Yuan Wei, Kwek Ernest B K
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore.
Indian J Orthop. 2020 Jul 28;54(Suppl 1):116-120. doi: 10.1007/s43465-020-00216-1. eCollection 2020 Sep.
The location of bisphosphonate-related atypical femoral fractures (AFFs) is related to the femoral bow. Other factors that might also be related to the distribution of AFFs are not well studied. In this study, we attempt to define the demographic factors that influence the distribution AFFs in our local population.
The medical records of all the patients diagnosed with AFFs treated in our institution between 2008 and 2017 were retrospectively reviewed and divided based on fracture location into subtrochanteric and mid-shaft groups. Demographic data were collected and compared between the two groups. Independent factors affecting the location of AFFs were identified via multivariate analysis.
Seventy-nine AFFs in 71 patients were included. Thirty-two fractures occurred at the subtrochanteric region and 47 occurred at the mid-shaft. Age, bone density, anterior femoral bow and lateral femoral bow were significantly different between the two groups, whereas height, weight, body mass index, presence of prodromal symptoms, type and duration of bisphosphonates were not significantly different. Multivariate analysis showed anterior femoral bow was the only independent factor associated with the location of AFFs.
Anterior femoral bow is the only factor that can predict the location of AFFs. In our population, other demographic factors were not found to be predictive.
双膦酸盐相关非典型股骨骨折(AFFs)的位置与股骨弓有关。其他可能与AFFs分布相关的因素尚未得到充分研究。在本研究中,我们试图确定影响我们当地人群中AFFs分布的人口统计学因素。
回顾性分析2008年至2017年在我院接受治疗的所有诊断为AFFs患者的病历,并根据骨折部位分为转子下组和股骨干中段组。收集两组的人口统计学数据并进行比较。通过多变量分析确定影响AFFs部位的独立因素。
纳入71例患者的79例AFFs。32例骨折发生在转子下区域,47例发生在股骨干中段。两组之间的年龄、骨密度、股骨前弓和股骨外侧弓有显著差异,而身高、体重、体重指数、前驱症状的存在、双膦酸盐的类型和使用时间无显著差异。多变量分析显示股骨前弓是与AFFs部位相关的唯一独立因素。
股骨前弓是唯一能预测AFFs部位的因素。在我们的人群中,未发现其他人口统计学因素具有预测性。