非典型股骨骨折的最新进展。

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Paul A Anderson, Stephen L Kates, Nelson D Watts
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引用次数: 0

摘要

➤ 非典型股骨骨折(AFFs)是小转子和骨骺突起之间的应力性骨折,最常见的原因是长期(3 至 5 年)服用抗骨质吸收药物。二分之一以上的病例会出现前驱症状,包括髋部、腹股沟、大腿和膝部疼痛,通常会被误诊。 ➤ 所有 AFF 患者的非手术治疗包括停用双膦酸盐、评估骨质疏松症的继发原因以及优化维生素 D 和钙的摄入。髓内钉适用于完全骨折和有明显骨折线的不完全骨折。➤ AFF 后使用甲状旁腺激素(PTH)类似物(特立帕肽和阿巴帕肽)治疗可预防高危患者发生其他骨折,但对骨折愈合的影响尚不明确。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Update on Atypical Femoral Fractures.

➤ Atypical femoral fractures (AFFs) are stress fractures between the lesser trochanter and the metaphyseal flare that are most commonly related to prolonged (3 to 5 years) antiresorptive medication use.➤ An important finding is a visible transverse line in the lateral cortex, known as the "dreaded black line." Complete fractures are transverse and have minimal comminution.➤ Prodromal symptoms including hip, groin, thigh, and knee pain are present in more than one-half of cases and are usually misdiagnosed.➤ Nonoperative treatment for all patients with AFF includes withdrawal of bisphosphonates, assessment for secondary causes of osteoporosis, and optimization of vitamin D and calcium.➤ Incomplete fractures without a visible line can initially be treated nonoperatively with protected weight-bearing.➤ Intramedullary nailing is indicated for complete fractures and incomplete fractures with a visible fracture line. Delayed healing after fixation should be anticipated.➤ Treatment with parathyroid hormone (PTH) analogs (teriparatide and abaloparatide) after AFF prevents other fractures in high-risk patients, but the effect on healing of the fracture is unclear.

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来源期刊
CiteScore
8.90
自引率
7.50%
发文量
660
审稿时长
1 months
期刊介绍: The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.
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