长期双磷酸盐治疗引起的非典型股骨骨折

Ioan-Mihai Japie, R. Rădulescu, A. Bădilă, E. Japie, A. Papuc, T. Ciobanu, A. Dumitru, C. Cirstoiu
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引用次数: 0

摘要

摘要介绍。双膦酸盐(bp)是骨质疏松症患者的主要治疗方法,尽管长期治疗可能导致非典型骨折。材料和方法。我们在2008年至2017年间进行了一项回顾性研究,纳入了23例非典型股骨骨折(AFFs)的女性患者。bp治疗的平均疗程为5.2年。我们纳入了7例粗隆下骨折和18例股骨干骨折。2例患者出现双侧股骨骨折。18例患者在骨折诊断前2 ~ 18个月出现前驱症状,均为低能创伤。我们研究中的所有患者都接受了髓内钉或伽玛钉手术。术后平均随访2年。结果。在所有23例女性患者中,共有25例骨折,其中10例采用gamma钉固定,15例采用髓内钉固定。从患者总数来看:13例患者完全愈合,6例延迟愈合,3例不愈合(2例髓内钉和1例伽玛钉),而在1例患者中,我们观察到植入物失败。结论。bp治疗后af的治疗对骨科医生在手术技术和术后随访方面都是一个挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Atypical Femoral Fractures due to long-term bisphosphonates therapy
Abstract Introduction. Bisphosphonates (BPs) represent the main therapy in patients with osteoporosis, although a long-term treatment can lead to atypical fractures. Material and methods. We conducted a retrospective study between 2008 and 2017 and included 23 female patients with atypical femoral fractures (AFFs). The mean period of BPs therapy administration was 5.2 years. We included 7 subtrochanteric fractures and 18 femoral shaft fractures. Two of the total patients presented bilateral femoral fractures. 18 patients presented prodromal symptoms from 2 to 18 months before the diagnosis of fractures, all of them following low energy trauma. All the patients included in our study underwent surgery with intramedullary nail or gamma nail. The postoperative mean follow-up was 2 years. Results. Of all 23 female patients with a total of 25 fractures – 10 underwent osteosynthesis with gamma nail and 15 underwent osteosynthesis with intramedullary nail. From the total number of patients: 13 patients achieved complete union, 6 presented delayed union and 3 non-union (2 intramedullary nail and one gamma nail), whereas in one patient treated previously with gamma nail we observed implant failure. Conclusion. The treatment of AFFs after BPs therapy administration represents a challenge for orthopaedic surgeons regarding both surgical technique and postoperative follow-up.
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