An emerging pattern of subtrochanteric stress fractures: A long-term complication of alendronate therapy?
| Autor: | Tet Sen Howe, Ernest Beng Kee Kwek, Seo Kiat Goh, Meng Ai Png, Joyce Suang Bee Koh |
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| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Time Factors Fractures Stress Osteoporosis Pain Bone remodeling Bone Density medicine Insufficiency fracture Humans Femur Osteoporosis Postmenopausal Aged Retrospective Studies General Environmental Science Aged 80 and over Stress fractures Alendronate Bone Density Conservation Agents business.industry Incidence Alendronic acid Retrospective cohort study Middle Aged medicine.disease Surgery Radiography General Earth and Planetary Sciences Female Complication business Femoral Fractures medicine.drug |
| Zdroj: | Injury. 39:224-231 |
| ISSN: | 0020-1383 |
| Popis: | Summary Background Subtrochanteric insufficiency fractures in post-menopausal patients have not been commonly reported in the literature. A recent increase in the incidence of such fractures occurring in patients while on alendronate therapy led us to conduct a retrospective review of these patients in our institution. Methods Seventeen patients, with a mean age of 66 years, sustained low energy subtrochanteric fractures within a 20-month period. These patients were incidentally found to be on alendronate therapy for an average of 4.8 years. Clinical data and history were reviewed and roentgenograms were evaluated by a single investigator. All additional imaging and bone mineral density measurements available were analysed. Results A characteristic fracture configuration suggestive of an insufficiency stress fracture was identified on plain radiographs. This consisted of (a) cortical thickening in the lateral side of the subtrochanteric region, (b) a transverse fracture, and (c) a medial cortical spike. In addition, 9 (53%) patients had bilateral findings of stress reactions or fractures, and 13 (76%) had symptoms of prodromal pain. Conclusions These insufficiency fractures could possibly have developed from the over suppression of bone turnover from prolonged alendronate therapy, in keeping with recently published evidence. This study further highlights the need for heightened awareness of alendronate's potential adverse effects. |
| Databáze: | OpenAIRE |
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