与长期服用双膦酸盐相关的非典型股骨骨折的髓内固定治疗

被引:7
作者
周耀东 [1 ]
陈宇杰 [2 ]
袁慧仪 [3 ]
罗强 [3 ]
梁加利 [3 ]
机构
[1] 上海交通大学医学院苏州九龙医院骨科
[2] 上海交通大学附属第六人民医院骨科
[3] 中国香港大学玛丽医院矫形与创伤外科学系
关键词
股骨骨折; 二磷酸盐类; 骨折固定术,髓内; 非典型骨折;
D O I
暂无
中图分类号
R687.3 [骨骼手术];
学科分类号
100220 [骨科学];
摘要
目的探讨髓内固定治疗与长期服用双膦酸盐相关的非典型股骨骨折的疗效。方法回顾性分析2008年2月至2012年4月采用髓内固定治疗的21例(24侧骨折)与长期服用双膦酸盐相关的非典型股骨骨折患者资料,男2例,女19例;左侧10例,右侧8例,双侧3例;平均年龄为74.2岁(60~95岁);从服药开始至出现骨折时间为58.6个月(37~95个月)。15例(18侧骨折)由低能量损伤所致,6例无明显创伤。骨折部位:股骨转子下骨折13侧,股骨干骨折11侧。骨折AO分型均为32A2型。所有患者均于入院48 h内手术,股骨转子下骨折采用股骨长重建钉或长的股骨近端防旋髓内钉固定,股骨干骨折采用股骨髓内钉固定。术后观察患者的骨折愈合情况,末次随访时采用Thoresen评分标准评定患肢功能恢复情况。结果所有患者术后获平均2.0年(1.0~2.5年)随访。21例患者24侧骨折均获骨性愈合,平均愈合时间为5.1个月(3~8个月)。末次随访时根据Thoresen评分标准评定患肢功能:优20侧,良3侧,可1侧,优良率为95.8%。无伤口感染、内固定物松动、断裂及骨折不愈合等并发症发生。结论髓内固定是治疗与长期服用双膦酸盐相关的非典型股骨骨折的有效方法。
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共 13 条
[1]
The Outcome of Surgically Treated Femur Fractures Associated With Long-Term Bisphosphonate Use [J].
Weil, Yoram A. ;
Rivkin, Gurion ;
Safran, Ori ;
Liebergall, Meir ;
Foldes, A. Joseph .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2011, 71 (01) :186-190
[2]
Bisphosphonate-Related Subtrochanteric Femoral Fractures [J].
Gunawardena, Indunil ;
Baxter, Mark ;
Rasekh, Yama .
AMERICAN JOURNAL OF GERIATRIC PHARMACOTHERAPY, 2011, 9 (03) :194-198
[3]
Alendronate-associated femoral insufficiency fractures and femoral stress reactions.[J].Wang; Kemble;Moaveni; Afshin;Dowrick; Adam;Liew; Susan.Journal of Orthopaedic Surgery.2011, 1
[4]
Atypical Subtrochanteric and Diaphyseal Femoral Fractures: Report of a Task Force of the American Society for Bone and Mineral Research [J].
Shane, Elizabeth ;
Burr, David ;
Ebeling, Peter R. ;
Abrahamsen, Bo ;
Adler, Robert A. ;
Brown, Thomas D. ;
Cheung, Angela M. ;
Cosman, Felicia ;
Curtis, Jeffrey R. ;
Dell, Richard ;
Dempster, David ;
Einhorn, Thomas A. ;
Genant, Harry K. ;
Geusens, Piet ;
Klaushofer, Klaus ;
Koval, Kenneth ;
Lane, Joseph M. ;
McKiernan, Fergus ;
McKinney, Ross ;
Ng, Alvin ;
Nieves, Jeri ;
O'Keefe, Regis ;
Papapoulos, Socrates ;
Sen, Howe Tet ;
van der Meulen, Marjolein C. H. ;
Weinstein, Robert S. ;
Whyte, Michael .
JOURNAL OF BONE AND MINERAL RESEARCH, 2010, 25 (11) :2267-2294
[5]
Is Surgery Necessary for Femoral Insufficiency Fractures after Long-term Bisphosphonate Therapy? [J].
Ha, Yong-Chan ;
Cho, Myung-Rae ;
Park, Ki Hong ;
Kim, Shin-Yoon ;
Koo, Kyung-Hoi .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (12) :3393-3398
[6]
Case Reports: Subtrochanteric Femoral Stress Fractures after Prolonged Alendronate Therapy [J].
Cermak, Katerina ;
Shumelinsky, Felix ;
Alexiou, Jean ;
Gebhart, Michael J. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2010, 468 (07) :1991-1996
[7]
Alendronate-related femoral diaphysis fracture-what should be done to predict and prevent subsequent fracture of the contralateral side? [J].
Edwards, M. H. ;
McCrae, F. C. ;
Young-Min, S. A. .
OSTEOPOROSIS INTERNATIONAL, 2010, 21 (04) :701-703
[8]
Association of low-energy femoral fractures with prolonged bisphosphonate use: a case--control study [J].
Vasikaran, S. D. .
OSTEOPOROSIS INTERNATIONAL, 2009, 20 (08) :1457-1458
[9]
Severely suppressed bone turnover and atypical skeletal fragility [J].
Visekruna, Maja ;
Wilson, Deborah ;
McKiernan, Fergus Eoin .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2008, 93 (08) :2948-2952
[10]
Low-energy femoral shaft fractures associated with alendronate use [J].
Neviaser, Andrew S. ;
Lane, Joseph M. ;
Lenart, Brett A. ;
Edobor-Osula, Folorunsho ;
Lorich, Dean G. .
JOURNAL OF ORTHOPAEDIC TRAUMA, 2008, 22 (05) :346-350