Leung Frankie, Lau Tak-Wing, To Michael, Luk Keith Dip-Kei, Kung Annie Wai Chee
Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Room 505, Professorial Block, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong, China.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.10.2008.1073. Epub 2009 Mar 5.
Antiresorptive bisphosphonate agents are the mainstay of treatment for osteoporosis in both men and postmenopausal women. However, recent studies have raised concerns about the oversuppression of bone turnover related to the long-term use of bisphosphonates. Cases of atypical femoral diaphyseal and subtrochanteric fracture were reported recently in patients on long-term alendronate, and oversuppression of bone turnover was postulated to be the cause. We retrospectively reviewed all patients with femoral diaphyseal and subtrochanteric fracture presented between July 2003 and June 2008, and identified 10 patients who reported prior bisphosphonate use. Bone formation markers of all these patients were in the low range. Although the incidence of bisphosphonate-related atypical fracture accounts for an extremely low percentage of the total number of femoral diaphyseal and subtrochanteric fractures, we observed a steady increase from 0% in 2003 to 2004 to 25% in 2007 to 2008.
抗吸收双膦酸盐类药物是男性和绝经后女性骨质疏松症治疗的主要药物。然而，最近的研究引发了对长期使用双膦酸盐类药物导致骨转换过度抑制的担忧。近期有报道称，长期服用阿仑膦酸钠的患者出现了非典型股骨干和转子下骨折，推测骨转换过度抑制是其原因。我们回顾性分析了2003年7月至2008年6月期间所有出现股骨干和转子下骨折的患者，确定了10例曾使用过双膦酸盐类药物的患者。所有这些患者的骨形成标志物均处于较低水平。尽管双膦酸盐相关非典型骨折的发生率在股骨干和转子下骨折总数中所占比例极低，但我们观察到其发生率从2003年至2004年的0%稳步上升至2007年至2008年的25%。
