Bisphosphonate use and the risk of atypical fractures

2020 ◽  
Vol 325 (1) ◽  
pp. 1259-1262
Author(s):  
Debdipta Bose ◽  
Nithya J. Gogtay
Keyword(s):  
Atypical Fractures

scholarly journals Current concept of stress fractures with an additional category of atypical fractures: a perspective review with representative images

2021 ◽  
Vol 12 ◽  
pp. 204201882110496
Author(s):  
Yoto Oh ◽  
Kouhei Yamamoto ◽  
Toshitaka Yoshii ◽  
Masanobu Kitagawa ◽  
Atsushi Okawa
Keyword(s):  
Physiological Stress ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Fragility Fractures ◽  
Stress Fractures ◽  
Atypical Fractures ◽  
Elastic Resistance ◽  
Pathologic Fractures ◽  
Clinical Conditions

Stress fractures have traditionally been classified into three categories: fatigue fractures due to overuse of bone with normal elastic resistance; insufficiency fractures due to everyday physiological stress on fragile bone with poor elastic resistance; and pathologic fractures due to bone weakness involving tumors. The concept of atypical fractures has emerged and is considered a type of stress fracture. However, there has been some inconsistency in interpretation when using the traditional classification of stress fractures, and atypical femoral fractures (AFFs) can potentially be classified into subtypes: “typical” AFFs involving bone turnover suppression due to specific drugs (e.g. bisphosphonates) and fragility fractures of the bowed femoral shaft. In this article, the classification of stress fractures is redefined with the addition of atypical fractures as a fourth category, in which biological activity for fracture healing is absent, to promote consistent understanding and interpretation of clinical conditions involving stress fractures.

scholarly journals A Suspicious Atypical Fracture of 5th Metatarsal Bone: A Case Report

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0033
Author(s):  
Byeong-Seop Park ◽  
Seungbum Koo ◽  
Won-keun Park ◽  
Ki-bum Kwon ◽  
Kyoung Min Lee
Keyword(s):  
Callus Formation ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Metatarsal Bone ◽  
Atypical Fracture ◽  
Atypical Fractures ◽  
Strenuous Activity ◽  
History Of ◽  
Surgical Fixation ◽  
The Right

Category: Trauma Introduction/Purpose: Long-term usage of bisphosphonate can severely suppress bone turnover and alter bone mechanical properties, thereby resulting in atypical fractures that mainly occur at the femur.We present a rare case of suspicious atypical fracture of the metatarsal bone. Methods: A 63-year-old woman presented to our clinic with a primary complain of a one-week history of pain in her right foot. The patient had no history of trauma to the right foot and denied any strenuous activity. She experienced lateral foot pain while walking within her home. She was on alendronate therapy for osteoporosis for a decade. X ray and CT examination revealed a fifth metatarsal fracture whose features were compatible with those of atypical femoral fractures (Figure 1). Results: The patient was advised to discontinue alendronate and underwent percutaneous surgical fixation of the fracture via a proximal approach using a 4.0-mm half-threaded cannulated screw. Postoperatively, a short leg cast was created and the patients performed non-weight bearing ambulation until the cast was removed at the sixth postoperative week. Radiography in the sixth postoperative week revealed callus formation. Conclusion: Our findings suggest that physicians must keep in mind that atypical fractures could possibly occur at bones other than the femur.

Bisphosphonate Therapy and Atypical Fractures

2013 ◽  
Vol 44 (2) ◽  
pp. 137-151 ◽  
Author(s):  
Anas Saleh ◽  
Vishal V. Hegde ◽  
Anish G. Potty ◽  
Joseph M. Lane
Keyword(s):  
Bisphosphonate Therapy ◽  
Atypical Fractures

scholarly journals Atypical fractures do not have a thicker cortex

2012 ◽  
Vol 23 (12) ◽  
pp. 2893-2896 ◽  
Author(s):  
V. A. Koeppen ◽  
J. Schilcher ◽  
P. Aspenberg
Keyword(s):  
Atypical Fractures

Atypical Fractures of the Femur: Evaluation and Treatment

JBJS Reviews ◽  
2015 ◽  
Vol 3 (3) ◽  
Author(s):  
Travis Blood ◽  
R.J. Feller ◽  
Eric Cohen ◽  
Christopher T. Born ◽  
Roman Hayda
Keyword(s):  
Atypical Fractures ◽  
Fractures Of The Femur

scholarly journals Atypical Fractures Are Mainly Subtrochanteric in Singapore and Diaphyseal in Sweden: A Cross-Sectional Study

2015 ◽  
Vol 30 (11) ◽  
pp. 2127-2132 ◽  
Author(s):  
Jörg Schilcher ◽  
Tet Sen Howe ◽  
Meng Ai Png ◽  
Per Aspenberg ◽  
Joyce SB Koh
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Atypical Fractures

scholarly journals Acute Nontraumatic Clavicle Fracture Associated with Long-Term Bisphosphonate Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Shen Hwa Vun ◽  
Yahya Husami ◽  
Sajan Shareef ◽  
Diane Bramley
Keyword(s):  
Clavicle Fracture ◽  
Critical Evaluation ◽  
Osteonecrosis Of The Jaw ◽  
Bisphosphonate Therapy ◽  
Low Energy ◽  
Insufficiency Fractures ◽  
Atypical Fractures

Cases of osteonecrosis of the jaw, insufficiency fractures and atypical low energy or atraumatic fractures of pelvis, femur (subtrochanteric/mid-shaft/distal-third), tibia, fibula, metatarsal, humerus, and ulna related to long-term bisphosphonate therapy have been reported in the literature. We present the case of an acute nontraumatic clavicle fracture, associated with long-term bisphosphonate therapy, which to our knowledge has not been reported previously. This case highlights the need of critical evaluation of patients with atypical fractures during long-term bisphosphonate therapy.

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