Atypical subtrochanteric fractures in Korean hip fracture study

Lee, Y.-K.; Kim, T.-Y.; Ha, Yong Chan; Song, Sang Heon; Kim, J. W.; Shon, Hyun Chul; Chang, Jae Suk; Koo, Kyung‐Hoi

doi:10.1007/s00198-017-4112-2

Cited by 16 publications

(10 citation statements)

References 26 publications

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“…However, our study also found that nearly half of AFF in our population were in patients not exposed to bisphosphonates, 47.8% of patients with AFF had no previously documented exposure to BP. This was similar to a previous Korean study who found 64.7% of their cohort with no previous BP exposure 19 and past case series from Singapore 20 , in contrast studies in the ethnic white population have shown that majority of AFF occurs in the context of BP exposure 21 . It is also interesting to…”

Section: Discussionsupporting

confidence: 91%

Incidence of Atypical Femoral Fracture and Its Mortality in a Single Center in Singapore

et al. 2021

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Section: Discussionsupporting

confidence: 91%

Incidence of Atypical Femoral Fracture and Its Mortality in a Single Center in Singapore

et al. 2021

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“…It is difficult to set up an adequately powered study because of the low incidence of AFF and healing of AFF can be affected by variables such as lower limb geometry (greater curvature of the femoral diaphysis) and location of fracture (subtrochanteric or diaphysis). [64][65][66] Above all, these results should be implied that TPTD works best when the fracture site is stable, either inherently or with surgical fixation. [67,68] The European Calcified Tissue Society suggested the use of TPTD after surgery of AFFs, even though strong evidence for improved fracture union is lacking.…”

Section: Does Tptd Aid the Union Of Aff?mentioning

confidence: 85%

Does Teriparatide Improve Fracture Union?: A Systematic Review

Yoon

Kim

2020

J Bone Metab

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We conducted an updated review of the evidence of teriparatide (TPTD) for fracture healing for the following questions. (1) Does it decrease fracture healing time?; (2) Can it be an alternative treatment for nonunion?; (3) Does it aid the union of atypical femoral fracture (AFF)? We searched PubMed, EMBASE, and Cochrane Library including "Fracture" AND "nonunion" AND "Teriparatide". In total, 57 publications met our inclusion criteria were summarized. This systemic review of the available literature revealed that TPTD works positively with regard to enhancing fracture healing time and union of AFF. There are also many case studies on the use of TPTD could be a potential new safe treatment for nonunion with no side effects. However, level 1 studies on the evidence of TPTD are still lacking so far. Over the last decade, a growing body of evidence has accumulated suggesting that TPTD can be an adjunct to enhance fracture healing or a therapeutic option to treat nonunion, but greater evidences from large volume prospective trials are needed.

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“…[22] From multicenter prospective study revealed that higher BMI and use of bisphosphonate were significant risk factors of AFF. [23] The development of atypical fractures is not associated with osteoporosis but pathophysiology of stress fracture due to altered bone structure and biomechanics. [24] It has been proposed that patients with longterm use of bisphosphonate may have a low bone turnover condition with impaired new bone formation and our patients with AFF are also mostly treated with anti-resorptive (93.9%, 46 of 49).…”

Section: Discussionmentioning

confidence: 99%

Different Pattern of T-Score Discordance between Patients with Atypical Femoral Fracture and Femur Neck Fracture

et al. 2023

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Background: Our study evaluated the prevalence and pattern of T-score discordance between the spine and hip in Korean patients with atypical femoral fracture (AFF) and femur neck fracture (FNF).Methods: A total of 49 patients (all women) who were treated for AFF and 1:3 matched 147 female patients with FNF were included from January 2012 to August 2022. A discordance of more than 1.5 between lumbar spine and femur neck bone mineral density (BMD) was defined as a difference and divided into 3 groups: lumbar low (LL; lumbar BMD is less than femur neck BMD), no discordance (ND), and femur neck low (FL; femur neck BMD is less than lumbar BMD). We compared the prevalence and pattern of discordance between 2 groups, and the associated risk factors of T-score discordance among the subjects were evaluated using regression analysis.Results: The prevalence of discordance was significantly higher in patients with AFF (51%) than in those with FNF (25.2%; <i>p</i><0.001). LL discordance was found in 46.9% of the patients with AFF but only 4.8% in those with FNF. Conversely, FL discordance was found in 4.1% of the patients with AFF and 20.4% in those with FNF, respectively. No specific risk factor was found as T-score discordance in the 2 groups.Conclusions: Clinicians should be aware that the pattern of T-score discordance can vary depending on the location of osteoporotic fractures. In addition, a longitudinal study would be necessary to verify the pattern of T-score discordance related to the osteoporotic fracture location.

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Atypical subtrochanteric fractures in Korean hip fracture study

Abstract: In Korean, ASF were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF.

Cited by 16 publications

References 26 publications

Incidence of Atypical Femoral Fracture and Its Mortality in a Single Center in Singapore

Incidence of Atypical Femoral Fracture and Its Mortality in a Single Center in Singapore

Does Teriparatide Improve Fracture Union?: A Systematic Review

Different Pattern of T-Score Discordance between Patients with Atypical Femoral Fracture and Femur Neck Fracture

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