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KMID : 0438420100170010019
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Korean Journal of Bone Metabolism
2010 Volume.17 No. 1 p.19 ~ p.23
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Low Energy Femur Shaft and Subtrochanteric Fracture with Biphosphonate Therapy
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Kim Ji-Wan
Kim Jung-Jae
Lee Hee-Sang
Choo Suk-Kyu
Oh Hyoung-Keun
Chang Jae-Suk
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Abstract
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Purpose: The purpose of this study is to investigate the rate of bisphosphonate use among low energy femur shaft/subtrochanteric fractures and to analyze the differences in clinical features between bisphosphonate treated group and the control group.
Methods: We performed a retrospective study of postmenopausal women with low energy femoral shaft/subtrochanteric fractures from August 2002 to May 2009. Six subtrochanteric and 44 femoral shaft fractures were identified. The patients were divided into two groups: group A, patients who had a history of bisphosphonate treatment; group B, those who served as control. Age, union time, BMD and x-ray findings were compared between the two groups.
Results: Fifteen (30%) were being treated with bisphosphonate and the average duration of bisphophonate treatment was 39.5 months. Eight patients (53.3%) presented with a prodromal symptom, thigh pain and four patients (26.7%) showed bilateral lesions. The average age of group A and B was 71.0 and 70.6 years (P = 0.780), and the average union time of group A and B was 4.1 and 4.7 months (P = 0.475), respectively. The characteristic x-ray pattern was observed in 15 cases (100%) among group A, and 2 cases(5.7%) among group B (P < 0.001). The patients with BMD below T-score -2.5 were 13 cases (86.7%) in group A and 22 cases (62.9%) in group B (P = 0.765).
Conclusion: The rate of bisphosphonate use was 30% in the low energy femoral subtrochanteric/shaft fracture cases in the postmenopausal patients. The findings of this study suggest that medical practitioners should be careful with the osteoporosis patients who use prolonged bisphosphonate with thigh pain.
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KEYWORD
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Insufficiency fracture, Biphosphonate
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