Bilateral Atypical Femoral Fractures after Prolonged Bisphosphonate Therapy: A Case Report and New Approach to the Management of Iatrogenic Fractures

Bilateral Atypical Femoral Fractures after Prolonged Bisphosphonate Therapy: A Case Report and New Approach to the Management of Iatrogenic Fractures

Joseph Maalouly M.D

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Dany Aouad M.D

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Murielle Feghaly

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Cynthia Habib

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Georges El- Rassi M.D

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α University of Balamand

Bilateral Atypical Femoral Fractures after Prolonged Bisphosphonate Therapy: A Case Report and New Approach to the Management of Iatrogenic Fractures

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Abstract

Atypical femoral fractures (AFFs) are defined as atraumatic fractures of the femoral diaphysis and are known to be a complication of prolonged bisphosphonate (BP) therapy. Surgical treatment of AFFs consists of intramedullary (IM) nailing. We report the case of a 58year-old female patient who presented with bilateral femoral fractures after 12 years of BP therapy. Surgical management using IM nails resulted in iatrogenic fractures of the femoral shaft in both limbs. We therefore, opted for conservative treatment, where a non-weight bearing protocol was implemented. Healing was then observed after six months of follow-up.

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Reference Format

Kuntheavy Ing-Lorenzini,Jules Desmeules,Olivier Plachta,Domizio Suva,Pierre Dayer,Robin Peter (2009). Low-Energy Femoral Fractures Associated with the Long-Term Use of Bisphosphonates.
Arkan Sayed-Noor,Göran Sjödén (2009). Case Reports: Two Femoral Insufficiency Fractures after Long-term Alendronate Therapy.
Craig Capeci,Nirmal Tejwani (2009). Bilateral Low-Energy Simultaneous or Sequential Femoral Fractures in Patients on Long-Term Alendronate Therapy.
E Shane,D Burr,P Ebeling (2010). Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone.
E Shane,D Burr,B Abrahamsen (2014). Atypical subtrochanteric and diaphyseal femoral fractures: Second report of a task force of the American Society for Bone and Mineral Research.
Brett Rocos,Thomas Fleming,Karen Harding,Mehool Acharya,Andrew Riddick,Mike Kelly (2018). A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use.
S Das De,T Setiobudi,L Shen,S Das De (2010). A rational approach to management of alendronate-related subtrochanteric fractures.
Yoram Weil,Gurion Rivkin,Ori Safran,Meir Liebergall,A Foldes (2011). The Outcome of Surgically Treated Femur Fractures Associated With Long-Term Bisphosphonate Use.
Kenneth Egol,Ji Park,Zehava Rosenberg,Valerie Peck,Nirmal Tejwani (2013). Healing Delayed But Generally Reliable After Bisphosphonate-associated Complete Femur Fractures Treated with IM Nails.
B Teo,J Koh,S Goh,M Png,D Chua,T Howe (2014). Post-operative outcomes of atypical femoral subtrochanteric fracture in patients on bisphosphonate therapy.
H Fleish,R Russell,M Francis (1969). Diphosphonates inhibit hydroxyapatite dissolution in vitro and bone resorption in tissue culture and in vivo.
M Sato,W Grasser,N Endo,R Akins,H Simmons,D Thompson,E Golub,G Rodan (1991). Bisphosphonate action. Alendronate localization in rat bone and effects on osteoclast ultrastructure..
M Schaffler,K Choi,C Milgrom (1995). Aging and matrix microdamage accumulation in human compact bone.
Erich Durchschlag,Eleftherios Paschalis,Ruth Zoehrer,Paul Roschger,Peter Fratzl,Robert Recker,Roger Phipps,Klaus Klaushofer (2006). Bone Material Properties in Trabecular Bone From Human Iliac Crest Biopsies After 3- and 5-Year Treatment With Risedronate.
G Boivin,P Chavassieux,A Santora,J Yates,P Meunier (2000). Alendronate increases bone strength by increasing the mean degree of mineralization of bone tissue in osteoporotic women.
P Roschger,E Paschalis,P Fratzl,K Klaushofer (2008). Bone mineralization density distribution in health and disease.
N Kharwadkar,B Mayne,J Lawrence,V Khanduja (2017). Bisphosphonates and atypical subtrochanteric fractures of the femur.
K-J Lee,J Yoo,K-J Oh (2017). Surgical outcome of intramedullary nailing in patients with complete atypical femoral fracture: a multicenter retrospective study.
Yongping Cao,Satoshi Mori,Tasuku Mashiba,Michael Westmore,Linda Ma,Masahiko Sato,Tomoyuki Akiyama,Liping Shi,Satoshi Komatsubara,Kensaku Miyamoto,Hiromichi Norimatsu (2002). Raloxifene, Estrogen, and Alendronate Affect the Processes of Fracture Repair Differently in Ovariectomized Rats.
R Thompson,J Phillips,S Mccauley,J Elliott,C Moran (2012). Atypical femoral fractures and bisphosphonate treatment.

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Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

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No ethics committee approval was required for this article type.

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Not applicable for this article.

How to Cite This Article

Joseph Maalouly M.D. 2019. \u201cBilateral Atypical Femoral Fractures after Prolonged Bisphosphonate Therapy: A Case Report and New Approach to the Management of Iatrogenic Fractures\u201d. Global Journal of Medical Research - H: Orthopedic & Musculoskeletal System GJMR-H Volume 19 (GJMR Volume 19 Issue H2): .

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GJMR Volume 19 Issue H2
Pg. 21- 26

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Journal Specifications

Crossref Journal DOI 10.17406/gjmra

Print ISSN 0975-5888

e-ISSN 2249-4618

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Classification

GJMR-H Classification: NLMC Code: WI 965, WE 185

Submission ReceivedDecember 7, 2018
Peer Review Double Blind
Handling Editor
Accepted January 4, 2019
Published January 15, 2019

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v1.2

Issue date

May 31, 2019

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Article Matrices

Total Score: 105

Country: Lebanon

Subject: Global Journal of Medical Research - H: Orthopedic & Musculoskeletal System

Authors: Joseph Maalouly M.D, Dany Aouad M.D, Murielle Feghaly, Cynthia Habib, Georges El- Rassi M.D (PhD/Dr. count: 0)

View Count (all-time): 162

Total Views (Real + Logic): 2768

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Publish Date: 2019 05, Fri

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Total Views: 2768

Total Downloads: 1403

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