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Atypical femoral neck fracture after prolonged bisphosphonate therapy

Journal of Pathology and Translational Medicine 2020년 54권 4호 p.346 ~ 350
김광균, 박영욱, 김태형, 서경덕,
소속 상세정보
김광균 ( Kim Kwang-Kyoun ) - Konyang University Hospital Department of Orthopedic Surgery
박영욱 ( Park Young-Wook ) - Konyang University Hospital Department of Pathology
김태형 ( Kim Tae-Hyeong ) - Konyang University Hospital Department of Orthopedic Surgery
서경덕 ( Seo Kyung-Deok ) - Konyang University Hospital Department of Orthopedic Surgery

Abstract


Of the drugs developed to prevent and treat osteoporosis, bisphosphonate has played a very important role in preventing osteoporotic fractures. However, case reports describing atypical femoral fractures in patients using long-term bisphosphonates have emerged. The majority of atypical femur fractures occurs in the lateral aspect of the subtrochanteric or femur diaphysis, which is explained by accumulation of tensile stress in these areas. Although the superior cortex of the femur neck withstands maximum tensile stress, to our knowledge, there have been only two reports (three cases) of atypical femoral neck fracture. In addition, none of those case reports revealed detailed pathology related to suppressed bone turnover rate. We encountered an incomplete femoral neck fracture and diagnosed it as “atypical” on the basis of the patient’s lack of trauma and medication history and pathological findings. For patients with groin pain, minimal or no trauma, and a history of long-term bisphosphonate use, an atypical femoral neck fracture should be considered.

키워드

Atypical femur fracture; Femur neck fracture; Tensile strength; Bisphosphonate

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