Evidence map›Paper›PMID 28474166›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017

Undisturbed local bone formation capacity in patients with atypical femoral fractures: a case series.

H P Bögl, P Aspenberg, J Schilcher

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
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1 · What the graph read from it

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Increased rate of reoperation in atypical femoral fractures is related to patient characteristics and not fracture type. A nationwide cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Article
  3. Management Challenges in Atypical Femoral Fractures: A Case Report.Annals of geriatric medicine and research · 2020
    Article
  4. Article
  5. Review
4 · The record

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5 · Who and what money

Authors and funding

3 authors.

H P BöglDepartment of Experimental and Clinical Medicine, Faculty of Health Science, Linköping University, SE-581 85, Linköping, Sweden.
P AspenbergDepartment of Experimental and Clinical Medicine, Faculty of Health Science, Linköping University, SE-581 85, Linköping, Sweden.
J SchilcherDepartment of Orthopedic Surgery, Gävle hospital, SE-80 324, Gävle, Sweden. jorg.schilcher@regionostergotland.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We excised the fracture site in 8 patients with incomplete atypical femoral fractures by drilling an 11-mm-diameter hole. New bone formation could be seen in the hole within a normal time frame. Delayed healing of these fractures might be unrelated to an impaired capacity to form bone.

introductionIncomplete atypical femoral fractures (undisplaced cracks) heal slowly or not at all, and often progress to a complete fracture with minimal trauma. The impaired healing has been attributed to an impaired biologic healing capacity related to bisphosphonate use, or, alternatively, to the mechanical environment within the fracture crack. This study aimed to investigate the capacity for bone formation after resection of the fracture site.

methodsBetween 2008 and 2014, we recruited eight patients with incomplete atypical femoral fractures. All used oral bisphosphonates before the fracture for on average 8 years (range 4 to 15) and complained of thigh pain. The fractures were stabilized with reamed cephalomedullary nails. During surgery, the fracture site in the lateral cortex was resected with a cylindrical drill (diameter 11.5 mm). The cylindrical cortical defect allowed radiographic evaluation of new bone formation, and the patients were followed clinically and radiologically for 24 months (range 15 to 92).

resultsAfter 3 months, newly formed bone could be seen in the cortical defects in all patients. After 13-26 months, the previous defects showed continuous cortical bone. At final follow-up, all patients reported full recovery of pre-surgical complaints. No complications occurred and no reoperations were performed.

conclusionsNew bone formation occurred within a time frame that appears normal for healing of cortical bone defects. This suggests that the capacity to form new bone is intact.

Indexed as

AgedAged, 80 and overBone Density Conservation AgentsDiphosphonatesFemaleFemoral FracturesFollow-Up StudiesFracture Fixation, IntramedullaryFracture HealingFractures, StressHumansMaleMiddle AgedOsteogenesisOsteoporosisRadiographyBone Density Conservation AgentsDiphosphonatesAtypical femoral fractureBisphosphonatesFracture healingOsteoporosis

Identifiers

PMID28474166

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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.