Evidence map›Paper›PMID 30687667›Full record

ArticleJournal of orthopaedic case reports

Peri-implant Atypical Fractures Associated with Bisphosphonates: Should this Clinical Entity be Included in the Definition of Atypical Femoral Fracture? Case Report.

Nuno Duarte Simões, Zico Gonçalves, João Moreno, Frederico Paiva, Serafim Pinho, Miguel Varzielas

Abstract readCase Reports
In one paragraph

Article in Journal of orthopaedic case reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. The definition of atypical femoral fractures should include periprosthetic femoral fractures (PAFFs).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Article
4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Nuno Duarte SimõesDepartment of Orthopaedics, Centro-Hospitalar Tondela-Viseu, Portugal, Av. Rei D. Duarte, 3504 509 -Viseu, Portugal.
Zico GonçalvesDepartment of Orthopaedics, Centro-Hospitalar Tondela-Viseu, Portugal, Av. Rei D. Duarte, 3504 509 -Viseu, Portugal.
João MorenoDepartment of Orthopaedics, Centro-Hospitalar Tondela-Viseu, Portugal, Av. Rei D. Duarte, 3504 509 -Viseu, Portugal.
Frederico PaivaDepartment of Orthopaedics, Centro-Hospitalar Tondela-Viseu, Portugal, Av. Rei D. Duarte, 3504 509 -Viseu, Portugal.
Serafim PinhoDepartment of Orthopaedics, Centro-Hospitalar Tondela-Viseu, Portugal, Av. Rei D. Duarte, 3504 509 -Viseu, Portugal.
Miguel VarzielasDepartment of Orthopaedics, Centro-Hospitalar Tondela-Viseu, Portugal, Av. Rei D. Duarte, 3504 509 -Viseu, Portugal.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn recent years, growing evidence of the association between bisphosphonate use and incidence of atypical femoral fractures has emerged. Cases of peri-implant fractures associated with bisphosphonate use suggest the emergence of a new clinical entity because they are not currently covered by the definition of atypical femoral fracture. CASE REPORT: We present here two rare clinical cases treated in our hospital. Two women (68 and 76 years old) with peri-implant (cephalomedullary nail) fractures and history of prolonged bisphosphonate use (11 and 14 years). Both fractures occurred after minor trauma and showed an atypical fracture pattern. One of the patients underwent revision osteosynthesis and had a 12 months follow-up. The second patient was submitted to orthopedic treatment and had a 6months follow-up.

conclusionAlthough reports of periprosthetic fractures and peri-implant(plate and screws) have been published, references to peri-implant cephalomedullary nail fractures were not found in the literature. Here, we question if these fracture types should be included in the current definition of atypical femoral fracture, or form a new clinical entity.

Indexed as

Atypical femoral fractureBisphosphonatePeri-implant fracture

Identifiers

PMID30687667
PMCPMC6343574

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