ArticleHSS journal : the musculoskeletal journal of Hospital for Special Surgery2012
Management strategy for symptomatic bisphosphonate-associated incomplete atypical femoral fractures.
Article in HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- Medical Management of Patients After Atypical Femur Fractures: a Systematic Review and Recommendations From the European Calcified Tissue Society.The Journal of clinical endocrinology and metabolism · 2020Guideline
- Radiographic Evolution of Contralateral Asymptomatic Incomplete Atypical Femoral Fractures in Autoimmune Disease Patients.Diagnostics (Basel, Switzerland) · 2026Article
- Bisphosphonate-Associated Atypical Femoral Fractures: A Description of Surgical Techniques in the Revision Fixation Setting With an Emphasis on Avoiding Varus Malalignment: A Two-Case Report.Case reports in orthopedics · 2026Article
- Impact of Prolonged Bisphosphonate Therapy on Atypical Femoral Fractures: Insights from a Single-Center Experience.Journal of personalized medicine · 2025Article
- Conservative Treatment With Teriparatide for Symptomatic Incomplete Atypical Femoral Fractures: A Retrospective Observational Study.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Teriparatide Does not Have Beneficial Effects on Bone Healing in Complete Atypical Femur Fractures.Calcified tissue international · 2024Article
- Atypical Tibial Fracture Treated with Osteosynthesis Associated with Total Knee Arthroplasty: Case Report.Revista brasileira de ortopedia · 2023Article
- Atypical femur fractures associated with bisphosphonate therapy: post-operative outcomes.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Management of Osteoporosis Medication after Osteoporotic Fracture.Hip & pelvis · 2022Review
- Surgical and Pharmacological Management of Periprosthetic Atypical Femoral Fractures: A Narrative Literature Review.Geriatric orthopaedic surgery & rehabilitation · 2022Article
- A brief review and clinical evidences of teriparatide therapy for atypical femoral fractures associated with long-term bisphosphonate treatment.Frontiers in surgery · 2022Review
- Bilateral atypical fractures of the femur: Ten years AFTER ten years of bisphosphonate therapy.Bone reports · 2021Article
- Drug-induced Hyperprolactinemia Results in Atypical Atypical Fracture.Hip & pelvis · 2021Article
- Post-operative Rehabilitation of Atypical Femoral Fracture in a Single Center.Progress in rehabilitation medicine · 2020Article
- Natural history of incomplete atypical femoral fractures in patients after a prolonged and variable course of bisphosphonate therapy-a long-term radiological follow-up.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Article
- The effects of teriparatide on acceleration of bone healing following atypical femoral fracture: comparison between daily and weekly administration.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Article
- A proposal for an atypical femur fracture treatment and prevention clinical practice guideline.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Review
- Lateral fixation: an alternative surgical approach in the prevention of complete atypical femoral fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2018Article
- Surgical outcome of atypical subtrochanteric and femoral fracture related to bisphosphonates use in osteoporotic patients with or without teriparatide treatment.BMC musculoskeletal disorders · 2017Article
- A new contralateral atypical femoral fracture despite sequential therapy with teriparatide and strontium ranelate.Bone reports · 2017Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLong-term bisphosphonate use has often been associated with atypical femoral fractures. These fractures evolve from incomplete femoral fractures. A previous study demonstrated that the presence of a radiolucent line in an incomplete fracture can indicate a high risk of progression to complete fracture. QUESTIONS/PURPOSES: The aim of this study is to present a management strategy for symptomatic bisphosphonate-associated incomplete atypical femoral fractures. Specific study questions include the following: (1) Is there a difference in the prognosis of these fractures based on the presence or absence of a radiolucent fracture line? (2) Can treatment with teriparatide assist in clinical/radiographic healing of these incomplete fractures? (3) Is there a characteristic biochemical profile in these patients? PATIENTS AND
methodsWe retrospectively examined all femur radiographs ordered by the metabolic bone disease service at our hospital between July 1, 2006 and July 1, 2011 and identified 10 patients with a total of 14 incomplete fractures. Nine patients received bisphosphonates for a mean duration of 10 ± 5 years (range, 4-17). The mean follow-up since the time of diagnosis was 20 ± 11 months (range, 6-36 months).
resultsFive fractures did not have a radiolucent fracture line and were treated conservatively with partial weight-bearing restrictions and pharmacologic therapy. All five of these fractures healed with conservative management. Nine fractures had a radiolucent fracture line, and only two of these were treated successfully with conservative management including teriparatide. Six of the eight patients with a radiolucent line elected for surgical prophylaxis after 3 months of conservative management, whereas one patient underwent surgical prophylaxis without a trial of conservative management. Regarding the biochemical profiles, bone turnover markers for our patient cohort were in the lower quartile.
conclusionsFractures without a radiolucent line appear to respond to conservative management and not require surgical prophylaxis. Teriparatide treatment may hold promise in promoting healing of these fractures.
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