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Journal of Children's Orthopaedics

Erschienen in:

01.03.2012 | Original Clinical Article

Changing pattern of femoral fractures in osteogenesis imperfecta with prolonged use of bisphosphonates

verfasst von: N. Nicolaou, Y. Agrawal, M. Padman, J. A. Fernandes, M. J. Bell

Erschienen in: Journal of Children's Orthopaedics | Ausgabe 1/2012

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Abstract

Purpose

Osteogenesis imperfecta (OI) has been treated with bisphosphonates for many years, with some clear clinical benefits. In adults, there are reports of a new pattern of atraumatic subtrochanteric fractures with bisphosphonate treatment. This study assesses if bisphosphonate treatment leads to an altered pattern of femoral fractures.

Methods

Retrospective review of imaging for a cohort of 176 bisphosphonate-treated OI patients to identify the locations of femoral fractures over a two-year period, as compared to a historical control group managed pre-bisphosphonates.

Results

Sixteen femoral fractures were identified in this time period in the bisphosphonate-treated group. All but two were within the subtrochanteric region. In comparison, the historical group—composed of 26 femoral fractures—had a more widespread fracture pattern, with the most frequent location being the mid-diaphysis. Many of the subtrochanteric fractures in the treatment group occurred with minimal trauma.

Conclusions

It appears that concerns over the treatment of the adult osteoporotic population with bisphosphonates are amplified and mirrored in OI. It is possible that the high bending moments in the proximal femur together with altered mechanical properties of cortical bone secondary to the use of this group of drugs increase the risk of this type of injury, which warrants further modification of surgical management of the femur.

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Titel: Changing pattern of femoral fractures in osteogenesis imperfecta with prolonged use of bisphosphonates
verfasst von: N. Nicolaou
Y. Agrawal
M. Padman
J. A. Fernandes
M. J. Bell
Publikationsdatum: 01.03.2012
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Children's Orthopaedics / Ausgabe 1/2012
Print ISSN: 1863-2521
Elektronische ISSN: 1863-2548
DOI: https://doi.org/10.1007/s11832-011-0380-0

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Changing pattern of femoral fractures in osteogenesis imperfecta with prolonged use of bisphosphonates

Abstract

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Conclusions

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