Trotter Christopher C, Pfister Alfred K, Whited Brant A, Goldberg Todd H, Artz Steven A
West Virginia University School of Medicine, Charleston, WV, USA.
W V Med J. 2011 Mar-Apr;107(2):8-13.
Several cases have been reported of unusual spontaneous fractures with minimal trauma in the subtrochanteric and diaphyseal areas of the femur linked to long-term bisphosphonate use. After encountering three such patients, we conducted a review of published cases. The average age of these individuals were 68 years and approximately 25% had received concomitant glucocorticoids. Histomorphometric bone biopsy studies performed in some individuals have suggested that severe suppression of bone turnover may be the underlying cause; however, cause and effect has not been firmly established. Moreover, population studies have found this type of fracture rare and not increased in patients who have received bisphosphonate treatment. Physicians should continue to use bisphosphonate agents as a primary treatment for osteoporosis.
已有多例报告称，长期使用双膦酸盐类药物与股骨转子下和骨干区域发生的极少创伤性异常自发性骨折有关。在遇到3例此类患者后，我们对已发表的病例进行了回顾。这些患者的平均年龄为68岁，约25%的患者同时接受过糖皮质激素治疗。一些患者进行的组织形态计量学骨活检研究表明，骨转换严重受抑可能是潜在原因；然而，因果关系尚未完全确立。此外，人群研究发现这类骨折很少见，接受双膦酸盐治疗的患者中并未增多。医生应继续将双膦酸盐类药物作为骨质疏松症的主要治疗药物。
