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Differences in subtrochanteric and diaphyseal atypical femoral fractures in a super-aging prefectural area: YamaCAFe Study.
Takakubo, Yuya; Miyaji, Takahiro; Ohta, Daichi; Ito, Juji; Oki, Hiroharu; Momma, Ryosuke; Naganuma, Yasushi; Honma, Ryusuke; Akabane, Takeru; Uno, Tomohiro; Sasaki, Akiko; Suran, Yang; Dairaku, Katsuyuki; Goto, Shinichi; Goto, Yasuo; Kanauchi, Yumiko; Kobayashi, Shinji; Nakajima, Taku; Matsuda, Michiharu; Masuda, Keiji; Mura, Nariyuki; Takenouchi, Kenji; Tsuchida, Hiroyuki; Onuma, Yasushi; Shibuya, Junichirou; Nagase, Takaaki; Yamaguchi, Osamu; Urayama, Yasuhiro; Furukawa, Takashi; Okuda, Shouta; Huang, Hanqing; Noro, Atsushi; Ogura, Ken; Nakamura, Takeshi; Sasaki, Kan; Ishi, Masaji; Takagi, Michiaki.
Afiliación
  • Takakubo Y; Faculty of Orthopaedic Surgery & Rehabilitation, Yamagata University, Yamagata, Japan. takakubo-y@med.id.yamagata-u.ac.jp.
  • Miyaji T; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Ohta D; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Ito J; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Oki H; Faculty of Orthopaedic surgery, Yamagata Saisei Hospital, Yamagata, Japan.
  • Momma R; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Naganuma Y; Faculty of Orthopaedic surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
  • Honma R; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Akabane T; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Uno T; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Sasaki A; Faculty of Orthopaedic surgery, Yamagata Saisei Hospital, Yamagata, Japan.
  • Suran Y; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Dairaku K; Faculty of Orthopaedic surgery, Okitama Public General Hospital, Yamagata, Japan.
  • Goto S; Faculty of Orthopaedic surgery, Tsuruoka Municipal Shonai Hospital, Yamagata, Japan.
  • Goto Y; Faculty of Orthopaedic surgery, Sagae City Hospital, Yamagata, Japan.
  • Kanauchi Y; Faculty of Orthopaedic surgery, Yamagata Prefectural Kahoku Hospital, Yamagata, Japan.
  • Kobayashi S; Faculty of Orthopaedic surgery, Shiseido General Hospital, Yamagata, Japan.
  • Nakajima T; Faculty of Orthopaedic surgery, Sanyudo Hospital, Yamagata, Japan.
  • Matsuda M; Faculty of Orthopaedic surgery, Tohoku Central Hospital, Yamagata, Japan.
  • Masuda K; Faculty of Orthopaedic surgery, Yamagata City Hospital, Yamagata, Japan.
  • Mura N; Faculty of Orthopaedic surgery, Yoshioka Hospital, Yamagata, Japan.
  • Takenouchi K; Faculty of Orthopaedic surgery, Kitamurayama Hospital, Yamagata, Japan.
  • Tsuchida H; Faculty of Orthopaedic surgery, Miyuki social medical corporation, Miyukikai Hospital, Yamagata, Japan.
  • Onuma Y; Faculty of Orthopaedic surgery, Yamagata Tokusyukai Hospital, Yamagata, Japan.
  • Shibuya J; Faculty of Orthopaedic surgery, Yamagata Prefectural Shinjo Hospital, Yamagata, Japan.
  • Nagase T; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Yamaguchi O; Faculty of Orthopaedic surgery, Sinoda General Hospital, Yamagata, Japan.
  • Urayama Y; Faculty of Orthopaedic surgery, Mamurogawa Town Hospital, Yamagata, Japan.
  • Furukawa T; Faculty of Orthopaedic surgery, Yoshioka Hospital, Yamagata, Japan.
  • Okuda S; Faculty of Orthopaedic surgery, Nihonkai General Hospital, Yamagata, Japan.
  • Huang H; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
  • Noro A; Faculty of Orthopaedic surgery, Yamagata City Hospital, Yamagata, Japan.
  • Ogura K; Faculty of Orthopaedic surgery, Yonezawa City Hospital & Ogura Orthopaedic Clinic, Yamagata & Sendai, Japan.
  • Nakamura T; Faculty of Orthopaedic surgery, Funayama Hospital, Yamagata, Japan.
  • Sasaki K; Faculty of Orthopaedic surgery, Yamagata Saisei Hospital, Yamagata, Japan.
  • Ishi M; Faculty of Orthopaedic surgery, Yamagata Saisei Hospital, Yamagata, Japan.
  • Takagi M; Faculty of Orthopaedic surgery, Yamagata University, Yamagata, Japan.
J Bone Miner Metab ; 39(4): 700-711, 2021 Jul.
Article en En | MEDLINE | ID: mdl-33821304
INTRODUCTION: Atypical femoral fractures (AFFs) have been correlated with long-term use of bisphosphonates (BPs), glucocorticoids (GCs), and femoral geometry. We investigated the incidence and characteristics of subtrochanteric (ST) and diaphyseal (DP) AFFs in all institutes in a super-aging prefectural area. MATERIALS AND METHODS: We performed a blinded analysis of radiographic data in 87 patients with 98 AFFs in all institutes in Yamagata prefectural area from 2009 to 2014. Among the 98 AFFs, 57 AFFs comprising 11 ST fractures in 9 patients and 46 DP fractures in 41 patients with adequate medical records and X-rays were surveyed for time to bone healing and geometry. RESULTS: Of the 87 patients, 67 received BPs/denosumab (77%) and 10 received GCs (11%). Surgery was performed in 94 AFFs. Among 4 AFFs with conservative therapy, 3 required additional surgery. In univariate regression analyses for ST group versus DP group, male-to-female ratio was 2/7 versus 1/40, mean age at fracture was 58.2 (37-75) versus 78 (60-89) years, rheumatic diseases affected 55.5% (5/9) versus 4.9% (2/41), femoral lateral bowing angle was 1.7 (0-6) versus 11.8 (0.8-24)°, GC usage was 67% (6/9) versus 4.9% (2/41), and bone healing time was 12.1 (6-20) versus 8.1 (3-38) months (p < 0.05). In multivariate analyses, higher male-to-female ratio, younger age, greater proportion affected by rheumatic diseases, and higher GC usage remained significant (p < 0.05). CONCLUSIONS: The incidence of AFFs in our prefectural area was 1.43 cases/100,000 persons/year. This study suggests that the onset of ST AFFs have greater correlation with the worse bone quality, vice versa, the onset of DP AFFs correlated with the bone geometry. The developmental mechanisms of AFFs may differ significantly between ST and DP fractures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Envejecimiento / Diáfisis / Fracturas del Fémur / Fracturas de Cadera Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Bone Miner Metab Asunto de la revista: METABOLISMO Año: 2021 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Envejecimiento / Diáfisis / Fracturas del Fémur / Fracturas de Cadera Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Bone Miner Metab Asunto de la revista: METABOLISMO Año: 2021 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón