Introduction: Long-term bisphosphonate (BP) administration may cause an atypical femoral fracture that is occasionally bilateral. We encountered a case of an impending atypical femoral fracture on the contralateral side that progressed to a complete fracture early after surgery for an atypical femoral fracture.
Case Report: An 83-year-old woman who had received long-term BP therapy developed a right femoral atypical incomplete fracture that progressed to a complete fracture 5 days after surgery for an atypical complete left femoral fracture.
Conclusion: The findings from this case suggest that when an atypical femoral fracture occurs in patients receiving long-term BP therapy, the possibility of an impending atypical femoral fracture on the contralateral side should be considered, and radiographs or CT images should be obtained for both legs. To prevent long-term bed rest in older adults, one- or two-stage bilateral surgery should be considered when imaging reveals bilateral atypical femoral fractures.
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http://dx.doi.org/10.13107/jocr.2024.v14.i06.4530 | DOI Listing |
Acta Radiol
January 2025
Department of Orthopedics and Experimental and Clinical Medicine, Faculty of Health Science, Linköping University, Linköping, Sweden.
Background: Bisphosphonate-associated stress fractures, atypical femur fractures (AFF), are a rare subgroup of femoral stress fractures. Their correct and early diagnosis is imperative for appropriate treatment.
Purpose: To investigate the sensitivity of written radiology reports to mention radiographic features of AFF, depending on the time period and academic level of the hospital.
J Surg Case Rep
January 2025
Department of Orthopedic Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
Atypical femoral fractures (AFF) are rare stress fractures with specific diagnostic criteria, as outlined in a report published by the American Society for Bone and Mineral Research. These criteria are categorized into major and minor features, and AFF can be classified as either complete or incomplete. Bisphosphonates have been shown to increase the risk of AFF, and most cases of AFF are associated with bisphosphonate use.
View Article and Find Full Text PDFFront Surg
January 2025
Department of Orthopedics, Dokuz Eylul University, Izmir, Türkiye.
Ureteral papillary carcinoma is a rare subtype of urothelial carcinoma, ranking fourth among cancers following prostate (or breast) cancer, lung cancer, and colorectal cancer. Although previous studies have documented bone metastases mainly in the pelvis, spine, ribs, and femur, this case report presents the first recorded instance of metastasis occurring in the acromioclavicular joint. A 62-year-old woman with a history of left flank pain and macroscopic hematuria underwent a left nephroureterectomy, which revealed ureteral papillary carcinoma.
View Article and Find Full Text PDFCase Rep Oncol Med
January 2025
Orthopaedic Surgery Department, University of Missouri, Columbia, Missouri, USA.
Atypical femoral fractures (AFFs) are rare fractures usually associated with medications that can ultimately alter bone metabolism. Imatinib, a drug prescribed for treatment of chronic myeloid leukemia (CML), has been associated with altered bone homeostasis, however, with unknown clinical significance. Here, we present the case of a 17-year-old female, with a diagnosis of CML undergoing chronic imatinib therapy, who developed an AFF treated successfully with prophylactic fixation with intramedullary nailing.
View Article and Find Full Text PDFJ Soc Cardiovasc Angiogr Interv
December 2024
Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, San Diego, California.
Background: A minimum threshold activated clotting time (ACT) to guide heparin dosing during percutaneous coronary intervention (PCI) is associated with lower ischemic complications. However, data are variable regarding the risk of high ACT levels. The aim of this study was to assess the impact of peak procedural ACT on complications and mortality for transfemoral and transradial access PCI.
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