Clinical Features and Outcomes of Bilateral Atypical Femoral Fractures

Hamahashi, Kosuke; Noguchi, Toshihiro; Uchiyama, Yoshiyasu; Sato, Masato; Watanabe, Masahiko

doi:10.1155/2020/8824756

Cited by 2 publications

(1 citation statement)

References 16 publications

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“…Many studies note that the AFF occurred at the same anatomical location of the femur bilaterally, similar to our observations. 13 , 19 , 20 The literature also suggests that AFF patients have a high risk of radiological abnormality (pre-AFF) or contralateral fracture and that these patients may benefit from contralateral imaging. 5 , 17 Interestingly, one of our patients with AFF initially presented with chronic left hip pain in an outpatient setting.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures

Khalil,

Yammine,

Rameh

et al. 2024

JBMR Plus

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This retrospective study investigates the prevalence of atypical femoral fractures (AFFs) among patients admitted with hip and shaft fractures at a tertiary referral center in Beirut, Lebanon. We analyzed electronic medical records and radiology studies of patients aged above 40 admitted with hip and shaft fractures between January 2006 and December 2019. Fractures were confirmed by ICD9 or ICD10 codes. All cases were reviewed by radiologists, and AFFs were identified according to the 2013 revised ASBMR criteria. We identified 1366 hip and shaft fracture patients, of which 14 female patients had 19 AFFs. This represents a prevalence of 1.0% among all hip and shaft fractures patients and 1.7% among all female hip and shaft fracture patients. Bilateral AFFs were found in 5 of the 14 patients. Patients with AFF tended to be younger, with a mean age of 74.3 (±8.6) yr compared to 78.0 (±10.6) for patients with non-AFF fractures. A total of 36% of AFF patients had a prior history of non-traumatic fracture at first admission. A high percentage of patients with AFFs reported intake of proton pump inhibitors (42.9%) and glucocorticoids (21.4%). Bisphosphonate exposure was noted in 64.3% of AFF patients. None of the AFF patients were active smokers or consumed alcohol regularly. BMD assessments were available for 7 AFF patients, indicating osteoporosis in 4 and osteopenia in 3 cases. Hip axis length measurements showed no significant difference between AFF patients (N = 7) and sex and age-matched controls (N = 21). The study underlines the prevalence and characteristics of AFFs in Lebanon, which is consistent with the numbers reported in the literature (0.32%–5%). A larger prospective study that includes hospitals across the nation is needed to gain a more comprehensive view of the prevalence of AFFs in the Lebanese population.

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Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures

Khalil,

Yammine,

Rameh

et al. 2024

JBMR Plus

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Bilateral Atypical Femoral Fractures after Bisphosphonate Treatment for Osteoporosis: A Literature Review

Hwang

Seo

Lim

et al. 2023

JCM

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Introduction: This literature review aimed to investigate the incidence, anatomical concerns, etiology, symptoms, diagnostic tools, management, and prognosis of bisphosphonate (BP)—associated bilateral atypical femoral fractures (AFFs). Methods: The PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to 20 March 2022. All cases of bilateral AFFs were included, excluding those without any bisphosphonate treatment information and those in which the femoral fracture did not precisely fit into the diagnostic criteria for AFF. Results: We identified 43 patients with bilateral AFFs associated with BP use and conducted a comprehensive analysis. Among 43 patients, 29 (67%) had prodromal symptoms. Regarding the simultaneity of fracture, 21 cases (49%) occurred simultaneously, and 22 cases (51%) occurred sequentially. Alendronate was the most commonly used BP treatment (59%). Regardless of the medication type, BP intake duration was more than 5 years in 77%. The initial diagnosis was performed using X-rays in all cases. A total of 53% of patients had complete fractures, and all patients underwent surgical treatment. Among the remaining patients with incomplete fractures, 18% and 29% received surgical and medical treatments, respectively. After BP discontinuation, teriparatide was most commonly used (63%). Conclusions: The careful evaluation of relevant imaging findings in patients with thigh/groin pain allows the identification of early incomplete fractures and timely management. Since the rate of contralateral side fractures is also high, imaging studies should be performed on the asymptomatic contralateral side.

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Clinical Features and Outcomes of Bilateral Atypical Femoral Fractures

Cited by 2 publications

References 16 publications

Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures

Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures

Bilateral Atypical Femoral Fractures after Bisphosphonate Treatment for Osteoporosis: A Literature Review

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