The Incidence of Atypical Femoral Fractures in Patients with Rheumatic Disease: Yamagata Prefectural Committee of Atypical Femoral Fractures (YamaCAFe) Study
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- Takakubo Yuya
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Ohta Daichi
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Ishi Masaji
- Department of Orthopaedic Surgery, Yamagata Saisei Hospital
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- Ito Juji
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Oki Hiroharu
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Naganuma Yasushi
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Uno Tomohiro
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Sasaki Akiko
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Akabane Takeru
- Department of Orthopaedic Surgery, Yamagata Prefectural Central Hospital
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- Dairaku Katsuyuki
- Department of Orthopaedic Surgery, Okitama Public General Hospital
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- Goto Shinichi
- Department of Orthopaedic Surgery, Tsuruoka Municipal Shonai Hospital
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- Goto Yasuo
- Department of Orthopaedic Surgery, Sagae City Hospital
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- Kanauchi Yumiko
- Department of Orthopaedic Surgery, Yamagata Prefectural Kahoku Hospital
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- Kobayashi Shinji
- Department of Orthopaedic Surgery, Shiseido Hospital
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- Nakajima Taku
- Department of Orthopaedic Surgery, Sanyudo Hospital
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- Masuda Keiji
- Department of Orthopaedic Surgery, Saiseikan Yamagata City Hospital
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- Matsuda Michiharu
- Department of Orthopaedic Surgery, Tohoku Central Hospital
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- Mura Nariyuki
- Department of Orthopaedic Surgery, Yoshioka Hospital
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- Takenouchi Kenji
- Department of Orthopaedic Surgery, Kitamurayama Hospital
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- Tsuchida Hiroyuki
- Department of Orthopaedic Surgery, Miyuki Social Medical Corporation, Miyukikai Hospital
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- Onuma Yasushi
- Department of Orthopaedic Surgery, Yamagata Tokusyukai Hospital
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- Shibuya Junichirou
- Department of Orthopaedic Surgery, Yamagata Prefectural Shinjo Hospital
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- Seino Mitsuyoshi
- Department of Orthopaedic Surgery, Shonai Amarume Hospital
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- Yamaguchi Osamu
- Department of Orthopaedic Surgery, Sinoda General Hospital
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- Hiragami Ken
- Department of Orthopaedic Surgery, Miyuki Social Medical Corporation, Miyukikai Hospital
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- Urayama Yasuhiro
- Department of Orthopaedic Surgery, Mamurogawa Town Hospital
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- Furukawa Takashi
- Department of Orthopaedic Surgery, Yoshioka Hospital
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- Okuda Shouta
- Department of Orthopaedic Surgery, Nihonkai General Hospital
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- Ogura Ken
- Department of Orthopaedic Surgery, Yonezawa City Hospital
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- Nakamura Takeshi
- Department of Orthopaedic Surgery, Funayama Hospital
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- Sasaki Kan
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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- Konta Tsuneo
- Department of Cardiology, Pulmonology and Nephrology, Yamagata University Faculty of Medicine
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- Takagi Michiaki
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine
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抄録
<p>Atypical femoral fractures (AFFs) have been reported to occur with minimal or spontaneous subtrochanteric and femoral shaft fractures with a characteristic transverse pattern, compared with typical femoral fractures in young patients with high-energy trauma. AFFs are related to long-term use of bisphosphonates (BPs), glucocorticoids and rheumatic diseases. We have estimated a blind analysis of AFFs in rheumatic patients receiving BPs and glucocorticoids ordinary over a long time in all Yamagata prefectural area through radiographic examination. The 123 AFFs including suspected cases over six years were collected and reviewed by two independent orthopedic surgeons. We found 86 patients with a total of 99 AFFs between 2009 and 2014 (1.43 cases/100,000 person/year). Of these 99 AFFs, 11 were in 8 rheumatic patients including three patients with bilateral AFFs. The incidence of AFFs in rheumatic patients had trend to increase from 2012. The mean age of all 8 patients was 54.9 years. All 8 patients received BPs and 7/8 received prednisolone (PSL). The mean dose of PSL was 14 mg/day. Compared to patients with unilateral AFFs, those with bilateral AFFs in rheumatic patients were on a higher dose of PSL (20 mg/day vs. 7 mg/day) and had less femoral neck-shaft angle (129° vs. 136°, p < 0.05). In conclusion, the incidence of AFFs in rheumatic patients showed a trend to increase from 2012 to 2014 in Yamagata prefecture. Careful management of AFFs is of particular importance in rheumatic patients who have taken high doses of PSL and have small femoral neck-shaft angle.</p>
収録刊行物
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- The Tohoku Journal of Experimental Medicine
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The Tohoku Journal of Experimental Medicine 242 (4), 327-334, 2017
東北ジャーナル刊行会