文献简介

出版社:Y. Saita et al. / Bone

作  者:Yoshitomo Saita,Muneaki Ishijima,AtsuhikoMogami,Mitsuaki Kubota,Tomonori Baba,

编  号:doi.org/10.1016/j.bone.2014.06.008

关键字:Atypical femoral fracture (AFF),Osteoporosis,Lower limb alignment,Femorotibial angle (FTA),Bisphosphonate

年  份:2013   点击量:1958

文献摘要

      Atypical femoral fractures (AFFs) are stress-related fractures that are speculated to associate with  long- term treatment with bisphosphonates for osteoporosis. A history of AFF is a high risk factor for the development  of a subsequentAFF in the same location of the contralateral femur, suggesting that a patient's individual anatomical factor(s) are related to the fracture site of AFFs. In this study,we investigated the radiographs of fourteen  AFFs  (four bilateral fractures among ten patients) treated at six hospitals associatedwith our university between 2005 and 2010. The fracture site and standing femorotibial angle (FTA),which reflects themechanical axis of the lower limb, were measured on weight-bearing lower limb radiographs. The fracture site and FTA of patients with typical femoral fractures (TFF) were compared to those of patients with AFFs. The correlations were examined using Spearman's rank correlation coefficients. The fracture locations in the femora were almost the same in the patients with bilateral AFFs. There was a positive correlation between the fracture site and the standing FTA in the patients with AFFs (r = 0.82, 95% confidence interval; 0.49 to 0.94), indicating that the larger the standing FTA (varus alignment), the more distal the site of the fracture in the femur. The FTA of the patients with atypical diaphyseal femoral fracture were significantly larger compared to that of those with not only atypical subtrochanteric fractures but also TFFs. In conclusion, the fracture sites of AFFs are associated with the standing lower limb alignment, while those of TFFs are not.