Prasarn ML. Clin Orthop Relat Res. 2012; doi:10.1007/s11999-012-2412-6.
Patients with bisphosphonates-associated femoral shaft fractures have more complications compared with patients not treated with bisphosphonates, despite low rates of other risk factors and ample use of biologic adjuvants, according to recent study results.
From 2002 to 2008, researchers identified 43 patients with bisphosphonates-associated femoral shaft fractures and 20 patients with similar fractures but not treated with bisphosphonates. Both groups received similar implants, however, patients in the bisphosphonates cohort received a greater number of adjuvants. Preoperative osteoporosis and radiographic findings of the characteristic bisphosphonates femur fracture were recorded by researchers, as well as any early complications.
Preoperatively, 24% of patients treated with bisphosphonates had confirmed osteoporosis and a greater mean cortex to shaft diameter ratio vs. 5% and 15% of the patients not treated with bisphosphonates. Forty-eight percent of the bisphosphonates cohort had proximal fracture location. Similarly, proximal fracture location was found in 40% of the control group. Researchers found 21% of the bisphosphonates cohort had intraoperative fractures and 30% had postoperative plate failures.
“The increasing size of the aging population portends a growing pool of patients receiving bisphosphonates — for longer times — and therefore, increasing numbers of these types of fractures,” the researchers wrote. “Health care providers at all levels need to recognize this association, and additional study is needed to help improve treatment for this emerging problem.”