UZUN DÖNEM BİFOSFONAT KULLANIMINA BAĞLI EŞZAMANLI BİLATERAL FEMUR SUBTROKANTERİK KIRIK İLE BAŞVURAN HASTA Concurrent Bilateral Subtrochanteric Femoral Fracture Related with Long-Term Bisphosponate Usage
Abstract
ÖZET
Bifosfonatlar osteoporoz tedavisinde yaygın olarak kulanılmaktadır. Bifosfonatların etki mekanizması, kemik
rezorpsiyonu supresyonudur. Uzun dönem bifosfonat kullanımında ise son yıllarda gittikçe artan sayıda atipik
femur kırıkları bildirilmektedir.
Biz, 60 yaşında, metastatik meme karsinomu tanılı, uzun süreli bifosfonat kullanımına bağlı eşzamanlı bilateral
femur subtrokanterik kırık ile başvuran postmenapozal kadın hastada, klinik presentasyon, tanı konulması,
tedavi ve takibini yayınlıyoruz.
Her iki kırık hattından frozen gönderildi, frozen inceleme sonucunda, tümöral dokuya rastlanmadı. Hastanın aynı
seansta sağ kalçasına proksimal femoral çivi, sol kalçasına femur proksimal anatomik plak uygulandı. Her iki alt
ekstremitesine tam yük vererek yürüyebildiği, kalça eklem hareketlerinde istirahat ve egzersizle ağrı olmadığı
görüldü.
Anahtar kelimeler : Bifosfonat; osteoporoz; femur kırığı
ABSTRACT
Bisphosphonates are widely used in the treatment of osteoporosis. Bisphosphonates act via suppression of
bone resorption. Growing numbers of atypical femur fractures have been reported in the use of long-term
bisphosphonates in recent years.
In this case report, we present clinical presentation, diagnosis, and treatment as well as follow-up of a 60-yearold
postmenopausal female patient who had metastatic breast carcinoma, with bilateral femoral subtrochanteric
fracture associated with long-term use of bisphosphonates.
Frozen species were sent from both fracture lines, as a result of the frozen examination, no tumoral tissue was
found. Proximal femoral nail to right hiccup and femur proximal anatomical plaque to left hiccup were applied
in the same session. The patient was able to walk with full load on both lower extremities, and there was no ain
in the hip joint movements in the rest and exercise.
Keywords: Bisphosphonate; osteoporosis; femoral fracture
References
- 1- Tonino RP, Meunier PJ, Emkey R, Rodriguez-Portales JA, Menkes CJ, Wasnich RD, et al. Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. J Clin Endocrinol Metab 2000;85:3109-15. 2- Çakmak S, Mahiroğulları M, Keklikçi K, Sarı E. Bilateral low-energy sequential femoral shaft fractures in patients on long-term bisphosphonate therapy. Acta Orthop Traumatol Turc 2013;47(3):162-72 3- Atik OŞ, Suluova F, Görmeli G, Yıldırım A. Insufficiency femoral fractures in patients undergoing prolonged alendronate therapy . Eklem Hastalık Cerrahisi. 2010;21(1):56-9 4- Ataoğlu B, Kaptan AY, Eren TK, Yapar AE. Atypical femoral fracture following zoledronic acid treatment. Eklem Hastalık Cerrahisi 2016;27(1):54-7. 5- Ustabaşıoğlu F, Çağlar NS; Akın T, Ayşar Ö, Aytekin E. Uzun Dönem Bifosfonat Kullanım Sonrası Bilateral Femur Diafiz Kırığı: Olgu Sunumu Türk Osteoporoz Dergisi 2012;18: 92-4. 6- Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993;94:646-50. 7- Fleisch H. Bisphosphonates: mechanisms of action. Endocr Rev 1998;19:80-100. 8- Yılmaz S, Atalay İB, Öztürk R, Güngör BŞ. The Evaluation of the Surgical and Functional Results of the Tumor Resection Prosthesis in Proximal Femur Malignant Bone Tumors. Acta Oncol Tur. 2019; 52(2): 250-5. DOI: 10.5505/aot.2019.62134 9- Toğral G, Arıkan M, Aktaş E, Öztürk R, Güven O, Eksioğlu F. Surgical management of bone metastases from urological malignancies: an analysis of 70 cases. Acta Orthop Traumatol Turc. 2015;49(6):634-40 10- Schubert M, Klatte I, Linek W, Müller B, Döring K, Eckelt U, et al. The Saxon bisphosphonate register - therapy and prevention of bisphosphonate-related osteonecrosis of the jaws. Oral Oncol 2012 ;48:349-54.
Abstract
References
- 1- Tonino RP, Meunier PJ, Emkey R, Rodriguez-Portales JA, Menkes CJ, Wasnich RD, et al. Skeletal benefits of alendronate: 7-year treatment of postmenopausal osteoporotic women. J Clin Endocrinol Metab 2000;85:3109-15. 2- Çakmak S, Mahiroğulları M, Keklikçi K, Sarı E. Bilateral low-energy sequential femoral shaft fractures in patients on long-term bisphosphonate therapy. Acta Orthop Traumatol Turc 2013;47(3):162-72 3- Atik OŞ, Suluova F, Görmeli G, Yıldırım A. Insufficiency femoral fractures in patients undergoing prolonged alendronate therapy . Eklem Hastalık Cerrahisi. 2010;21(1):56-9 4- Ataoğlu B, Kaptan AY, Eren TK, Yapar AE. Atypical femoral fracture following zoledronic acid treatment. Eklem Hastalık Cerrahisi 2016;27(1):54-7. 5- Ustabaşıoğlu F, Çağlar NS; Akın T, Ayşar Ö, Aytekin E. Uzun Dönem Bifosfonat Kullanım Sonrası Bilateral Femur Diafiz Kırığı: Olgu Sunumu Türk Osteoporoz Dergisi 2012;18: 92-4. 6- Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993;94:646-50. 7- Fleisch H. Bisphosphonates: mechanisms of action. Endocr Rev 1998;19:80-100. 8- Yılmaz S, Atalay İB, Öztürk R, Güngör BŞ. The Evaluation of the Surgical and Functional Results of the Tumor Resection Prosthesis in Proximal Femur Malignant Bone Tumors. Acta Oncol Tur. 2019; 52(2): 250-5. DOI: 10.5505/aot.2019.62134 9- Toğral G, Arıkan M, Aktaş E, Öztürk R, Güven O, Eksioğlu F. Surgical management of bone metastases from urological malignancies: an analysis of 70 cases. Acta Orthop Traumatol Turc. 2015;49(6):634-40 10- Schubert M, Klatte I, Linek W, Müller B, Döring K, Eckelt U, et al. The Saxon bisphosphonate register - therapy and prevention of bisphosphonate-related osteonecrosis of the jaws. Oral Oncol 2012 ;48:349-54.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 8, 2020 |
| Published in Issue | Year 2020 Volume: 10 Issue: 2 |