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Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research

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Harvard

Shane, E, Burr, D, Ebeling, PR, Abrahamsen, B, Adler, RA, Brown, TD, Cheung, AM, Cosman, F, Curtis, JR, Dell, R, Dempster, D, Einhorn, TA, Genant, HK, Geusens, P, Klaushofer, K, Koval, K, Lane, JM, McKiernan, F, McKinney, R, Ng, A, Nieves, J, O'Keefe, R, Papapoulos, S, Sen, HT, van der Meulen, MCH, Weinstein, RS, Whyte, M & American Society for Bone and Mineral Research 2010, 'Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research' Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, vol. 25, no. 11, pp. 2267-94. https://doi.org/10.1002/jbmr.253

APA

CBE

Shane E, Burr D, Ebeling PR, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster D, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Koval K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O'Keefe R, Papapoulos S, Sen HT, van der Meulen MCH, Weinstein RS, Whyte M, American Society for Bone and Mineral Research. 2010. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 25(11):2267-94. https://doi.org/10.1002/jbmr.253

MLA

Vancouver

Author

Shane, Elizabeth ; Burr, David ; Ebeling, Peter R ; Abrahamsen, Bo ; Adler, Robert A ; Brown, Thomas D ; Cheung, Angela M ; Cosman, Felicia ; Curtis, Jeffrey R ; Dell, Richard ; Dempster, David ; Einhorn, Thomas A ; Genant, Harry K ; Geusens, Piet ; Klaushofer, Klaus ; Koval, Kenneth ; Lane, Joseph M ; McKiernan, Fergus ; McKinney, Ross ; Ng, Alvin ; Nieves, Jeri ; O'Keefe, Regis ; Papapoulos, Socrates ; Sen, Howe Tet ; van der Meulen, Marjolein C H ; Weinstein, Robert S ; Whyte, Michael ; American Society for Bone and Mineral Research. / Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. In: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 2010 ; Vol. 25, No. 11. pp. 2267-94.

Bibtex

@article{44364d3cb2bb4e388b717ea8056a9bf6,
title = "Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research",
abstract = "Reports linking long-term use of bisphosphonates (BPs) with atypical fractures of the femur led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address key questions related to this problem. A multidisciplinary expert group reviewed pertinent published reports concerning atypical femur fractures, as well as preclinical studies that could provide insight into their pathogenesis. A case definition was developed so that subsequent studies report on the same condition. The task force defined major and minor features of complete and incomplete atypical femoral fractures and recommends that all major features, including their location in the subtrochanteric region and femoral shaft, transverse or short oblique orientation, minimal or no associated trauma, a medial spike when the fracture is complete, and absence of comminution, be present to designate a femoral fracture as atypical. Minor features include their association with cortical thickening, a periosteal reaction of the lateral cortex, prodromal pain, bilaterality, delayed healing, comorbid conditions, and concomitant drug exposures, including BPs, other antiresorptive agents, glucocorticoids, and proton pump inhibitors. Preclinical data evaluating the effects of BPs on collagen cross-linking and maturation, accumulation of microdamage and advanced glycation end products, mineralization, remodeling, vascularity, and angiogenesis lend biologic plausibility to a potential association with long-term BP use. Based on published and unpublished data and the widespread use of BPs, the incidence of atypical femoral fractures associated with BP therapy for osteoporosis appears to be very low, particularly compared with the number of vertebral, hip, and other fractures that are prevented by BPs. Moreover, a causal association between BPs and atypical fractures has not been established. However, recent observations suggest that the risk rises with increasing duration of exposure, and there is concern that lack of awareness and underreporting may mask the true incidence of the problem. Given the relative rarity of atypical femoral fractures, the task force recommends that specific diagnostic and procedural codes be created and that an international registry be established to facilitate studies of the clinical and genetic risk factors and optimal surgical and medical management of these fractures. Physicians and patients should be made aware of the possibility of atypical femoral fractures and of the potential for bilaterality through a change in labeling of BPs. Research directions should include development of animal models, increased surveillance, and additional epidemiologic and clinical data to establish the true incidence of and risk factors for this condition and to inform orthopedic and medical management.",
author = "Elizabeth Shane and David Burr and Ebeling, {Peter R} and Bo Abrahamsen and Adler, {Robert A} and Brown, {Thomas D} and Cheung, {Angela M} and Felicia Cosman and Curtis, {Jeffrey R} and Richard Dell and David Dempster and Einhorn, {Thomas A} and Genant, {Harry K} and Piet Geusens and Klaus Klaushofer and Kenneth Koval and Lane, {Joseph M} and Fergus McKiernan and Ross McKinney and Alvin Ng and Jeri Nieves and Regis O'Keefe and Socrates Papapoulos and Sen, {Howe Tet} and {van der Meulen}, {Marjolein C H} and Weinstein, {Robert S} and Michael Whyte and {American Society for Bone and Mineral Research}",
note = "{\circledC} 2010 American Society for Bone and Mineral Research.",
year = "2010",
month = "11",
day = "1",
doi = "10.1002/jbmr.253",
language = "English",
volume = "25",
pages = "2267--94",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "American Society for Bone and Mineral Research",
number = "11",

