Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing
We report 2 cases of atypical femoral fracture displacement despite treatment with intramedullary (IM) nailing. Both patients had received more than 3 years of bisphosphonates. One patient had prophylactic fixation of an atypical femur fracture due to intractable pain. The other had undergone nailin...
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Online Access: | https://doi.org/10.1177/2151458514522058 |
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doaj-8835725988c54042a8c291c1e0f65abd2020-11-25T03:46:27ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45852151-45932014-03-01510.1177/2151458514522058Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral NailingChristian Fang FRCSEd0Jackie Yee-Man Chau LMCHK1Siu-Bon Woo FRCSEd2Tak-Wing Lau FRCSEd3Kenny Kwan FRCSEd4Frankie Leung FRCSEd5 Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong, China Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong, China Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen, ChinaWe report 2 cases of atypical femoral fracture displacement despite treatment with intramedullary (IM) nailing. Both patients had received more than 3 years of bisphosphonates. One patient had prophylactic fixation of an atypical femur fracture due to intractable pain. The other had undergone nailing previously for a traumatic shaft fracture. The patient then received bisphosphonate later and sustained an atypical fracture with the nail in place. Both femoral nails were slotted, cannulated stainless steel piriformis entry designs. These 2 cases are among the first reported failures of IM fixation in preventing displacement of a bisphosphonate stress fracture. We advice caution when using slotted nails in prophylaxis of atypical femur fractures because of its significantly reduced torsional stiffness compared to modern nonopen sectioned nails.https://doi.org/10.1177/2151458514522058 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Christian Fang FRCSEd Jackie Yee-Man Chau LMCHK Siu-Bon Woo FRCSEd Tak-Wing Lau FRCSEd Kenny Kwan FRCSEd Frankie Leung FRCSEd |
spellingShingle |
Christian Fang FRCSEd Jackie Yee-Man Chau LMCHK Siu-Bon Woo FRCSEd Tak-Wing Lau FRCSEd Kenny Kwan FRCSEd Frankie Leung FRCSEd Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing Geriatric Orthopaedic Surgery & Rehabilitation |
author_facet |
Christian Fang FRCSEd Jackie Yee-Man Chau LMCHK Siu-Bon Woo FRCSEd Tak-Wing Lau FRCSEd Kenny Kwan FRCSEd Frankie Leung FRCSEd |
author_sort |
Christian Fang FRCSEd |
title |
Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing |
title_short |
Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing |
title_full |
Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing |
title_fullStr |
Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing |
title_full_unstemmed |
Propagation of Bisphosphonate-Related Femoral Stress Fractures Despite Femoral Nailing |
title_sort |
propagation of bisphosphonate-related femoral stress fractures despite femoral nailing |
publisher |
SAGE Publishing |
series |
Geriatric Orthopaedic Surgery & Rehabilitation |
issn |
2151-4585 2151-4593 |
publishDate |
2014-03-01 |
description |
We report 2 cases of atypical femoral fracture displacement despite treatment with intramedullary (IM) nailing. Both patients had received more than 3 years of bisphosphonates. One patient had prophylactic fixation of an atypical femur fracture due to intractable pain. The other had undergone nailing previously for a traumatic shaft fracture. The patient then received bisphosphonate later and sustained an atypical fracture with the nail in place. Both femoral nails were slotted, cannulated stainless steel piriformis entry designs. These 2 cases are among the first reported failures of IM fixation in preventing displacement of a bisphosphonate stress fracture. We advice caution when using slotted nails in prophylaxis of atypical femur fractures because of its significantly reduced torsional stiffness compared to modern nonopen sectioned nails. |
url |
https://doi.org/10.1177/2151458514522058 |
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