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      • Poster Session : PS 0354 ; Epidemiology and Public Health : Prevalence and Associating Factors with Atypical Femoral Fractures: An Asian Single Center Based Case-Control Study

        ( Dam Kim ),( Yoon Kyoung Sung ),( Soo Kyung Cho ),( Mink Yung Han ),( Yee Suk Kim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Current evidence suggests that there is an association between bisphosphonate use and atypical femoral fractures (AFFs). However, the extent of this risk remains unclear, especially in Asian population. In this study, we aimed to estimate the proportion of AFFs among total patients with femoral fractures and to compare the characteristics of patients with AFFs with that of patients with classic femoral fractures (CFFs). Methods: A total of 578 female patients with low-energy femoral fractures who had been hospitalized at an Asian single university hospital were retrospectively enrolled. Patients were classifi ed into two groups according to the site of fracture: AFF group for patients with subtrochanteric or diaphyseal femoral fractures and CFF group for patients with intertrochateric or neck fractures. We assessed the association of bisphosphonate use and AFFs with using multivariate logistic regression analysis. Results: Twenty-seven patients (4. 7%) with AFFs and 551 patients (95. 3%) with CFFs were identifi ed. Of the patients with AFFs, 11 (40. 7%) had been treated with bisphosphonates compared with 40 (7. 3%) in the CFF group. With adjusting the age, body mass index, types of injury (slip or fall), and history of rheumatoid arthritis, bisphosphonate was the only predictor for atypical fractures (OR 9. 8, CI 3. 7-26. 4). Among the patients with using bisphosphonate when they fractured (n=44), the proportionof AFFs was nearly 21% (n=9). The proportions of AFFs among femoral fractures were increased according to the duration of bisphosphonate; 15. 4% (n=6) in patients with <5 years and 60% (n=3) in patients =5 years, respectively. Conclusions: The proportion of AFFs was around 5% among the patients with femoral fractures and AFF were associated with bisphosphonate use in Asian ethnicity. Longer duration of treatment resulted in augmented risk, though any period in bisphosphonate use could cause atypical femur fracture.

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