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Treatment and Prognosis of Femoral Insufficiency Fracture Associated with Prolonged Bisphosphonate Use
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Ki Chan An, Dae Hyun Park, Guemin Gong, Ju Young Kim, Sang Bum Kim, Seung Yeob Sakong
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J Korean Fract Soc 2014;27(1):10-16. Published online January 31, 2014
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DOI: https://doi.org/10.12671/jkfs.2014.27.1.10
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 Abstract
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- PURPOSE
This study was conducted to investigate and identify an appropriate fracture treatment method by analyzing patients in whom a femoral incompetence fracture occurred after receiving a long-term bisphosphonate administration.
MATERIALS AND METHODS
The subjects of this study were 13 cases out of ten patients among those who had a history of receiving bisphosphonate for more than five years and had a fracture or an imminent fracture with a characteristic radiological finding in the femoral subtrochanteric region and the interfemoral region. The period of the drug administration, bone density, the existence of a prodromal symptom, and bilateral fracture were investigated.
RESULTS
In seven out of the 13 cases, the patients complained of painat the femoral and pelvic parts as a prodrome (53.8%), and three of them showed a bilateral fracture (30%). An imminent fracture with a prodrome was observed in six cases (46.2%); for three of these cases, a prophylactic fixture pexis was performed by inserting a metal nail into the medullary cavity, and in two out of these three, a complete fracture was found within 11 months on average (3 to 19 months). In the three prophylactic fixture pexis performed cases, no postoperative complications were found, and a radiological finding of concrescence was seen within one year after the operation. Among the nine operation performed cases after the fracture, non-union was found in two.
CONCLUSION
In the patients who have received bisphosphonate for a long periodof time, a prodome may be a useful indicator of a fracture in the femoral subtrochanteric region and the interfemoral region; therefore, a careful observation is necessary. A prophylactic internal fixation is recommended for patients with imminent fracture with a prodome since they have a high risk of a complete fracture is high in them.
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Citations
Citations to this article as recorded by  - Subtrochanteric Fracture Reduction during Intramedullary Nailing: Technical Note
Gyu Min Kong
Journal of the Korean Fracture Society.2019; 32(2): 107. CrossRef
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Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
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Ki Chan An, Dae Hyun Park, Yong Wook Kwon
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J Korean Fract Soc 2011;24(3):256-261. Published online July 31, 2011
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DOI: https://doi.org/10.12671/jkfs.2011.24.3.256
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Abstract
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- PURPOSE
To investigate the relationship between the greenstick laminar fractures and the dural tear in low lumbar burst fractures and their optimal treatment.
MATERIALS AND METHODS
We enrolled 51 patients (52 cases) who had been diagnosed with low lumbar burst fracture from June 2003 to May 2007. The average age was 39 years (range, 22 to 58), 30 male patients (58.8%), and 21 female patients (41.2%). Average follow-up periods was 19 months (range, 11 to 45). Lumbar CT scan were taken 1 mm slices in precision for all patients. We judged it incomplete fracture if lumbar CT scans show loss of cortical continuity over 3 slices if there is an aggrement of two among one radiologist and two orthopaedic surgeons reached a consensus. Dural tear and entrapment of nerve root were confirmed intraoperatively by the senior surgeon.
RESULTS
In 52 burst fractures, complete lamina fractures occurred in 21 cases and there were green stick laminar fractures in 14 cases. Neurologic defect has been found in 12 cases, 5 (63%) from complete laminar fractures and 3 (37%) from green stick laminar fractures. Dural tears has been detected in 9 cases (26%), 4 (19%) from complete laminar fractures and 5 (36%) from green stick laminar fractures.
CONCLUSION
Dural tear and nerve root entrapment can be accompanied in patients with green stick fracture. There is necessary to consider the possibility of dural tear and nerve root entrapment before operation and to indentify carefully to the presence of nerve root entrapment during operation.
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Citations
Citations to this article as recorded by - Risk factors for damage to the dura mater in thoracic and lumbar spine injury
A. G. Martikyan, A. A. Grin, A. E. Talypov, S. L. Arakelyan
Hirurgiâ pozvonočnika (Spine Surgery).2022; 19(1): 31. CrossRef - Clinical Efficacy of Large-Channel Percutaneous Lumbar Endoscopic Decompression in the Treatment of Lumbar Spinal Stenosis Secondary to Old Compression Fractures
Junlin Liu, Qingquan Kong, Walter Munesu Chirume, Pin Feng, Bin Zhang, Junsong Ma, Yuan Hu
World Neurosurgery.2022; 166: e118. CrossRef - Diagnostics, pathogenesis and treatment of damage to the dura mater in spinal injury
A. G. Martikyan, A. A. Grin
Russian journal of neurosurgery.2018; 20(2): 74. CrossRef
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