Surgical outcome of intramedullary nailing in patients with complete atypical femoral fracture: A multicenter retrospective study |
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| Institution: | 1. Department of Orthopaedic Surgery, Keimyung University Dongsan Medical Center, Daegu, South Korea;2. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea;3. Department of Orthopaedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea;4. Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea;5. Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea;6. Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju, South Korea;7. Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan, South Korea;1. Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands;2. Haaglanden Medical Center, Department of Trauma Surgery, The Netherlands;3. Department of Medical Decision Making/Quality of Care Institute, Leiden University Medical Center, Leiden, The Netherlands;1. Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel;2. Department of Orthopedic Surgery, Bone and Joint Reconstruction Research Center, Shafa Hospital, IUMS, Tehran, Iran;3. Department of Pharmacology, University of Toronto, Toronto, ON, Canada;4. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran;5. Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran;6. Department of Orthopaedics, NYU Langone Medical Center''s Hospital for Joint Diseases, White Plains, New York;7. Division of Orthopedic Surgery, Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada;1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China;2. Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China;1. Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China;2. Hebei Medical University, Shijiazhuang, Hebei, 050051, China;1. Department of Surgery, Division of Trauma, Critical Care, and General Surgery, Mayo Clinic, Rochester, MN, United States;2. Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States;3. Office of Translation to Practice, Mayo Clinic, Rochester, MN, United States;4. Mayo Medical School, Mayo Clinic, Rochester, MN, United States;5. Department of Surgery, University of Minnesota, Minneapolis, MN, United States |
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| Abstract: | BackgroundManagement of atypical femoral fracture on bisphosphonate therapy still remains controversy and is reported high rate of complications. The aim of this study was to evaluate the outcome of intramedullary nailing in patients with atypical femoral fracture who took bisphosphonate more than one year through the multicenter retrospective study.MethodsWe gathered 75 atypical femoral fractures from seven institutions between 2009 and 2014. Among them 46 atypical femoral fractures which met the inclusion criteria was evaluated in this study. The average age was 70.1 years (53–80) and the average duration of bisphosphonate use was 5.1 years (1–15 years). Medical records and radiographs were reviewed to determine time to union, union rate, need for revision surgery, restoration of ambulatory function, and complications.ResultsTwenty-nine (63%) fractures healed within 6 months without complications. The average time to union except two non-union was 24.9 weeks (11–48 weeks). Two patients (4.3%) underwent revision surgery for non-union and there was no implant failure. Thirty-seven (80.4%) patients achieved their pre-fracture ambulatory function at the final follow up.ConclusionsAlthough the incidence of delayed bone healing is high in atypical femoral fracture on bisphosphonate therapy even treated with intramedullary nailing, the incidence of revision surgery and implant failure was relatively lower than those of extramedullary devices. |
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| Keywords: | Bisphosphonate Atypical femoral fracture Intramedullary nailing Union |
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