Epidemiology, Pathophysiology and Management of Atypical Femur Fractures: an Update.

IF 5.3 2区 医学
Lucy Collins, Hanh H Nguyen, Frances Milat, Peter R Ebeling
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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.

非典型股骨骨折的流行病学、病理生理学和治疗:最新进展。
回顾目的:总结最近发表的关于非典型股骨骨折(AFFs)的流行病学、发病机制和治疗的文章。最近的发现:aff在抗吸收治疗个体、bisphosphonate-naïve个体和单基因骨病个体中都有报道。发生AFF的可能性随着抗吸收治疗的延长而增加。抗再吸收停药后AFF风险下降。亚洲种族已成为AFF的重要危险因素。尽管目前ASBMR AFF病例定义中排除了AFF,但假体周围AFF和非经典部位非典型骨折的报道越来越多。AFF后,应停止抗吸收治疗,考虑髓内钉手术治疗,对侧股骨成像,并解决潜在的骨质疏松症。新出现的证据表明,特立帕肽可能有助于手术治疗的房颤愈合,但对保守治疗的不完全性房颤不起作用。aff仍然是抗吸收治疗的一种罕见的副作用。新兴的兴趣领域和进一步的研究包括遗传和种族风险因素以及AFFs诊断技术的进步。
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来源期刊
Current Osteoporosis Reports
Current Osteoporosis Reports ENDOCRINOLOGY & METABOLISM-
CiteScore
8.40
自引率
2.30%
发文量
44
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.
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