AI Article Synopsis
- A 64-year-old woman with a long history of bisphosphonate use experienced a displaced atypical femur fracture due to a fall, requiring surgical intervention.
- The patient underwent a unique surgical technique that involved removing abnormal bone at the fracture site and securing the bone with an intramedullary nail, while also starting teriparatide therapy post-surgery.
- Her recovery was notably quick, achieving full fracture healing in 3.5 months, which is significantly faster than the average healing time for atypical femur fractures reported at 10.7 months.
Article Abstract
Background/objective: Atypical femur fractures (AFFs) caused by long-term bisphosphonate use are associated with high rates of delayed healing and nonunion.
Case Report: A 64-year-old woman with osteopenia on alendronate for 15 years sustained a displaced left AFF following a fall from standing height. Imaging showed an acute displaced transverse diaphyseal left femur fracture with lateral cortical thickening and beaking. She underwent an open reduction and internal fixation with insertion of a cephalomedullary nail placed in compression mode, utilizing a novel technique involving intraoperative removal of the endosteal hypertrophied cortical bone at the fracture site. Alendronate was stopped and teriparatide was initiated postoperatively. Radiographs at 3.5 months postsurgery showed evidence of normal fracture union with mature callus formation.
Discussion: AFFs caused by prolonged bisphosphonate use have a high rate of delayed healing and nonunion due to abnormal bone remodeling. Use of teriparatide postoperatively has been shown to reduce healing time in small observational studies in surgically treated patients. Our case demonstrates an expedited healing time of 3.5 months using teriparatide combined with a novel surgical technique involving removal of a portion of the abnormally remodeled bone and placement of an intramedullary nail in compression mode.
Conclusion: Our case demonstrates an expedited healing time of 3.5 months compared to the average reported healing time for AFF of 10.7 months, supporting the use of the combination of teriparatide and a novel surgical technique.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447537 | PMC |
| http://dx.doi.org/10.1016/j.aace.2024.05.001 | DOI Listing |
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