지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
초록· 키워드
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Purpose: Recent literature has noted incidences of subtrochanteric atypical femoral fractures (AFFs) in patients who have taken long-term bisphosphonates (BPs). Most cases of subtrochanteric AFFs have been treated with intramedullary nailing and cases of delayed union have been reported. On the other hand, there is no data available on the complications associated with endosteal thickening or cortical thickening. This study evaluated the results of surgical treatment according to the endosteal thickening of the lateral cortex in subtrochanteric AFFs. Materials and Methods: Investigation was performed at the Department of Orthopaedic Surgery, Jeju National University Hospital. The study consisted of patients with subtrochanteric AFFs, defined by the American Society for Bone and Mineral Research (ASBMR) major criteria, who underwent intramedullary nailing from March 2012 to October 2014. The cases were categorized into two groups based on the presence of endosteal thickening. The evaluation included the demographic data, radiographic data of initial reduction state, and duration of BPs. Results: The demographic data and duration of BPs were similar in the two groups. On the other hand, varus reduction (Group I: 12.5% vs. Group II: 78.9%; p=0.001), delayed union (Group I: 0% vs. Group II: 70.0%; p=0.003), nonunion (Group I: 0% vs. Group II: 47.4%; p=0.017), and union time (Group I: 5.5 months vs. Group II: 8.3 months; p<0.001) were significantly different in the two groups. Conclusion: Endosteal thickening of the lateral cortex in subtrochanteric AFFs was identified as an independent factor that decides the reduction of the fracture and nonunion. The endosteal thickening should be removed to obtain anatomical alignment for successful surgical results.
목차
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참고문헌 (40)
참고문헌 신청
Lloyd AA / 2017 / Atypical fracture with long-term bisphosphonate therapy is associated with altered cortical composition and reduced fracture resistance / Proc Natl Acad Sci U S A 114:8722~8727
Koh A / 2017 / Atypical femoral fractures related to bisphosphonate treatment: issues and controversies related to their surgical management / Bone Joint J 99:295~302
Gedmintas L / 2013 / Bisphosphonates and risk of subtrochanteric, femoral shaft, and atypical femur fracture:a systematic review and meta-analysis / J Bone Miner Res 28:1729~1737
Shane E / 2014 / Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research / J Bone Miner Res 29:1~23
Schilcher J / 2014 / Histology of 8 atypical femoral fractures: remodeling but no healing / Acta Orthop 85:280~286
Koh A / 2017 / Atypical femoral fractures related to bisphosphonate treatment: issues and controversies related to their surgical management / Bone Joint J 99:295~302
Gedmintas L / 2013 / Bisphosphonates and risk of subtrochanteric, femoral shaft, and atypical femur fracture:a systematic review and meta-analysis / J Bone Miner Res 28:1729~1737
Shane E / 2014 / Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research / J Bone Miner Res 29:1~23
Schilcher J / 2014 / Histology of 8 atypical femoral fractures: remodeling but no healing / Acta Orthop 85:280~286
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