Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=30035084
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\30035084
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Orthop+Translat
2016 ; 7
(ä): 7-22
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Atypical femoral fractures and current management
#MMPMID30035084
Zheng N
; Tang N
; Qin L
J Orthop Translat
2016[Oct]; 7
(ä): 7-22
PMID30035084
show ga
With the rapid increase in patients receiving bisphosphonates (BPs) for treating
osteoporosis, one of the clinical complications associated with its long-term use
is atypical femoral fractures (AFFs). Although the absolute risk for AFFs is low
and it was a consensus that AFFs were acceptable compared with the amount of
osteoporotic fractures BPs have prevented, epidemiological studies have proved
that BPs had a strong association with AFFs and possibly more people were going
to suffer from this adverse effect with wide prescriptions of this drug. In
addition, AFFs seemed to have impaired ability to heal. Thus, to understand the
mechanism(s) behind AFFs is important and desirable for considering preventive
measures. This article reviewed the clinical features of AFFs as well as
potential underlining pathological characteristics, such as the decreased
turnover rate caused by BPs that led to multiple-level alternations, e.g.,
changes not only at cellular and tissue levels, but also related to changes in
bone micro- and macrostructure and organic/inorganic contents, leading to
potentially compromised mechanical properties of cortical bone when exposed to
prolonged BP therapy. Severely suppressed bone turnover may also be the
underlying mechanism for impaired fracture healing in patients with AFFs. The
rising concerns about the risk for AFFs in nonosteoporotic patients receiving
high-dose BPs to treat cancers were also discussed. Detailed investigation will
help develop potential targeted pharmacological treatments such as parathyroid
hormone. In addition, potential innovative internal fixation implants were
discussed with regard to dynamic and biological fixation for enhancing AFF
repair.
free
free
free
