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Subtrochanteric fractures in bisphosphonate-naive patients: results from the HORIZON-recurrent fracture trial.

Publication ,  Journal Article
Adachi, JD; Lyles, K; Boonen, S; Colón-Emeric, C; Hyldstrup, L; Nordsletten, L; Pieper, C; Recknor, C; Su, G; Bucci-Rechtweg, C; Magaziner, J
Published in: Calcif Tissue Int
December 2011

Our purpose was to characterize the risks of osteoporosis-related subtrochanteric fractures in bisphosphonate-naive individuals. Baseline characteristics of patients enrolled in the HORIZON-Recurrent Fracture Trial with a study-qualifying hip fracture were examined, comparing those who sustained incident subtrochanteric fractures with those sustaining other hip fractures. Subjects were bisphosphonate-naive or had a bisphosphonate washout period of 6-24 months and subsequently received an annual infusion of zoledronic acid 5 mg or placebo after low-trauma hip-fracture repair. In total, 2,127 men and women were included. Of the qualifying hip fractures, 5.2% were subtrochanteric, 54.8% femoral neck, 33.0% intertrochanteric, and 7.1% other (generally complex fractures of mixed type). Significant baseline (pre-hip fracture) differences were seen between index hip-fracture types, with the percentage of patients with extreme mobility problems being twofold higher in patients with index subtrochanteric fracture (9.9%) compared to other patients. The distribution of hip-fracture types was similar between the treatment groups at baseline. No patients with index subtrochanteric fractures and six patients with other qualifying hip fractures reported prior bisphosphonate use. Only one further subtrochanteric fracture occurred in each treatment group over an average 2-year patient follow-up. Subtrochanteric fractures are not uncommon in bisphosphonate-naive patients. Extreme difficulties with mobility may be a unique risk factor predisposing to development of incident subtrochanteric fractures rather than other types of hip fracture. In patients with recent hip fracture who received zoledronic acid therapy, the incidence of new subtrochanteric fractures was too small to draw any meaningful conclusions.

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Published In

Calcif Tissue Int

DOI

EISSN

1432-0827

Publication Date

December 2011

Volume

89

Issue

6

Start / End Page

427 / 433

Location

United States

Related Subject Headings

  • Risk Factors
  • Male
  • Humans
  • Hip Fractures
  • Follow-Up Studies
  • Female
  • Endocrinology & Metabolism
  • Double-Blind Method
  • Diphosphonates
  • Bone Density Conservation Agents
 

Citation

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Adachi, J. D., Lyles, K., Boonen, S., Colón-Emeric, C., Hyldstrup, L., Nordsletten, L., … Magaziner, J. (2011). Subtrochanteric fractures in bisphosphonate-naive patients: results from the HORIZON-recurrent fracture trial. Calcif Tissue Int, 89(6), 427–433. https://doi.org/10.1007/s00223-011-9543-8
Adachi, Jonathan D., Kenneth Lyles, Steven Boonen, Cathleen Colón-Emeric, Lars Hyldstrup, Lars Nordsletten, Carl Pieper, et al. “Subtrochanteric fractures in bisphosphonate-naive patients: results from the HORIZON-recurrent fracture trial.Calcif Tissue Int 89, no. 6 (December 2011): 427–33. https://doi.org/10.1007/s00223-011-9543-8.
Adachi JD, Lyles K, Boonen S, Colón-Emeric C, Hyldstrup L, Nordsletten L, et al. Subtrochanteric fractures in bisphosphonate-naive patients: results from the HORIZON-recurrent fracture trial. Calcif Tissue Int. 2011 Dec;89(6):427–33.
Adachi, Jonathan D., et al. “Subtrochanteric fractures in bisphosphonate-naive patients: results from the HORIZON-recurrent fracture trial.Calcif Tissue Int, vol. 89, no. 6, Dec. 2011, pp. 427–33. Pubmed, doi:10.1007/s00223-011-9543-8.
Adachi JD, Lyles K, Boonen S, Colón-Emeric C, Hyldstrup L, Nordsletten L, Pieper C, Recknor C, Su G, Bucci-Rechtweg C, Magaziner J. Subtrochanteric fractures in bisphosphonate-naive patients: results from the HORIZON-recurrent fracture trial. Calcif Tissue Int. 2011 Dec;89(6):427–433.
Journal cover image

Published In

Calcif Tissue Int

DOI

EISSN

1432-0827

Publication Date

December 2011

Volume

89

Issue

6

Start / End Page

427 / 433

Location

United States

Related Subject Headings

  • Risk Factors
  • Male
  • Humans
  • Hip Fractures
  • Follow-Up Studies
  • Female
  • Endocrinology & Metabolism
  • Double-Blind Method
  • Diphosphonates
  • Bone Density Conservation Agents