Attiq-ur Reman, Abdul Hamid, Karim Bakhsh.
Atypical femur fracture and its association with bisphosphonate therapy in osteoporotic women.
Pak J Med Health Sci Jan ;13(4):1308-10.

Aim : To evaluate the clinical outcome of atypical femoral fractures associated with bisphosphonate therapy in osteoporotic women. Study Design: Retrospective / Observational Place and Duration of Study : Department of Orthopaedics, Bolan Medical College Quetta from 1st January 2017 to 31st December 2018. Methods: A total of 10 patients had been diagnosed with an atypical femoral fracture had been followed for at least 15 months. We also included 10 patients with typical femoral fractures as a control group. The patients who had multiple co-morbidities or diseases which could possibly affect bone union were excluded. All procedures were done on reduction table and under image intensifier with spinal or epidural anesthesia. Results : Patients mean age was 70.5 years (57 to 89) years and the mean union of atypical femor al fractures was 10.1 months (6 to 16 months) and the mean medication was 64 weeks. Out of 10 cases 8 (80%) had subtrochanter fracture type. Revision surgery involving a bone graft was performed due to non-union in 1 out of 10 cases. This difference was statistically significant (p<0.05). The bisphosphonate administration duration was positively correlated with the union period (p<0.05). In contrast, There was no statistically significant correlation between the bisphosphonate administration, duration and the incidence of bilateral atypical fractures (p>0.05). Conclusion: Atypical femoral fractures required more time for union of bone as compared to typical femoral fracture. Bisphosphonate therapy led to a longer period of time required for bone union.

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