| Atypical Subtrochanteric and Diaphyseal Femoral Fractures |
| 비전형적 대퇴골 골절 |
| 양규현,송형근 |
| 연세대학교 의과대학 강남세브란스병원 정형외과교실 |
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| Abstract |
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Increasing numbers of atypical subtrochanteric fractures have been reported among long-term bisphosphonate users.
However, the nature and extent of the problem are unknown despite recent investigations. The task force of American
Society for Bone and Mineral Research (ASBMR) defined major and minor features of complete and incomplete
atypical femoral fractures; transverse or short oblique orientation, minimal or no associated trauma, a medial spike
when the fracture is complete, and absence of comminution. Minor features include their association with cortical
thickening, a periosteal reaction of the lateral cortex, prodromal pain, bilaterality, delayed healing, comorbid conditions,
and concomitant drug exposures, including bisphosphonate, glucocorticoids, and proton pump inhibitors. Based on
published data, the incidence of atypical femoral fractures associated with bisphosphonate therapy for osteoporosis
appears to be very low, particularly compared with the number of vertebral, hip, and other fractures that are prevented
by bisphosphonate. Physicians and patients should be aware of the possibility of atypical femoral fractures and of the
potential for bilaterality. |
| Key Words:
Atypical femoral fracture, Bisphosphonates, Osteoporosis |
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