Evaluation of factors affecting the occurrence of second atypical fracture after bone union of the first atypical fracture
| Autor: | Hiroyuki Tsuchie, Yuji Kasukawa, Kimio Saito, Itsuki Nagahata, Hayato Kinoshita, Manabu Akagawa, Koji Nozaka, Masaaki Takeshima, Norio Suzuki, Yuichi Ono, Naohisa Miyakoshi, Chie Sato, Nobusuke Shibata, Toshiaki Aizawa, Kentaro Ouchi, Shigeto Maekawa, Hidekazu Abe, Takanori Tomite, Yusuke Yuasa, Moto Kobatyashi, Yoichi Shimada |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Histology Multivariate analysis Physiology Endocrinology Diabetes and Metabolism Osteoporosis 030209 endocrinology & metabolism Fracture group 03 medical and health sciences 0302 clinical medicine Atypical femoral fracture Teriparatide Internal medicine Humans Medicine Bone Density Conservation Agents Diphosphonates business.industry Bone union Significant difference medicine.disease 030104 developmental biology Orthopedic surgery business Femoral Fractures Osteoporotic Fractures medicine.drug |
| Zdroj: | Bone. 143:115671 |
| ISSN: | 8756-3282 |
| DOI: | 10.1016/j.bone.2020.115671 |
| Popis: | Purpose Teriparatide is sometimes used in the treatment of atypical femoral fracture (AFF). Even if bone union is achieved, orthopedic physicians must consider the risk of relapse. This study aimed to investigate the factors affecting AFF recurrence, and to determine the appropriate treatment for osteoporosis after bone union. Methods One hundred thirty-one consecutive AFFs in 113 Japanese patients were included. Eleven patients had AFF in the unaffected limb (9 patients) after the first AFF or re-fracture at the original fracture site (2 patients) after bone union of the first AFF was confirmed. We divided all patients into two groups: the second fracture group (22 AFFs in 11 patients) and non-second fracture group (109 AFFs in 102 patients). We compared clinical information between the 2 groups and investigated the factors affecting AFF recurrence using the Student t-, Welch t-, and chi-square tests. Results Although there was no significant difference in clinical characteristics between the 2 groups, multivariate analysis of factors associated with AFF recurrence identified short duration of treatment with teriparatide and active vitamin D3 (p = 0.0408 and 0.0366, respectively) as risk factors. Even in the analysis excluding subtrochanteric AFF, short periods of teriparatide and active vitamin D3 administration were observed as risk factors (p = 0.0484 and 0.0346, respectively). Conclusion The administration of teriparatide for as long as possible after occurrence first AFF and the use of active vitamin D3 after completion of teriparatide therapy may be the most effective strategy to prevent the recurrence of AFF. |
| Databáze: | OpenAIRE |
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