Abstract

NEDER, Yamile V et al. Fracturas atípicas de fémur proximal asociadas al uso prolongado de bifosfonatos. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2018, vol.83, n.3, pp.152-156. ISSN 1852-7434.

Introduction: Bisphosphonates are currently considered a first-choice treatment for osteoporotic disease. A number of adverse effects call into question its long-term administration, such as proximal femoral pathological fractures. The purposes of this study were to determine the relationship between consumption of bisphosphonates and atypical femoral fractures, and to report the incidence in our institution. Methods: Retrospective, observational study, case-control unpaired analysis. Patients >55 years old with femoral fractures admitted from January 1, 2009 to May 31, 2015 were included. Considered variables were: sex, age, type of fracture, use, type and time of consumption of bisphosphonates. Fractures were divided into typical: pertrochanteric, and femoral neck, and atypical: subtrochanteric and diaphyseal. Atypical fractures were cases, and typical fractures functioned as controls. Results: A total of 517 patients met the inclusion criteria and were included in the study. Forty-two fractures were atypical and 236 were typical. Female sex predominated (81.4% of cases, and 83% of controls). Average age was 76 and 80 years, respectively. Association with bisphosphonates was observed in 44.2% of the cases, and 15.3% of controls (11.6% and 0.8% in pertrochanteric fractures, respectively). Conclusions: Alendronate was significantly associated with atypical femoral fractures. A relationship with length of consumption was not detected; however, incidence was higher after 4.5-5 years of use.

Keywords : Hip fracture; Osteoporosis; Bisphosphonates.

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