Management of atypical femoral fracture: a scoping review and comprehensive algorithm

BMC Musculoskeletal Disorders

Research Article

Giuseppe Toro¹  Giovanni Iolascon¹  Antimo Moretti¹  Guillermo Martínez-Díaz Guerra²  Cristina Ojeda-Thies³  Pedro Caba-Doussoux³  Giampiero Calabrò⁴  Gabriella Toro⁵ 

[1] Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Via De Crecchio, 4, 80138, Naples, Italy;Metabolic Bone Disease Unit, Department of Endocrinology, Hospital Universitario 12 de Octubre, Madrid, Spain;Trauma Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario 12 de Octubre, Madrid, Spain;Unit of Orthopaedics and Traumatology, Villa Malta Hospital, Sarno, Italy;Unit of Radiology, Santa Maria della Speranza Hospital, Battipaglia, Italy;

关键词: Teriparatide;    Denosumab;    Strontium Ranelate;    Antiresorptive Therapy;    Atypical Femoral Fracture;   

DOI  :  10.1186/s12891-016-1086-8

 received in 2016-02-02, accepted in 2016-05-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAtypical femoral fractures (AFF) are a rare type of femoral stress fracture recently described, potentially associated with prolonged bisphosphonate therapy. Evidence-based recommendations regarding diagnosis and management of these fractures are scarce. The purpose of this study is to propose an algorithm for the diagnosis and management of AFF.MethodsWe performed a PubMed search of the last ten years using the keywords “atypical femoral fractures” and identified further articles through an evaluation of the publications cited in these articles. Relevant studies were included by agreement between researchers, depending on their specialization. Pertinent points of debate were discussed based on the available literature, allowing for consensus regarding the proposed management algorithm.ResultsUsing a systematic approach we performed a scoping review that included a total of 137 articles.ConclusionsA practical guide for diagnosis and management of AFF based on the current concepts is proposed. In spite of the impressive large volume of published literature available since AFF were initially identified, the level of evidence is mostly poor, in particular regarding treatment choice. Therefore, further studies are required.

【 授权许可】

CC BY   
© Toro et al. 2016