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Of the drugs developed to prevent and treat osteoporosis, bisphosphonate has played a very important role in preventing osteoporotic fractures. However, case reports describing atypical femoral fractures in patients using long-term bisphosphonates have emerged. The majority of atypical femur fractures occurs in the lateral aspect of the subtrochanteric or femur diaphysis, which is explained by accumulation of tensile stress in these areas. Although the superior cortex of the femur neck withstands maximum tensile stress, to our knowledge, there have been only two reports (three cases) of atypical femoral neck fracture. In addition, none of those case reports revealed detailed pathology related to suppressed bone turnover rate. We encountered an incomplete femoral neck fracture and diagnosed it as “atypical” on the basis of the patient’s lack of trauma and medication history and pathological findings. For patients with groin pain, minimal or no trauma, and a history of long-term bisphosphonate use, an atypical femoral neck fracture should be considered.

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Current status of cytopathology practices in Korea : annual report on the Continuous Quality Improvement program of the Korean Society for Cytopathology for 2018 Yosep Chong, Haeyoen Jung, Jung-Soo Pyo, Soon Won Hong, Hoon Kyu Oh p. 318-331, [1]

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Pediatric granular cell tumor in the posterior wall of the larynx extending to the trachea Jungsuk Ahn, Na Rae Kim, Yong Han Sun p. 336-339

Atypical femoral neck fracture after prolonged bisphosphonate therapy Kwang-kyoun Kim, Young-wook Park, Tae-hyeong Kim, Kyung-deok Seo p. 346-350

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참고문헌 (20건) : 자료제공( 네이버학술정보 )

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번호 참고문헌 국회도서관 소장유무
1 Shane E, Burr D, Ebeling PR, et al. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2010; 25:2267-94. 미소장
2 Koh JS, Goh SK, Png MA, Ng AC, Howe TS. Distribution of atypical fractures and cortical stress lesions in the femur: implications on pathophysiology. Singapore Med J 2011; 52: 77-80. 미소장
3 Koch JC. The laws of bone architecture. Am J Anat 1917; 21: 177-298. 미소장
4 Kim DH, Lee EC, Kang SK. Insufficiency fracture of ipsilateral femur neck in patient treated with long term bisphosphonate treatment:a case report. J Bone Metab 2012; 19: 159-62. 미소장
5 Khan SK, Savaridas T, Hemers JS, Maarouf Z, Orgee JM, Orr MM. Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant? Clin Cases Miner Bone Metab 2016; 13: 38-41. 미소장
6 Schilcher J, Sandberg O, Isaksson H, Aspenberg P. Histology of 8atypical femoral fractures: remodeling but no healing. Acta Orthop 2014; 85: 280-6. 미소장
7 Kajino Y, Kabata T, Watanabe K, Tsuchiya H. Histological finding of atypical subtrochanteric fracture after long-term alendronate therapy. J Orthop Sci 2012; 17: 313-8. 미소장
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9 Whyte MP, Wenkert D, Clements KL, McAlister WH, Mumm S. Bisphosphonate-induced osteopetrosis. N Engl J Med 2003; 349:457-63. 미소장
10 Jain N, Weinstein RS. Giant osteoclasts after long-term bisphosphonate therapy: diagnostic challenges. Nat Rev Rheumatol 2009;5: 341-6. 미소장
11 Lorget F, Kamel S, Mentaverri R, et al. High extracellular calcium concentrations directly stimulate osteoclast apoptosis. Biochem Biophys Res Commun 2000; 268: 899-903. 미소장
12 Nielsen RH, Karsdal MA, Sorensen MG, Dziegiel MH, Henriksen K. Dissolution of the inorganic phase of bone leading to release of calcium regulates osteoclast survival. Biochem Biophys Res Commun 2007; 360: 834-9. 미소장
13 Rogers MJ, Crockett JC, Coxon FP, Mönkkönen J. Biochemical and molecular mechanisms of action of bisphosphonates. Bone 2011;49: 34-41. 미소장
14 Cremers S, Papapoulos S. Pharmacology of bisphosphonates. Bone 2011; 49: 42-9. 미소장
15 Parks TG, Baird DS, Wilson RI. Stress fractures of the neck of the femur. Ulster Med J 1970; 39: 111-8. 미소장
16 Bone HG, Hosking D, Devogelaer JP, et al. Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 2004; 350: 1189-99. 미소장
17 Greenblatt MB, Tsai JN, Wein MN. Bone turnover markers in the diagnosis and monitoring of metabolic bone disease. Clin Chem 2017; 63: 464-74. 미소장
18 Osada R, Zukawa M, Kimura T. Atypical ulnar fracture associated with long-term bisphosphonate use. J Orthop Sci 2015; 20: 1132-5. 미소장
19 Breglia MD, Carter JD. Atypical insufficiency fracture of the tibia associated with long-term bisphosphonate therapy. J Clin Rheumatol 2010; 16: 76-8. 미소장
20 Patel V, Graves L, Lukert B. Pelvic fractures associated with longterm bisphosphonate therapy-case report. J Musculoskelet Neuronal Interact 2013; 13: 251-4. 미소장

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