Evidence map›Paper›PMID 38951164›Full record

Observational studyOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024

Latent metabolic bone disease, skeletal dysplasia and other conditions related to low bone formation among 38 patients with subtrochanteric femoral fractures: a retrospective observational study.

Soichiro Kimura, Takashi Sunouchi, So Watanabe, Yoshitomo Hoshino, Naoko Hidaka, Hajime Kato, Shu Takeda, Masaomi Nangaku, Noriko Makita, Kotaro Azuma and 4 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2024. 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. Prevalence of hypophosphatasia in general and selected patient populations: a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Soichiro KimuraDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
Takashi SunouchiDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
So WatanabeOsteoporosis Center, The University of Tokyo Hospital, Tokyo, Japan.
Yoshitomo HoshinoDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
Naoko HidakaDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
Hajime KatoDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
Shu TakedaDivision of Endocrinology, Toranomon Hospital Endocrine Center, Tokyo, Japan.
Masaomi NangakuDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
Noriko MakitaDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
Kotaro AzumaOsteoporosis Center, The University of Tokyo Hospital, Tokyo, Japan.
Taro KojimaDepartment of Geriatric Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Takehiro MatsubaraDepartment of Orthopedic Surgery and Spinal Surgery, The University of Tokyo Hospital, Tokyo, Japan.
Taku SaitoOsteoporosis Center, The University of Tokyo Hospital, Tokyo, Japan.
Nobuaki ItoDivision of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan. nobitotky@gmail.com.ORCID http://orcid.org/0000-0002-4071-5372

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Subtrochanteric femoral fracture is rare and intractable due to the possible association with low bone formation. Retrospective analysis of 38 patients with subtrochanteric femoral fractures revealed that four patients suffered from disorders related to low bone formation and there were specific treatments for two of them. PURPOSE: The main aim of this study was to detect latent metabolic bone diseases and skeletal dysplasia associated with low bone formation among patients with morphologic atypical femoral fracture (AFF). A second aim was to evaluate the frequency of recognized risk factors, such as antiresorptive agents, glucocorticoids, and age.

methodsClinical information was retrospectively analyzed among 38 Japanese patients who were admitted to the Department of Orthopedic Surgery and Spinal Surgery and the Division of Emergency and Critical Care Medicine at the University of Tokyo Hospital with diagnoses of subtrochanteric fractures between February 2012 and March 2022.

resultsAmong 38 patients (including 30 females), 21 patients were aged 75 and over. Ten patients had past oral glucocorticoid use, and 18 had past antiresorptive agent use. Two patients were diagnosed with hypophosphatemic osteomalacia after the development of fractures. One patient was suspected to be a carrier of a loss-of-function variant of alkaline phosphatase, biomineralization associated (ALPL), and one other patient had previously been genetically diagnosed with pycnodysostosis. Among four patients with a diagnosis or suspicion of these metabolic bone diseases and skeletal dysplasia, four had past clinical fractures, two had past subtrochanteric femoral fractures, and two had subtrochanteric femoral fractures on both sides.

conclusionIf clinicians encounter patients with morphologic AFF, latent diseases related to low bone formation should be carefully differentiated because appropriate treatment may prevent delayed union and recurrent fractures. Additionally, it may be desirable to exclude these bone diseases in advance before initiating long-term use of antiresorptive agents in osteoporotic patients by screening with serum alkaline phosphatase levels to reduce the risk of morphologic AFF.

Indexed as

Bone Density Conservation AgentsBone Diseases, MetabolicGlucocorticoidsHip FracturesAgedAged, 80 and overFemaleHumansMaleMiddle AgedOsteogenesisOsteoporotic FracturesRetrospective StudiesRisk FactorsBone Density Conservation AgentsGlucocorticoidsAntiresorptiveAtypical femoral fractureFanconi syndromeFGF23-related hypophosphatemic osteomalaciaGlucocorticoidHypophosphatasiaPycnodysostosis

Identifiers

PMID38951164
PMCPMC11364693

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.