Materials Science and Engineering, Cornell University, Ithaca, New York, USA.
Curr Opin Support Palliat Care. 2012 Sep;6(3):348-54. doi: 10.1097/SPC.0b013e3283552d7d.
To review the definition, epidemiology, and putative pathophysiology of atypical femoral fractures and propose strategies for the management of patients with atypical fractures as well as patients on long-term bisphosphonates without atypical fractures.
Recent epidemiologic evidence shows that the absolute incidence of atypical femoral fractures is small compared with the incidence of typical hip fractures. However, long-term bisphosphonate use may be an important risk factor for atypical fractures, and minimal additional antifracture benefit has been demonstrated for treatment durations longer than 5 years for patients with postmenopausal osteoporosis. This review gives advice to aid clinicians in the management of patients with incipient or complete atypical fractures.
Extremely limited evidence is available for how best to manage patients with atypical fractures. A comprehensive metabolic approach for the management of patients on long-term bisphosphonates will help to prevent oversuppression of bone remodeling that is implicated in the pathogenesis of these fractures.
回顾非典型股骨骨折的定义、流行病学和可能的发病机制，并提出治疗非典型骨折患者以及长期使用双膦酸盐但无非典型骨折患者的策略。
最近的流行病学证据表明，与典型髋部骨折的发生率相比，非典型股骨骨折的绝对发生率较小。然而，长期使用双膦酸盐可能是导致非典型骨折的一个重要危险因素，对于绝经后骨质疏松症患者，治疗时间超过 5 年时，其骨折预防效果增加极为有限。本综述为临床医生提供了一些建议，以帮助他们管理有或无完全性非典型骨折的患者。
目前关于如何最好地治疗非典型骨折患者的证据极为有限。对长期使用双膦酸盐的患者进行全面代谢治疗有助于预防骨重建过度抑制，这与这些骨折的发病机制有关。
