Department of Orthopaedic Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Yosano-cho, Yosa-gun, Kyoto, Japan.
Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
J Hand Surg Asian Pac Vol. 2022 Oct;27(5):928-932. doi: 10.1142/S2424835522720481.
Atypical ulnar fracture (AUF) is a rare condition that may occur in patients treated with bisphosphonates. We describe the clinical course of a patient who had an AUF during treatment with denosumab. An 86-year-old woman treated with denosumab for 5 years experienced a complete transverse fracture of the proximal left ulna after falling from a standing height. Intraoperative photographs showed cortical thickening around the fracture site. Therefore, we diagnosed the patient with AUF and performed internal fixation with a locking plate. However, a re-fracture occurred 2.5 months after surgery, which was treated with locking plate replacement with a longer one with a bone graft. One year after the second surgery, the fracture healed. To our knowledge, this is the second case report of an AUF occurring during denosumab treatment. Our case highlights the importance of careful follow-up of patients receiving not only bisphosphonate, but also denosumab. Level V (Therapeutic).
非典型尺骨骨折（AUF）是一种罕见的情况，可能发生在接受双膦酸盐治疗的患者中。我们描述了一名接受地舒单抗治疗期间发生 AUF 的患者的临床病程。一名 86 岁女性因接受地舒单抗治疗 5 年，从站立高度跌倒后出现左尺骨近端完全横断骨折。术中照片显示骨折部位周围皮质增厚。因此，我们诊断为 AUF，并采用锁定钢板进行内固定。然而，术后 2.5 个月再次发生骨折，采用更长的带骨移植的锁定钢板进行了更换。第二次手术后 1 年，骨折愈合。据我们所知，这是第二例接受地舒单抗治疗期间发生 AUF 的病例报告。我们的病例强调了不仅对接受双膦酸盐治疗的患者，而且对接受地舒单抗治疗的患者进行仔细随访的重要性。 级别 V（治疗）。
