Intramedullary rod 03 medical and health sciences 0302 clinical medicine law medicine Humans Femur Aged General Environmental Science Fracture Healing 030222 orthopedics Femur fracture Stress fractures Bone Density Conservation Agents Diphosphonates business.industry 030208 emergency & critical care medicine Middle Aged medicine.disease Fracture Fixation Intramedullary Surgery Radiography Anterior cortex General Earth and Planetary Sciences Female Complication business Femoral Fractures Osteoporotic Fractures |
| Zdroj: | Injury. 50:S65-S69 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2019.01.048 |
| Popis: | In the last two decades bisphosphonates (BP) has become the mainstream therapy for osteoporosis and the benefit in reducing the incidence of fractures has been well demonstrated in several studies, together with the drug long term (5–10 years) efficacy and safety. A complication of the long-term use of bisphosphonates is a low-energy stress fractures located in the sub-trochanteric region and the femoral shaft called atypical femur fracture (AFF). These stress fractures can be seen on plain radiographs as simple transverse patterns, with unicortical beaking and hypertrophy of the diaphyseal lateral cortex. Usually a localized thigh pain in the prodromal phase may precede the fracture by months. The current surgical treatment of choice for AFFs is intramedullary nailing (IMN). However, the treatment of AFFs is associated with a higher rate of intra-operative and post-surgical complications. This is related to anatomical e biomechanical reasons. Iatrogenic fractures, deformities, medial gap opening, eccentric position of the distal nail tip with anterior cortex perforation, delayed or non-union are frequent complications of this procedure and healing rate of AFFs. The average healing time of almost 8 months for AFFs appeared to be longer than that for typical femoral fractures, which heal at an average of 3–6 months. The purpose of this study is to analyze the different surgical devices and techniques and to advance some considerations that can be useful to diminish the rate of failure and/or complications in the treatment of AFFs in both oncologic and osteoporotic patients. |
| Databáze: | OpenAIRE |
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