ArticleActa orthopaedica2014
Histology of 8 atypical femoral fractures: remodeling but no healing.
Article in Acta orthopaedica, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 70 citations in OpenAlex.
- Pathophysiology of Femoral Fractures in Hypophosphatasia.Current osteoporosis reports · 2025Review
- Comparing incomplete atypical femur fractures in patients with or without bisphosphonate treatment: radiography and bone morphology in a retrospective study of 19 cases.Acta orthopaedica · 2025Article
- PDGF-BB improves cortical bone quality through restoring the osteogenic microenvironment in the steroid-associated osteonecrosis of rabbits.Journal of orthopaedic translation · 2025Article
- The role of the fracture liaison service in the prevention of atypical femoral fractures.Therapeutic advances in musculoskeletal disease · 2023Review
- Advancement in the Treatment of Osteoporosis and the Effects on Bone Healing.Journal of clinical medicine · 2022Review
- Surveillance of atypical femoral fractures in a nationwide fracture register.Acta orthopaedica · 2022Article
- Surgical and Pharmacological Management of Periprosthetic Atypical Femoral Fractures: A Narrative Literature Review.Geriatric orthopaedic surgery & rehabilitation · 2022Article
- Bisphosphonate therapy associated with bilateral atypical femoral fracture and delayed union.Joint diseases and related surgery · 2022Article
- Article
- Atraumatic fractures of the femur.The British journal of radiology · 2021Review
- Intermittent Parathyroid Hormone Accelerates Stress Fracture Healing More Effectively Following Cessation of Bisphosphonate Treatment.JBMR plus · 2020Article
- Atypical femoral neck fracture after prolonged bisphosphonate therapy.Journal of pathology and translational medicine · 2020Article
- Intramedullary Nail Fixation with Autologous Bone Marrow Transplantation in an Incomplete Atypical Femoral Fracture Patient: Use of Bone Marrow Extracted from the Hollow Reamer.Case reports in orthopedics · 2020Article
- Case of atypical femoral fractures that mimicked the typical imaging findings of prostate cancer-induced bone metastasis.IJU case reports · 2019Article
- Article
- Insights into the kinetics of thermally induced crystallization of amorphous calcium phosphate.Physical chemistry chemical physics : PCCP · 2018Article
- Current Understanding of Epidemiology, Pathophysiology, and Management of Atypical Femur Fractures.Current osteoporosis reports · 2018Review
- Lateral fixation: an alternative surgical approach in the prevention of complete atypical femoral fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2018Article
- Undisturbed local bone formation capacity in patients with atypical femoral fractures: a case series.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- Understanding Bone Strength Is Not Enough.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe pathophysiology behind bisphosphonate-associated atypical femoral fractures remains unclear. Histological findings at the fracture site itself may provide clues. PATIENTS AND
methodsBetween 2008 and 2013, we collected bone biopsies including the fracture line from 4 complete and 4 incomplete atypical femoral fractures. 7 female patients reported continuous bisphosphonate use for 10 years on average. 1 patient was a man who was not using bisphosphonates. Dual-energy X-ray absorptiometry of the hip and spine showed no osteoporosis in 6 cases. The bone biopsies were evaluated by micro-computed tomography, infrared spectroscopy, and qualitative histology.
resultsIncomplete fractures involved the whole cortical thickness and showed a continuous gap with a mean width of 180 µm. The gap contained amorphous material and was devoid of living cells. In contrast, the adjacent bone contained living cells, including active osteoclasts. The fracture surfaces sometimes consisted of woven bone, which may have formed in localized defects caused by surface fragmentation or resorption.
interpretationAtypical femoral fractures show signs of attempted healing at the fracture site. The narrow width of the fracture gap and its necrotic contents are compatible with the idea that micromotion prevents healing because it leads to strains within the fracture gap that preclude cell survival.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.