Shimada Yohei, Ishikawa Tetsuhiro, Endo Jun, Katsuragi Jo, Kotani Toshiaki, Kiuchi Hitoshi, Kuniyoshi Kazuki, Ohtori Seiji
Orthopaedic Surgery, Sanmu Medical Center, Chiba, Japan.
Orthopaedic Surgery, Seirei Sakura Citizen Hospital, 2-36-2 Eharadai, Sakura, Chiba 285-8765, Japan.
Case Rep Orthop. 2017;2017:8602573. doi: 10.1155/2017/8602573. Epub 2017 Nov 29.
Long-term bisphosphonate use has been suggested to result in decreased bone remodelling and an increased risk of atypical fractures. Fractures of this nature commonly occur in the femur, and relatively few reports exist to show that they occur in other bones. Among eight previous reports of atypical ulnar fractures associated with bisphosphonate use, one report described nonunion in a patient who was treated with cast immobilization and another described ulna nonunion in one of three patients, all of whom were treated surgically with a locking plate. The remaining two surgical patients achieved bone union uneventfully following resection of the osteosclerotic lesion and iliac bone grafting before rigid fixation. We hypothesized that the discontinuation of bisphosphonate therapy, the use of teriparatide treatment, and low-intensity pulsed ultrasound (LIPUS) might have been associated with fracture healing.
长期使用双膦酸盐已被认为会导致骨重塑减少和非典型骨折风险增加。这种性质的骨折通常发生在股骨，而相对较少的报告表明它们发生在其他骨骼中。在之前八篇关于双膦酸盐使用相关非典型尺骨骨折的报告中，一篇报告描述了一名采用石膏固定治疗的患者出现骨不连，另一篇报告描述了三名手术治疗患者中的一名出现尺骨骨不连，这三名患者均接受了锁定钢板手术治疗。其余两名接受手术的患者在切除骨硬化病变并进行髂骨移植后，在刚性固定前顺利实现了骨愈合。我们推测，停用双膦酸盐治疗、使用特立帕肽治疗和低强度脉冲超声（LIPUS）可能与骨折愈合有关。
