GuidelineThe Journal of clinical endocrinology and metabolism2020
Medical Management of Patients After Atypical Femur Fractures: a Systematic Review and Recommendations From the European Calcified Tissue Society.
Guideline in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 3 of them syntheses that pooled 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.
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
63 citing papers in PubMed, 3 syntheses or guidelines pooled it, 107 citations in OpenAlex.
- Atypical fractures at non-classical sites associated with anti-resorptive therapy: a systematic review.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Pooled it
- The effect of teriparatide on fracture healing after atypical femoral fracture: A systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Pooled it
- UK clinical guideline for the prevention and treatment of osteoporosis.Archives of osteoporosis · 2022Guideline
- Trial
- Medication-related osteonecrosis of the external auditory canal and treatment with teriparatide.JCEM case reports · 2026Article
- [Interpretation of the 2025 Asian Federation of Osteoporosis Societies (AFOS) Clinical Consensus: Atypical femoral fractures in patients with osteoporosis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- Assessment of Teriparatide's Effect on Post-operative Functional Outcome and Fracture Healing.Journal of orthopaedic case reports · 2026Article
- Association of albumin, ASA class, and time with mortality, Re-admission, and Re-operation after proximal femoral fracture fixation.Journal of clinical orthopaedics and trauma · 2026Article
- Decortication in the Surgical Management of Complete Atypical Femoral Fractures: A Strategy to Accelerate Fracture Healing.Journal of clinical medicine · 2026Article
- Radiological Assessment of Atypical Femoral Fractures: A 10-Year Experience Across Two Centres.Journal of osteoporosis · 2026Article
- Atypical femoral fracture and jaw osteonecrosis under high doses of denosumab, healed with the aid of low dose of denosumab: a case report.Frontiers in endocrinology · 2026Article
- Bone-modifying therapy in multiple myeloma: a comprehensive review.Frontiers in oncology · 2026Review
- Alternative Osteoporosis Therapies After Bisphosphonate Associated Atypical Femur Fractures: A Retrospective Analysis.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- Longitudinal osteoporosis therapy: treat-to-target and sequential strategies-a narrative review.Therapeutic advances in musculoskeletal disease · 2026Review
- Medication-related osteonecrosis of the jaw: an evidence-based 2025 position statement from a Korean multidisciplinary task force.Journal of the Korean Association of Oral and Maxillofacial Surgeons · 2025Review
- Medication-Related Osteonecrosis of the Jaw: An Evidence-Based 2025 Position Statement from a Korean Multidisciplinary Task Force.Endocrinology and metabolism (Seoul, Korea) · 2025Article
- Osteoporosis Management after the Occurrence of Medication-Related Osteonecrosis of the Jaw: A 13-Year Experience at a Tertiary Center.Endocrinology and metabolism (Seoul, Korea) · 2025Article
- Asian Federation of Osteoporosis Societies 2025 consensus on atypical femoral fractures in patients with osteoporosis.Osteoporosis and sarcopenia · 2025Review
- Review
- Epidemiology, Pathophysiology and Management of Atypical Femur Fractures: an Update.Current osteoporosis reports · 2025Review
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 8 institutions in 6 countries.
Funding
Abstract
contextAtypical femur fractures (AFFs) are serious adverse events associated with bisphosphonates and often show poor healing. EVIDENCE ACQUISITION: We performed a systematic review to evaluate effects of teriparatide, raloxifene, and denosumab on healing and occurrence of AFF. EVIDENCE SYNTHESIS: We retrieved 910 references and reviewed 67 papers, including 31 case reports, 9 retrospective and 3 prospective studies on teriparatide. There were no RCTs. We pooled data on fracture union (n = 98 AFFs on teriparatide) and found that radiological healing occurred within 6 months of teriparatide in 13 of 30 (43%) conservatively managed incomplete AFFs, 9 of 10 (90%) incomplete AFFs with surgical intervention, and 44 of 58 (75%) complete AFFs. In 9 of 30 (30%) nonoperated incomplete AFFs, no union was achieved after 12 months and 4 (13%) fractures became complete on teriparatide. Eight patients had new AFFs during or after teriparatide. AFF on denosumab was reported in 22 patients, including 11 patients treated for bone metastases and 8 without bisphosphonate exposure. Denosumab after AFF was associated with recurrent incomplete AFFs in 1 patient and 2 patients of contralateral complete AFF. Eight patients had used raloxifene before AFF occurred, including 1 bisphosphonate-naïve patient.
conclusionsThere is no evidence-based indication in patients with AFF for teriparatide apart from reducing the risk of typical fragility fractures, although observational data suggest that teriparatide might result in faster healing of surgically treated AFFs. Awaiting further evidence, we formulate recommendations for treatment after an AFF based on expert opinion.
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.