Huang Chang-Yu, Chiang Chih-Yung, Yang Kai-Chiang, Wu Chang-Chin
Department of Orthopedics, En Chu Kong Hospital, New Taipei City, TWN.
School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, TWN.
Cureus. 2024 Sep 24;16(9):e70094. doi: 10.7759/cureus.70094. eCollection 2024 Sep.
Bone loss leading to osteoporosis is a well-known feature in patients with ankylosing spondylitis (AS), with the prevalence of osteoporosis varying widely across different studies. However, there is still no consensus on the treatment of osteoporosis in AS patients. A 67-year-old male, a case of AS under medication control, had taken oral bisphosphonate for about seven years for suspected osteoporosis due to compression fracture at T12 and discontinued for disproportionately high dual-energy X-ray absorptiometry T-score (11.0 SD). He had been well until his right hip painful disability developed after a fall at home with a resultant right subtrochanteric transverse fracture with medial cortical spike, fulfilling features of atypical femoral fractures five months later. Open reduction and internal fixation with a cephalomedullary femoral nail were performed smoothly on the same day, and the fracture healed slowly and eventually one year later with only supplementation of calcium with vitamin D.
骨质流失导致骨质疏松是强直性脊柱炎（AS）患者的一个众所周知的特征，不同研究中骨质疏松的患病率差异很大。然而，对于AS患者骨质疏松的治疗仍未达成共识。一名67岁男性，为AS药物控制病例，因T12压缩性骨折疑似骨质疏松口服双膦酸盐约七年，后因双能X线吸收法T值过高（11.0标准差）而停药。他一直状况良好，直到在家中摔倒后出现右髋疼痛性残疾，并导致右转子下横行骨折伴内侧皮质骨尖，五个月后符合非典型股骨骨折特征。同日顺利进行了股骨近端髓内钉切开复位内固定术，骨折愈合缓慢，最终一年后仅补充钙和维生素D。
