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Abstract
Introduction: Bisphosphonates have evolved as the basis for the treatment of osteoporosis, reducing the incidence of fractures. Recently, several publications have described the occurrence of atypical low-energy femur fractures associated with the use of bisphosphonates. The aim of this study was to assess the average healing time for atypical femur fractures associated with bisphosphonate treatment compared to a control group.
Materials and methods: We retrospectively evaluated 34 women (mean age 74 years) with atypical fractures; 16 of them had received bisphosphonates for at least five years. They were treated between 2006 and 2017 and stabilized with a cephalomedullary nail. This group was compared to a control group with similar characteristics.
Results: Twenty-two had subtrochanteric fractures and 12 had diaphyseal fractures. 14% of those who took bisphosphonates and underwent surgery needed a review compared to 5.5% of the control group. The mean consolidation time was longer in those treated with bisphosphonates (8.5 vs. 6 months), with a statistically significant difference (p <0.001).
Conclusions: The benefit of treatment with bisphosphonates in preventing fractures is greater than the risk of atypical fractures; however, it is important to assess the risk-benefit ratio of each patient at the beginning and during treatment, remembering that, despite this, the healing time is longer.
References
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Copyright (c) 2020 Cassio Mendes Cunha , Elzebio Marques Bandeira, Maria Claudia Maia Juares
