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A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use.

Publication ,  Journal Article
Rocos, B; Fleming, T; Harding, K; Acharya, M; Riddick, A; Kelly, M
Published in: Cureus
December 2, 2018

The aim of this study was to determine the incidence of atypical femoral fractures in our local population, study their current outcomes and present a novel surgical strategy based on these data. Patients who received surgical fixation of an atypical pattern proximal femoral fracture over a four-year period were identified and followed up in the clinic until union, revision surgery or death. The local incidence of atypical femoral fractures is 1.1 per 1000 per annum amongst patients receiving bisphosphonates. Twelve fixation procedures were carried out in 10 patients. Intra-operative reduction and nailing led to an average deformity of 8.5° varus and 13° apex anterior. Five cases required revision surgery. Fifty percent of primary procedures resulted in radiographic union within two years. We suggest that the lateral side of the fracture should be considered a primary nonunion. We advocate undertaking a wedge excision to correct the bone to a valgus morphology and stabilising with an intramedullary nail and a lateral tension plate. Multicentre studies are needed to demonstrate the efficacy of any particular approach.

Duke Scholars

Published In

Cureus

DOI

ISSN

2168-8184

Publication Date

December 2, 2018

Volume

10

Issue

12

Start / End Page

e3670

Location

United States

Related Subject Headings

  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences
 

Citation

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Chicago
ICMJE
MLA
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Rocos, B., Fleming, T., Harding, K., Acharya, M., Riddick, A., & Kelly, M. (2018). A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use. Cureus, 10(12), e3670. https://doi.org/10.7759/cureus.3670
Rocos, Brett, Thomas Fleming, Karen Harding, Mehool Acharya, Andrew Riddick, and Mike Kelly. “A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use.Cureus 10, no. 12 (December 2, 2018): e3670. https://doi.org/10.7759/cureus.3670.
Rocos B, Fleming T, Harding K, Acharya M, Riddick A, Kelly M. A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use. Cureus. 2018 Dec 2;10(12):e3670.
Rocos, Brett, et al. “A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use.Cureus, vol. 10, no. 12, Dec. 2018, p. e3670. Pubmed, doi:10.7759/cureus.3670.
Rocos B, Fleming T, Harding K, Acharya M, Riddick A, Kelly M. A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use. Cureus. 2018 Dec 2;10(12):e3670.

Published In

Cureus

DOI

ISSN

2168-8184

Publication Date

December 2, 2018

Volume

10

Issue

12

Start / End Page

e3670

Location

United States

Related Subject Headings

  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences