与双膦酸盐类药物相关的非典型股骨骨折的研究进展

Research Advancement on Bisphosphonate Related Atypical Fractures

双膦酸盐类药物能显著减少骨质疏松造成的髋部、脊柱及腕部等骨折,但长期应用可能会造成非典型部位的骨折。非典型股骨骨折多为简单横行或斜形,伴有内侧皮质鸟嘴样突起及股骨干皮质的弥漫性增厚。美国骨与矿物质研究学会推荐非典型骨折患者应立即停用双膦酸盐药物,并予以钙剂、维生素D及特立帕肽治疗,该骨折保守治疗很难愈合,对于完全性骨折患者,建议行股骨全长髓内钉内固定以保护整个股骨。

Bisphosphonates can remarkably decrease the osteoporotic fractures of the hip,vertebral column and wrist,but long-term use may lead to atypical fractures. The atypical fractures are common simple transverse or oblique configuration with breaking of inside cortex and diffusive thickness increase of shaft of femur. American Society for Bone and Mineral Research Task Force recommends that bisphosphonates should be discontinued immediately in the case of atypical fractures,and teriparatide,calcium and vitamin D should be given. The nonoperative treatment is not feasible or reliable for this type of fracture. For patients with complete fracture,surgical treatment of intramedullary nail fixation is recommended to protect the whole femur.