Lucy Collins, Hanh H Nguyen, Frances Milat, Peter R Ebeling
{"title":"Epidemiology, Pathophysiology and Management of Atypical Femur Fractures: an Update.","authors":"Lucy Collins, Hanh H Nguyen, Frances Milat, Peter R Ebeling","doi":"10.1007/s11914-025-00932-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarise recent publications addressing the epidemiology, pathogenesis and management of atypical femur fractures (AFFs).</p><p><strong>Recent findings: </strong>AFFs have been reported in anti-resorptive treated individuals, bisphosphonate-naïve individuals and individuals with monogenic bone diseases. The likelihood of developing an AFF increases with prolonged exposure to anti-resorptive treatment. AFF risk declines following anti-resorptive discontinuation. Asian ethnicity has emerged as an important risk factor for AFF. Although excluded from the current ASBMR AFF case definition, periprosthetic AFFs and atypical fractures at non-classical sites have been increasingly reported. Following an AFF, anti-resorptive therapy should be discontinued, surgical treatment with intramedullary nailing considered, the contralateral femur imaged, and the underlying osteoporosis addressed. Emerging evidence suggests teriparatide may aid healing in surgically managed AFFs but not in conservatively managed incomplete AFFs. AFFs remain a rare side effect of anti-resorptive treatment. Emerging areas of interest and further research include genetic and ethnic risk factors and advancements in diagnostic technologies for AFFs.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"23 1","pages":"40"},"PeriodicalIF":5.3000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Osteoporosis Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11914-025-00932-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: To summarise recent publications addressing the epidemiology, pathogenesis and management of atypical femur fractures (AFFs).
Recent findings: AFFs have been reported in anti-resorptive treated individuals, bisphosphonate-naïve individuals and individuals with monogenic bone diseases. The likelihood of developing an AFF increases with prolonged exposure to anti-resorptive treatment. AFF risk declines following anti-resorptive discontinuation. Asian ethnicity has emerged as an important risk factor for AFF. Although excluded from the current ASBMR AFF case definition, periprosthetic AFFs and atypical fractures at non-classical sites have been increasingly reported. Following an AFF, anti-resorptive therapy should be discontinued, surgical treatment with intramedullary nailing considered, the contralateral femur imaged, and the underlying osteoporosis addressed. Emerging evidence suggests teriparatide may aid healing in surgically managed AFFs but not in conservatively managed incomplete AFFs. AFFs remain a rare side effect of anti-resorptive treatment. Emerging areas of interest and further research include genetic and ethnic risk factors and advancements in diagnostic technologies for AFFs.
期刊介绍:
This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.