Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates

Detalhes bibliográficos
Autor(a) principal: Flores Santos, Francisco
Data de Publicação: 2013
Outros Autores: Pinheiro da Silva, José, Felicíssimo, Paulo
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323
Resumo: Introduction: Long-term treatment with bisphosphonates has been associated to atypical femoral fractures whose features are now clearly defined.Clinical Cases: We present two cases of female patients under bisphosphonate treatment for over 10 years who were admitted to our institution for subtrochanteric and femoral shaft fractures after low-energy trauma. They presented, respectively, a transverse and a short oblique femoral fracture, with thickening of the lateral cortex. They underwent surgical treatment obtaining good functional and imaging result.Discussion: These cases fulfill the established criteria for atypical femoral fracture, thereby illustrating a serious adverse event of long-term treatment with bisphosphonates. Such relationship has still not been clearly established by scientific evidence. However, its effectiveness in preventing osteoporotic fractures is well proven.Conclusion: The atypical femoral fractures are possibly a serious adverse effect of the long-term treatment with bisphosphonates. Scientific evidence still supports its use, however, the physician must be aware of these events and closely follow-up these patients.
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spelling Atypical Femoral Fractures Associated with Long-Term Treatment with BisphosphonatesFraturas Atípicas do Fémur Associadas a Terapêutica Prolongada com BisfosfonatosIntroduction: Long-term treatment with bisphosphonates has been associated to atypical femoral fractures whose features are now clearly defined.Clinical Cases: We present two cases of female patients under bisphosphonate treatment for over 10 years who were admitted to our institution for subtrochanteric and femoral shaft fractures after low-energy trauma. They presented, respectively, a transverse and a short oblique femoral fracture, with thickening of the lateral cortex. They underwent surgical treatment obtaining good functional and imaging result.Discussion: These cases fulfill the established criteria for atypical femoral fracture, thereby illustrating a serious adverse event of long-term treatment with bisphosphonates. Such relationship has still not been clearly established by scientific evidence. However, its effectiveness in preventing osteoporotic fractures is well proven.Conclusion: The atypical femoral fractures are possibly a serious adverse effect of the long-term treatment with bisphosphonates. Scientific evidence still supports its use, however, the physician must be aware of these events and closely follow-up these patients.Introdução: A terapêutica prolongada com bisfosfonatos tem sido associada a fraturas atípicas do fémur cujas características estão neste momento definidas.Casos Clínicos: Apresentam-se dois casos clínicos de doentes do género feminino sob terapêutica com bisfosfonatos há mais de 10 anos e que foram admitidas na nossa instituição por fraturas dos fémures resultantes de traumatismos de baixa energia. Estas fraturas localizavam-se na região subtrocantérica e mediodiafisária do fémur apresentando, respectivamente, traço simples transversal e oblíquo curto, com espessamento da cortical externa. Ambas foram submetidas a tratamento cirúrgico com bom resultado clínico e radiológico.Discussão: Os casos apresentados cumprem os critérios aceites para o diagnóstico de fratura atípica do fémur, ilustrando um efeito adverso grave da terapêutica prolongada com bisfosfonatos. A evidência científica ainda não estabeleceu esta associação de forma inequívoca. Por outro lado, a eficácia destes fármacos na prevenção de fraturas osteoporóticas está comprovada.Conclusão: A fratura atípica do fémur pode constituir um efeito adverso grave da terapêutica prolongada com bisfosfonatos. A evidência científica continua a suportar a sua utilização, mas o clínico deverá estar alerta e acompanhar atentamente estes doentes.Ordem dos Médicos2013-12-20info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegimage/jpegimage/jpegimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323oai:ojs.www.actamedicaportuguesa.com:article/4323Acta Médica Portuguesa; Vol. 26 No. 6 (2013): November-December; 746-750Acta Médica Portuguesa; Vol. 26 N.º 6 (2013): Novembro-Dezembro; 746-7501646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323/3818https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323/6941https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323/6942https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323/6943https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/4323/7065Flores Santos, FranciscoPinheiro da Silva, JoséFelicíssimo, Pauloinfo:eu-repo/semantics/openAccess2022-12-20T11:03:34Zoai:ojs.www.actamedicaportuguesa.com:article/4323Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:18:50.146779Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
Fraturas Atípicas do Fémur Associadas a Terapêutica Prolongada com Bisfosfonatos
title Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
spellingShingle Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
Flores Santos, Francisco
title_short Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
title_full Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
title_fullStr Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
title_full_unstemmed Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
title_sort Atypical Femoral Fractures Associated with Long-Term Treatment with Bisphosphonates
author Flores Santos, Francisco
author_facet Flores Santos, Francisco
Pinheiro da Silva, José
Felicíssimo, Paulo
author_role author
author2 Pinheiro da Silva, José
Felicíssimo, Paulo
author2_role author
author
dc.contributor.author.fl_str_mv Flores Santos, Francisco
Pinheiro da Silva, José
Felicíssimo, Paulo
description Introduction: Long-term treatment with bisphosphonates has been associated to atypical femoral fractures whose features are now clearly defined.Clinical Cases: We present two cases of female patients under bisphosphonate treatment for over 10 years who were admitted to our institution for subtrochanteric and femoral shaft fractures after low-energy trauma. They presented, respectively, a transverse and a short oblique femoral fracture, with thickening of the lateral cortex. They underwent surgical treatment obtaining good functional and imaging result.Discussion: These cases fulfill the established criteria for atypical femoral fracture, thereby illustrating a serious adverse event of long-term treatment with bisphosphonates. Such relationship has still not been clearly established by scientific evidence. However, its effectiveness in preventing osteoporotic fractures is well proven.Conclusion: The atypical femoral fractures are possibly a serious adverse effect of the long-term treatment with bisphosphonates. Scientific evidence still supports its use, however, the physician must be aware of these events and closely follow-up these patients.
publishDate 2013
dc.date.none.fl_str_mv 2013-12-20
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 26 No. 6 (2013): November-December; 746-750
Acta Médica Portuguesa; Vol. 26 N.º 6 (2013): Novembro-Dezembro; 746-750
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