Dichotomous location of 160 atypical femoral fractures
2013 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 84, no 6, 561-564 p.Article in journal (Refereed) Published
Background and purpose The risk of atypical fracture of the femur is associated with bisphosphonate use. While characterizing atypical fractures from a previous nationwide study in radiographic detail, we had the impression that the fractures were located either in the subtrochanteric region or in the shaft. We determined whether there is a dichotomy in this respect. less thanbrgreater than less thanbrgreater thanPatients and methods The distance between the atypical fractures and the lesser trochanter was measured on plain radiographs from 129 of 160 patients with atypical fractures, taken from 2008 through 2010. Analysis of the distances measured showed 2 clusters, which were then analyzed with regard to bisphosphonate use and age. less thanbrgreater than less thanbrgreater thanResults The distribution of the distances would be best described as 2 clusters, with a dichotomy at 8 cm. The proximal (subtrochanteric) cluster comprised 25 patients who were generally younger (median 71 years) than the 104 patients in the cluster with shaft fractures (median 80 years). The 95% CI for the difference between medians was 4-11 years. Of the patients with subtrochanteric fractures, 18 of 25 used bisphosphonates as compared to 89 of 104 with shaft fractures. less thanbrgreater than less thanbrgreater thanInterpretation The younger age and possibly smaller proportion of bisphosphonate users in the subtrochanteric cluster may be compatible with a greater influence of mechanical stress in the underlying pathophysiology of proximal fractures.
Place, publisher, year, edition, pages
Informa Healthcare , 2013. Vol. 84, no 6, 561-564 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-102976DOI: 10.3109/17453674.2013.866193ISI: 000328281100010OAI: oai:DiVA.org:liu-102976DiVA: diva2:685637
Funding Agencies|Swedish Research Council|VR 02031-47-5|Linkoping University||Ostergotland County Council||King Gustaf V and Queen Victoria Free Mason Foundation||Eli Lilly Co.||2014-01-092014-01-092014-08-21