Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
Osteoporos Int. 2017 Oct;28(10):2853-2858. doi: 10.1007/s00198-017-4112-2. Epub 2017 Jun 14.
In Korean, atypical subtrochanteric fractures (ASF) were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF.
Recently, ASF have been reported to increase among patients on bisphosphonate. However, the incidence of ASF and the association between ASF and bisphosphonate use have not been well defined in Asian population. Our purposes are (1) to estimate the proportion of ASF among Korean patients with proximal femur fracture and (2) to determine the associated risk factors of ASF in the Korean patients.
We conducted a multicenter (16 academic hospitals), prospective Korean hip fracture study on hip fracture in a cohort of patients aged 50 years or older from South Korea between July 2014 and May 2016. As a part of Korean hip fracture study, primary analysis examined the proportion of ASF among proximal femur fracture. To identify ASF, according to the definition by ASBMR task force, all radiographs of subtrochanteric fracture were reviewed. Associated risk factors for occurrence of ASF were also evaluated by using multivariable logistic regression analysis.
Among 1361 patients with proximal femoral fractures due to low-energy trauma, 17 fractures (1.2%) were identified as ASF. Higher BMI and use of bisphosphonate before injury were independent risk factors of ASF.
In Korean, ASF were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF.
在韩国，非典型转子下骨折（ASF）较为罕见。较高的 BMI 和双膦酸盐的使用是 ASF 的显著危险因素。
最近，有报道称在使用双膦酸盐的患者中，ASF 的发病率有所增加。然而，ASF 的发病率以及 ASF 与双膦酸盐使用之间的关联在亚洲人群中尚未得到很好的定义。我们的目的是：（1）估计韩国股骨近端骨折患者中 ASF 的比例；（2）确定韩国患者中 ASF 的相关危险因素。
我们进行了一项多中心（16 家学术医院）前瞻性韩国髋部骨折研究，纳入了 2014 年 7 月至 2016 年 5 月期间韩国 50 岁或以上髋部骨折患者队列。作为韩国髋部骨折研究的一部分，主要分析检查了股骨近端骨折中 ASF 的比例。为了确定 ASF，根据 ASBMR 工作组的定义，对所有转子下骨折的 X 线片进行了复查。使用多变量逻辑回归分析评估了发生 ASF 的相关危险因素。
在 1361 例因低能创伤导致的股骨近端骨折患者中，有 17 例（1.2%）被确定为 ASF。较高的 BMI 和受伤前使用双膦酸盐是 ASF 的独立危险因素。
在韩国，ASF 较为罕见。较高的 BMI 和双膦酸盐的使用是 ASF 的显著危险因素。
