Latent metabolic bone disease, skeletal dysplasia and other conditions related to low bone formation among 38 patients with subtrochanteric femoral fractures: a retrospective observational study
Authors' conclusion
If clinicians encounter patients with morphologic AFF, latent diseases related to low bone formation should be carefully differentiated because appropriate treatment may prevent delayed union and recurrent fractures. Additionally, it may be desirable to exclude these bone diseases in advance before initiating long-term use of antiresorptive agents in osteoporotic patients by screening with serum alkaline phosphatase levels to reduce the risk of morphologic AFF.
Study context
- Population
- Japanese patients admitted with subtrochanteric femoral fractures to the University of Tokyo Hospital, February 2012–March 202230 females
- Participants
- 38 patients
- Outcome
- Detection of latent metabolic bone diseases and skeletal dysplasia associated with low bone formation among patients with morphologic atypical femoral fracture (AFF)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Patients with disorders related to low bone formation
- 4
- Hypophosphatemic osteomalacia diagnosed after fracture
- 2
- Suspected carrier of loss-of-function ALPL variant
- 1
- Previously genetically diagnosed pycnodysostosis
- 1
- Specific treatments available
- 2 patients
Observational data: associations, not effects.
Further findings
Recognized risk factors
- Aged 75 and over
- 21
- Past oral glucocorticoid use
- 10
- Past antiresorptive agent use
- 18
Fracture history among the 4 patients with metabolic bone disease or skeletal dysplasia
- Past clinical fractures
- 4
- Past subtrochanteric femoral fractures
- 2
- Bilateral subtrochanteric femoral fractures
- 2
Original publication
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