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Revista de la Asociación Argentina de Ortopedia y Traumatología

On-line version ISSN 1852-7434


VANOLI, Fernando et al. ¿Tardan más en consolidar las fracturas asociadas a bifosfonatos?. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2019, vol.84, n.4, pp.320-329. ISSN 1852-7434.

Objectives: Bisphosphonates have become the gold standard treatment for osteoporosis, since they reduce the incidence of fractures. Recently, several papers described the occurrence of low-energy atypical femoral fractures associated with the use of bisphosphonates. The objective of this study was to compare the average time to healing of atypical femoral fractures in patients who received bisphosphonates and in a control group. Materials and Methods: We retrospectively evaluated 34 patients with atypical femoral fractures, 16 of whom had received treatment with bisphosphonates for at least 5 years, between 2006 and 2017, and whose fractures were stabilized with a cephalomedullary nail. They were compared with a control group of similar characteristics. Results: All the patients were female, with an average age of 74 years. Twenty-two fractures were subtrochanteric, while 12 involved the femoral shaft. Fourteen percent (14%) of the patients who received bisphosphonates and surgical management required a revision surgery, while 5.5% of the control group did not. The average time to bone healing was longer in those treated with bisphosphonates (8.5 months vs. 6 months), which was statistically significant (p <0.001). Conclusions: The benefits of using bisphosphonates for fracture prevention outweigh the risk of atypical fractures. However, it is important to evaluate the risk-benefit ratio in each patient at the beginning of the treatment and during the course of it, since, despite the benefits, healing time is longer.

Keywords : Bisphosphonates; Atypical femoral fractures; Osteoporosis.

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