The Incidence of Atypical Femoral Fractures in Patients with Rheumatic Disease: Yamagata Prefectural Committee of Atypical Femoral Fractures (YamaCAFe) Study

被引：14

作者：

Takakubo, Yuya ^{[1
]}

Ohta, Daichi ^{[1
]}

Ishi, Masaji ^{[2
]}

Ito, Juji ^{[1
]}

Oki, Hiroharu ^{[1
]}

Naganuma, Yasushi ^{[1
]}

Uno, Tomohiro ^{[1
]}

Sasaki, Akiko ^{[1
]}

Akabane, Takeru ^{[3
]}

Dairaku, Katsuyuki ^{[4
]}

Goto, Shinichi ^{[5
]}

Goto, Yasuo ^{[6
]}

Kanauchi, Yumiko ^{[7
]}

Kobayashi, Shinji ^{[8
]}

Nakajima, Taku ^{[9
]}

Masuda, Keiji ^{[10
]}

Matsuda, Michiharu ^{[11
]}

Mura, Nariyuki ^{[12
]}

Takenouchi, Kenji ^{[13
]}

Tsuchida, Hiroyuki ^{[14
]}

Onuma, Yasushi ^{[15
]}

Shibuya, Junichirou ^{[16
]}

Seino, Mitsuyoshi ^{[17
]}

Yamaguchi, Osamu ^{[18
]}

Hiragami, Ken ^{[14
]}

Urayama, Yasuhiro ^{[19
]}

Furukawa, Takashi ^{[12
]}

Okuda, Shouta ^{[20
]}

Ogura, Ken ^{[21
]}

Nakamura, Takeshi ^{[22
]}

Sasaki, Kan ^{[1
]}

Konta, Tsuneo ^{[23
]}

Takagi, Michiaki ^{[1
]}

机构：

[1] Yamagata Univ, Dept Orthopaed Surg, Fac Med, 2-2-2 Iida Nishi, Yamagata, Yamagata 9909585, Japan

[2] Yamagata Saisei Hosp, Dept Orthopaed Surg, Yamagata, Yamagata, Japan

[3] Yamagata Prefectural Cent Hosp, Dept Orthopaed Surg, Yamagata, Yamagata, Japan

[4] Okitama Publ Gen Hosp, Dept Orthopaed Surg, Yamagata, Japan

[5] Tsuruoka Municipal Shonai Hosp, Dept Orthopaed Surg, Tsuruoka, Yamagata, Japan

[6] Sagae City Hosp, Dept Orthopaed Surg, Sagae, Yamagata, Japan

[7] Yamagata Prefectural Kahoku Hosp, Dept Orthopaed Surg, Yamagata, Japan

[8] Shiseido Hosp, Dept Orthopaed Surg, Yamagata, Yamagata, Japan

[9] Sanyudo Hosp, Dept Orthopaed Surg, Yonezawa, Yamagata, Japan

[10] Saiseikan Yamagata City Hosp, Dept Orthopaed Surg, Yamagata, Yamagata, Japan

[11] Tohoku Cent Hosp, Dept Orthopaed Surg, Yamagata, Yamagata, Japan

[12] Yoshioka Hosp, Dept Orthopaed Surg, Tendo, Yamagata, Japan

[13] Kitamurayama Hosp, Dept Orthopaed Surg, Murayama, Yamagata, Japan

[14] Miyuki Social Med Corp, Miyukikai Hosp, Dept Orthopaed Surg, Kaminoyama, Yamagata, Japan

[15] Yamagata Tolcusyukai Hosp, Dept Orthopaed Surg, Yamagata, Yamagata, Japan

[16] Yamagata Prefectural Shinjo Hosp, Dept Orthopaed Surg, Shinjo, Yamagata, Japan

[17] Shonai Amarume Hosp, Dept Orthopaed Surg, Yamagata, Japan

[18] Sinoda Gen Hosp, Dept Orthopaed Surg, Yamagata, Yamagata, Japan

[19] Mamurogawa Town Hosp, Dept Orthopaed Surg, Yamagata, Japan

[20] Nihonkai Gen Hosp, Dept Orthopaed Surg, Sakata, Yamagata, Japan

[21] Yonezawa City Hosp, Dept Orthopaed Surg, Yonezawa, Yamagata, Japan

[22] Funayama Hosp, Dept Orthopaed Surg, Yonezawa, Yamagata, Japan

[23] Yamagata Univ, Dept Cardiol Pulmonol & Nephrol, Fac Med, Yamagata, Yamagata, Japan

来源：

TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE | 2017年 / 242卷 / 04期

基金：

日本学术振兴会;

关键词：

atypical femoral fracture; femur; prednisolone; rheumatic disease; small femoral neck-shaft angle; ARTHRITIS PATIENTS; BISPHOSPHONATE USE; FEMUR FRACTURE; RISK; SHAFT; ASSOCIATION; MORTALITY; JAPANESE; BONE;

D O I：

10.1620/tjem.242.327

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：327 / 334

页数：8

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