Observational studyBMC musculoskeletal disorders2017
Incidence and medical management of bisphosphonate-associated atypical femoral fractures in a major trauma centre: a retrospective observational study.
Observational study in BMC musculoskeletal disorders, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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Who cites it
6 citing papers in PubMed.
- Review
- Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures.JBMR plus · 2024Article
- Atypical femur fracture in a male without history of bisphosphonate use: a case report.Journal of medical case reports · 2024Article
- Surgical Treatment for Bisphosphonate-related Atypical Femoral Fracture: A Systematic Review.The archives of bone and joint surgery · 2021Review
- Post-operative Rehabilitation of Atypical Femoral Fracture in a Single Center.Progress in rehabilitation medicine · 2020Article
- Atypical femur fractures: current understanding and approach to management.Therapeutic advances in musculoskeletal disease · 2020Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundAtypical femoral fractures (AFFs) are rare events associated with increased duration of bisphosphonate exposure. Recommended management of AFFs include cessation of bisphosphonates and imaging of the contralateral femur. The aims of this study were to identify the local incidence of AFFs in bisphosphonate users and to audit the medical management of AFFs against published recommendations.
methodsA retrospective analysis of the admissions database for a major trauma centre identified all femoral fractures (3150) in a five-year period (July 2009 to June 2014). Electronic health records and radiographs were reviewed using the 2013 American Society for Bone and Mineral Research (ASBMR) diagnostic criteria for AFF to establish the number of cases. To estimate incidence, the total number of bisphosphonate users was derived from primary care prescription and secondary care day-case records. Medical management of cases with AFF on bisphosphonates was audited against guidance from ASBMR and Medicines & Healthcare Products Regulatory Agency.
results10 out of 3150 femoral fractures met criteria for AFF; 7 of these patients had a history of exposure to bisphosphonates (6 oral, 1 intravenous). There were 19.1 AFFs per 100,000 years of bisphosphonate use in our region. Bisphosphonates were stopped and the contralateral femur imaged in only 2 of the 7 patients treated with bisphosphonates.
conclusionOur local incidence is in line with published figures; however, this is the first published evidence suggesting that medical management and identification of AFF may be suboptimal. Managing these patients remains challenging due to their rarity and possible lack of awareness.
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