Atypical incomplete femoral neck fracture in patients taking long-term bisphosphonate Case report, a report of 2 casesopen access
- Authors
- Suh, You-Sung; Jang, Byung-Woong; Nho, Jae-Hwi; Won, Sung-Hun; Lee, Won-Seok
- Issue Date
- Mar-2019
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Keywords
- atraumatic; atypical; bisphosphonate; femoral neck fracture; osteoporosis
- Citation
- Medicine, v.98, no.9
- Journal Title
- Medicine
- Volume
- 98
- Number
- 9
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/4674
- DOI
- 10.1097/MD.0000000000014701
- ISSN
- 0025-7974
1536-5964
- Abstract
- Rationale: We present 2 cases of lateral incomplete impending fracture of the femoral neck without trauma in elderly patients taking long-term bisphosphonate (BP) treatment, and we defined it as atypical femoral neck fracture (AFNF). To the best of our knowledge, this is the first report on the follow-up results of AFNF. Patient concerns: Patients in both cases had been taking BP drugs for a long time with osteoporosis. The duration of BP treatment was 6 years, and there was no history of repeated stresses. Diagnoses: All fractures were linear at the lateral aspect of the mid portion of the femoral neck, and the BMD of the femoral neck was -0.9, and -1.8, respectively. Interventions: Internal fixation was performed in both cases (73 years, 68 years) using cannulated screws. Outcomes: In both patients who underwent screw fixation, the fracture line started to extend distally at 4 weeks and 2 weeks following surgery. In the 3-month follow-up image, the length of the fracture increased by 20.1 mm and 9.9 mm, respectively. There was a problem with active rehabilitation, and the possibility of revision was also found to be a burden in terms of mortality and cost in older patients. Lessons: In the case of AFNF, guidelines for treatment should be set in consideration of the decreased bone healing, even when the fracture pattern is simple. Arthroplasty based on a wider indication may be worth considering.
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Collections - College of Medicine > Department of Orthopedic Surgery > 1. Journal Articles
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