Treatment and Prognosis of Femoral Insufficiency Fracture Associated with Prolonged Bisphosphonate Use.
10.12671/jkfs.2014.27.1.10
- Author:
Ki Chan AN
1
;
Dae Hyun PARK
;
Guemin GONG
;
Ju Young KIM
;
Sang Bum KIM
;
Seung Yeob SAKONG
Author Information
1. Department of Orthopedic Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. ronin211@naver.com
- Publication Type:Original Article
- Keywords:
Bisphophonate;
Femoral incompetence fracture;
Femoral imminent fracture
- MeSH:
Bone Density;
Fractures, Stress*;
Humans;
Methods;
Postoperative Complications;
Prodromal Symptoms;
Prognosis*
- From:Journal of the Korean Fracture Society
2014;27(1):10-16
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was conducted to investigate and identify an appropriate fracture treatment method by analyzing patients in whom a femoral incompetence fracture occurred after receiving a long-term bisphosphonate administration. MATERIALS AND METHODS: The subjects of this study were 13 cases out of ten patients among those who had a history of receiving bisphosphonate for more than five years and had a fracture or an imminent fracture with a characteristic radiological finding in the femoral subtrochanteric region and the interfemoral region. The period of the drug administration, bone density, the existence of a prodromal symptom, and bilateral fracture were investigated. RESULTS: In seven out of the 13 cases, the patients complained of painat the femoral and pelvic parts as a prodrome (53.8%), and three of them showed a bilateral fracture (30%). An imminent fracture with a prodrome was observed in six cases (46.2%); for three of these cases, a prophylactic fixture pexis was performed by inserting a metal nail into the medullary cavity, and in two out of these three, a complete fracture was found within 11 months on average (3 to 19 months). In the three prophylactic fixture pexis performed cases, no postoperative complications were found, and a radiological finding of concrescence was seen within one year after the operation. Among the nine operation performed cases after the fracture, non-union was found in two. CONCLUSION: In the patients who have received bisphosphonate for a long periodof time, a prodome may be a useful indicator of a fracture in the femoral subtrochanteric region and the interfemoral region; therefore, a careful observation is necessary. A prophylactic internal fixation is recommended for patients with imminent fracture with a prodome since they have a high risk of a complete fracture is high in them.
