Combined Effect of a Locking Plate and Teriparatide for Incomplete Atypical Femoral Fracture: Two Case Reports of Curved Femurs

Abstract

In surgical treatment for atypical femoral fractures (AFFs), reconstruction nail fixation is recommended for both complete and incomplete fractures. Although it has been reported that AFF is affected by many factors, The ASBMR Task Force 2013 Revised Case Definition of AFFs states that a curved femur is often seen in Asian patients. It is sometimes difficult to insert a nail into a femur in incomplete AFF patients with severely curved femurs. We report two incomplete bisphosphonate-related AFF patients with marked femoral curvatures treated by locking plates and teriparatide, showing early bone unions and favorable long-term outcomes.

Effect of Teriparatide on Healing of Atypical Femoral Fractures: A Systemic Review

“…One patient was additionally treated with strontium ranelate because of persistent discomfort after 24 months of TPTD treatment. [ 25 26 27 28 29 30 31 ]…”

Management of atypical femoral fracture: a scoping review and comprehensive algorithm

“…Plate fixation could be a substitute in order to avoid the complications and technical difficulties associated with IM nailing [ 24 , 69 ]. A long locking plate could be a good option when choosing plate fixation, particularly in the case of fractures associated with SSBT, in which healing by second intention through a more elastic construct may adequately stimulate fracture healing.…”

Simultaneous Bilateral Atypical Femoral Fracture: Case Presentation

“…Although most of the literature does not support the use of plates in FFA [6,8,18] its use is described in incomplete fractures with excellent results, another serious indication in very curved femurs where the placement of a nail would be very difficult or with great risk of iatrogenic fracture and in very narrow femurs [20].…”