}

RIS

TY - JOUR

T1 - Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research

AU - Shane, Elizabeth

AU - Burr, David

AU - Ebeling, Peter R

AU - Abrahamsen, Bo

AU - Adler, Robert A

AU - Brown, Thomas D

AU - Cheung, Angela M

AU - Cosman, Felicia

AU - Curtis, Jeffrey R

AU - Dell, Richard

AU - Dempster, David

AU - Einhorn, Thomas A

AU - Genant, Harry K

AU - Geusens, Piet

AU - Klaushofer, Klaus

AU - Koval, Kenneth

AU - Lane, Joseph M

AU - McKiernan, Fergus

AU - McKinney, Ross

AU - Ng, Alvin

AU - Nieves, Jeri

AU - O'Keefe, Regis

AU - Papapoulos, Socrates

AU - Sen, Howe Tet

AU - van der Meulen, Marjolein C H

AU - Weinstein, Robert S

AU - Whyte, Michael

AU - American Society for Bone and Mineral Research

N1 - © 2010 American Society for Bone and Mineral Research.

PY - 2010/11/1

Y1 - 2010/11/1

N2 - Reports linking long-term use of bisphosphonates (BPs) with atypical fractures of the femur led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address key questions related to this problem. A multidisciplinary expert group reviewed pertinent published reports concerning atypical femur fractures, as well as preclinical studies that could provide insight into their pathogenesis. A case definition was developed so that subsequent studies report on the same condition. The task force defined major and minor features of complete and incomplete atypical femoral fractures and recommends that all major features, including their location in the subtrochanteric region and femoral shaft, transverse or short oblique orientation, minimal or no associated trauma, a medial spike when the fracture is complete, and absence of comminution, be present to designate a femoral fracture as atypical. Minor features include their association with cortical thickening, a periosteal reaction of the lateral cortex, prodromal pain, bilaterality, delayed healing, comorbid conditions, and concomitant drug exposures, including BPs, other antiresorptive agents, glucocorticoids, and proton pump inhibitors. Preclinical data evaluating the effects of BPs on collagen cross-linking and maturation, accumulation of microdamage and advanced glycation end products, mineralization, remodeling, vascularity, and angiogenesis lend biologic plausibility to a potential association with long-term BP use. Based on published and unpublished data and the widespread use of BPs, the incidence of atypical femoral fractures associated with BP therapy for osteoporosis appears to be very low, particularly compared with the number of vertebral, hip, and other fractures that are prevented by BPs. Moreover, a causal association between BPs and atypical fractures has not been established. However, recent observations suggest that the risk rises with increasing duration of exposure, and there is concern that lack of awareness and underreporting may mask the true incidence of the problem. Given the relative rarity of atypical femoral fractures, the task force recommends that specific diagnostic and procedural codes be created and that an international registry be established to facilitate studies of the clinical and genetic risk factors and optimal surgical and medical management of these fractures. Physicians and patients should be made aware of the possibility of atypical femoral fractures and of the potential for bilaterality through a change in labeling of BPs. Research directions should include development of animal models, increased surveillance, and additional epidemiologic and clinical data to establish the true incidence of and risk factors for this condition and to inform orthopedic and medical management.

AB - Reports linking long-term use of bisphosphonates (BPs) with atypical fractures of the femur led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address key questions related to this problem. A multidisciplinary expert group reviewed pertinent published reports concerning atypical femur fractures, as well as preclinical studies that could provide insight into their pathogenesis. A case definition was developed so that subsequent studies report on the same condition. The task force defined major and minor features of complete and incomplete atypical femoral fractures and recommends that all major features, including their location in the subtrochanteric region and femoral shaft, transverse or short oblique orientation, minimal or no associated trauma, a medial spike when the fracture is complete, and absence of comminution, be present to designate a femoral fracture as atypical. Minor features include their association with cortical thickening, a periosteal reaction of the lateral cortex, prodromal pain, bilaterality, delayed healing, comorbid conditions, and concomitant drug exposures, including BPs, other antiresorptive agents, glucocorticoids, and proton pump inhibitors. Preclinical data evaluating the effects of BPs on collagen cross-linking and maturation, accumulation of microdamage and advanced glycation end products, mineralization, remodeling, vascularity, and angiogenesis lend biologic plausibility to a potential association with long-term BP use. Based on published and unpublished data and the widespread use of BPs, the incidence of atypical femoral fractures associated with BP therapy for osteoporosis appears to be very low, particularly compared with the number of vertebral, hip, and other fractures that are prevented by BPs. Moreover, a causal association between BPs and atypical fractures has not been established. However, recent observations suggest that the risk rises with increasing duration of exposure, and there is concern that lack of awareness and underreporting may mask the true incidence of the problem. Given the relative rarity of atypical femoral fractures, the task force recommends that specific diagnostic and procedural codes be created and that an international registry be established to facilitate studies of the clinical and genetic risk factors and optimal surgical and medical management of these fractures. Physicians and patients should be made aware of the possibility of atypical femoral fractures and of the potential for bilaterality through a change in labeling of BPs. Research directions should include development of animal models, increased surveillance, and additional epidemiologic and clinical data to establish the true incidence of and risk factors for this condition and to inform orthopedic and medical management.

U2 - 10.1002/jbmr.253

DO - 10.1002/jbmr.253

M3 - Journal article

VL - 25

SP - 2267

EP - 2294

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 11

ER -

ID: 32188089