Iwata Ken, Mashiba Tasuku
Department of Orthopedic Surgery, Kagawa University Faculty of Medicine, Japan.
Clin Calcium. 2016 Jan;26(1):73-9.
We demonstrated microdamage accumulation in the fracture sites in the patients of subtrochanteric atypical femoral fracture with long term bisphosphonate therapy and of incomplete shaft fracture of lateral femoral bowing without bisphosphonate therapy. Based on these findings, pathogenesis of atypical femoral fracture is revealed stress fracture caused by accumulation of microdamages between distal to the lesser trochanter and proximal to the supracondylar flare in the femur in association with severely suppressed bone turnover and/or abnormal lower limb alignment, that causes stress concentration on the lateral side cortex of the femur.
我们证明了长期接受双膦酸盐治疗的转子下非典型股骨骨折患者以及未接受双膦酸盐治疗的外侧股骨弓形骨干不完全骨折患者骨折部位存在微损伤积累。基于这些发现，非典型股骨骨折的发病机制为：由于股骨小转子远端至髁上扩张近端之间的微损伤积累，同时伴有严重抑制的骨转换和/或下肢对线异常，导致股骨外侧皮质应力集中，从而引发应力性骨折。
