Toro Giuseppe, Ojeda-Thies Cristina, Calabrò Giampiero, Toro Gabriella, Moretti Antimo, Guerra Guillermo Martínez-Díaz, Caba-Doussoux Pedro, Iolascon Giovanni
Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Via De Crecchio, 4, 80138, Naples, Italy.
Trauma Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario 12 de Octubre, Madrid, Spain.
BMC Musculoskelet Disord. 2016 May 23;17:227. doi: 10.1186/s12891-016-1086-8.
Atypical femoral fractures (AFF) are a rare type of femoral stress fracture recently described, potentially associated with prolonged bisphosphonate therapy. Evidence-based recommendations regarding diagnosis and management of these fractures are scarce. The purpose of this study is to propose an algorithm for the diagnosis and management of AFF.
We performed a PubMed search of the last ten years using the keywords "atypical femoral fractures" and identified further articles through an evaluation of the publications cited in these articles. Relevant studies were included by agreement between researchers, depending on their specialization. Pertinent points of debate were discussed based on the available literature, allowing for consensus regarding the proposed management algorithm.
Using a systematic approach we performed a scoping review that included a total of 137 articles.
A practical guide for diagnosis and management of AFF based on the current concepts is proposed. In spite of the impressive large volume of published literature available since AFF were initially identified, the level of evidence is mostly poor, in particular regarding treatment choice. Therefore, further studies are required.
非典型股骨骨折（AFF）是一种最近才被描述的罕见的股骨应力性骨折类型，可能与长期双膦酸盐治疗有关。关于这些骨折的诊断和治疗的循证医学建议很少。本研究的目的是提出一种AFF的诊断和治疗算法。
我们使用关键词“非典型股骨骨折”在PubMed上搜索了过去十年的文献，并通过评估这些文章中引用的出版物来识别更多文章。根据研究人员的专业领域，通过协商纳入相关研究。基于现有文献讨论了相关的争议点，从而就提议的治疗算法达成共识。
我们采用系统的方法进行了一项范围综述，共纳入137篇文章。
基于当前概念，提出了一份AFF诊断和治疗的实用指南。尽管自AFF首次被发现以来已发表了大量令人印象深刻的文献，但证据水平大多较差，尤其是在治疗选择方面。因此，需要进一步的研究。
