Atypical femoral fractures: epidemiology, etiology, and patient management

作者：Donnelly Eve; Saleh Anas; Unnanuntana Aasis; Lane Joseph M^*

来源：Current Opinion in Supportive and Palliative Care, 2012, 6(3): 348-354.

DOI：10.1097/SPC.0b013e3283552d7d

• atypical fracture
• bisphosphonate
• diaphyseal fracture
• osteoporosis
• subtrochanteric fracture

Purpose of review %26lt;br%26gt;To review the definition, epidemiology, and putative pathophysiology of atypical femoral fractures and propose strategies for the management of patients with atypical fractures as well as patients on long-term bisphosphonates without atypical fractures. %26lt;br%26gt;Recent findings %26lt;br%26gt;Recent epidemiologic evidence shows that the absolute incidence of atypical femoral fractures is small compared with the incidence of typical hip fractures. However, long-term bisphosphonate use may be an important risk factor for atypical fractures, and minimal additional antifracture benefit has been demonstrated for treatment durations longer than 5 years for patients with postmenopausal osteoporosis. This review gives advice to aid clinicians in the management of patients with incipient or complete atypical fractures. %26lt;br%26gt;Summary %26lt;br%26gt;Extremely limited evidence is available for how best to manage patients with atypical fractures. A comprehensive metabolic approach for the management of patients on long-term bisphosphonates will help to prevent oversuppression of bone remodeling that is implicated in the pathogenesis of these fractures.

• 出版日期2012-9