Korean J Bone Metab > Volume 17(1); 2010 > Article
Korean Journal of Bone Metabolism 2010;17(1):19-23.
Low Energy Femur Shaft and Subtrochanteric Fracture with Biphosphonate Therapy
Biphosphonate 사용력이 있는 환자에서 저에너지 손상으로 발생한 대퇴 간부 및 전자하 골절
울산대학교 의과대학 서울아산병원 정형외과학교실, 인제대학교 의과대학 해운대 백병원 정형외과학교실1, 인제대학교 의과대학 일산 백병원 정형외과교실2
The purpose of this study is to investigate the rate of bisphosphonate use among low energy femur shaft/ subtrochanteric fractures and to analyze the differences in clinical features between bisphosphonate treated group and the control group.
We performed a retrospective study of postmenopausal women with low energy femoral shaft/subtrochanteric fractures from August 2002 to May 2009. Six subtrochanteric and 44 femoral shaft fractures were identified. The patients were divided into two groups: group A, patients who had a history of bisphosphonate treatment; group B, those who served as control. Age, union time, BMD and x-ray findings were compared between the two groups.
Fifteen (30%) were being treated with bisphosphonate and the average duration of bisphophonate treatment was 39.5 months. Eight patients (53.3%) presented with a prodromal symptom, thigh pain and four patients (26.7%) showed bilateral lesions. The average age of group A and B was 71.0 and 70.6 years (P = 0.780), and the average union time of group A and B was 4.1 and 4.7 months (P = 0.475), respectively. The characteristic x-ray pattern was observed in 15 cases (100%) among group A, and 2 cases(5.7%) among group B (P < 0.001). The patients with BMD below T-score -2.5 were 13 cases (86.7%) in group A and 22 cases (62.9%) in group B (P = 0.765).
The rate of bisphosphonate use was 30% in the low energy femoral subtrochanteric/shaft fracture cases in the postmenopausal patients. The findings of this study suggest that medical practitioners should be careful with the osteoporosis patients who use prolonged bisphosphonate with thigh pain. [Korean Journal of Bone Metabolism, 17(1): 19-23, 2010]
Key Words: Insufficiency fracture, Biphosphonate


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