Flores Santos Francisco, Pinheiro da Silva José, Felicíssimo Paulo
Serviço de Ortopedia. Hospital Fernando Fonseca. Amadora. Portugal.
Serviço de Ortopedia. Hospital Força Aérea. Lisboa. Portugal.
Acta Med Port. 2013 Nov-Dec;26(6):746-50. Epub 2013 Dec 20.
Long-term treatment with bisphosphonates has been associated to atypical femoral fractures whose features are now clearly defined.
We present two cases of female patients under bisphosphonate treatment for over 10 years who were admitted to our institution for subtrochanteric and femoral shaft fractures after low-energy trauma. They presented, respectively, a transverse and a short oblique femoral fracture, with thickening of the lateral cortex. They underwent surgical treatment obtaining good functional and imaging result.
These cases fulfill the established criteria for atypical femoral fracture, thereby illustrating a serious adverse event of long-term treatment with bisphosphonates. Such relationship has still not been clearly established by scientific evidence. However, its effectiveness in preventing osteoporotic fractures is well proven.
The atypical femoral fractures are possibly a serious adverse effect of the long-term treatment with bisphosphonates. Scientific evidence still supports its use, however, the physician must be aware of these events and closely follow-up these patients.
长期使用双膦酸盐类药物治疗与非典型股骨骨折有关，其特征现已明确界定。
我们报告两例女性患者，她们接受双膦酸盐治疗超过10年，因低能量创伤导致股骨转子下和股骨干骨折而入住我院。她们分别出现了横行和短斜行股骨骨折，外侧皮质增厚。她们接受了手术治疗，获得了良好的功能和影像学结果。
这些病例符合非典型股骨骨折的既定标准，从而说明了长期使用双膦酸盐类药物治疗的严重不良事件。这种关系尚未得到科学证据的明确证实。然而，其预防骨质疏松性骨折的有效性已得到充分证明。
非典型股骨骨折可能是长期使用双膦酸盐类药物治疗的严重不良反应。科学证据仍然支持其使用，然而，医生必须意识到这些事件并密切随访这些患者。
