Bone Abstracts

Introduction: The correlation between the occurrence of atypical femur fractures (AFFs) and prolonged bisphosphonate use has been reported in many studies. However, the incidence of AFFs is extremely low, which results in the lack of studies illuminating its treatment and clinical results so far. In this study, we aim to elucidate the clinical outcomes of bisphosphonate-associated AFFs and the clinical results depending on the bisphosphonate therapy period.

Materials and methods: 1. Materials

From 2004 to 2014, we retrospectively reviewed 15 patients (16 cases) with AFFs, of whom four patients had one side complete AFFs and other side incomplete AFFS and one patient with bilateral complete AFFs was considered as two cases. Sixteen typical fracture patients with similar sex, age, injured site, BMI and operation method were used as a control group. Patients with any co-morbidities that may influence bone hearing were excluded from the control group. In one patient, AFF occurred 7 years in right femur after a typical fracture occurred in her left femur and her left typical femur was included in the control group.

2. Methods

We evaluated bone union and complications using radiography and physical examination. Bone union was defined when bone continuity of the fracture site was confirmed in anterior, posterior, and lateral radiography or the maturation of callus was closed in three or more fracture planes out of four without tenderness and movement of the lesions clinically. Use or no use of bisphosphonate, duration and kinds of bisphosphonate were investigated. We compared bone union period and complications with the control group. We evaluated correlation between bone union period and duration of bisphosphonate. The minimum follow up duration was 12 months.