장기간 비스포스포네이트를 사용한 골다공증 환자에서 순차적으로 발생한 양측성 대퇴경부 부전골절- 증례보고 -
Sequential Bilateral Insufficiency Fractures of the Femur Neck in Patients Treated with Prolonged Bisphosphonate Therapy - A Case Report -
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초록
최근 비스포스포네이트의 장기간 사용과 관련된 부전골절에 대한 관심이 높아지고 있으며, 대부분의 보고가 대퇴골 간부혹은 골반골 골절에 집중적으로 이루어 지고 있다. 하지만, 비스포스포네이트의 사용과 관련된 대퇴경부에 발생한 부전골절은 아직 국내에서 보고된 바가 없다. 저자들은 8년간 골다공증으로 알렌드로네이트를 사용한 70세 여자환자에서 발생한 양측성 대퇴경부 골절 환자를 수술적으로 치료하여 1년 추시에서 방사선학적 및 임상적으로 불유합이나 부정유합같은 합병증 없이 골절부위가 치유된 것으로 판단되었다.
Abstract
The relationship between long-term bisphosphonate usage and insufficiency fracture in osteoporotic elderly patients has been increased interest in recent years. Most reported insufficiency fractures are predominantly concentrated on proximal femoral shaft or pelvic bone. However, there was no report about insufficiency femoral neck fracture after long term use of bisphosphonate in domestic. We experienced a rare case of a 70-years-old woman who was diagnosed with bilateral insufficiency femoral neck fracture after 8 years use of alendronate. We performed an internal fixation using 6.5 mm diameter cannulated screws for the both insufficiency femoral neck fracture. Symptoms disappeared immediately after the surgery and there was no radiologic and clinical complication such as nonunion or delayed union up to the latest follow-up at 12 months postoperatively. [Korean Journal of Bone Metabolism, 18(1): 65-68, 2011]
참고문헌 (10)
- Schapira D, "Insufficiency fractures of the pubic ramus", Semin Arthritis Rheum, 25, pp.373~382 (1996)
- Kitajima I, "Insufficiency fracture of the femoral neck after intramedullary nailing", J Orthop Sci, 4, pp.304~306 (1999)
- Shane E, "Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research", J Bone Miner Res, 25, pp.2267~2294 (2010)
- Goh SK, "Subtrochanteric insufficiency fractures in patients on alendronate therapy: a caution", J Bone Joint Surg Br, 89, pp.349~353 (2007)
- Kwek EB, "An emerging pattern of subtrochanteric stress fractures: a long-term complication of alendronate therapy", Injury, 39, pp.224~231 (2008)
- Ha YC, "Is surgery necessary for femoral insufficiency fractures after long-term bisphosphonate therapy", Clin Orthop Relat Res, 468, pp.3393~3398 (2010)
- Kim KC, "Initially missed occult fractures of the proximal femur in elderly patients: implications for need of operation and their morbidity", ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 130, pp.915~920, SPRINGER
- 박정관, "장기간 Bisphosphonate계 약물 복용 후 발생한 양측 대퇴 전자 하부 피로 골절", 대한정형외과학회지, 45(2), pp.146~150 (2010), 대한정형외과학회
- Chavassieux P, "Insights into material and structural basis of bone fragility from diseases associated with fractures: how determinants of the biomechanical properties of bone are compromised by disease", Endocr Rev, 28, pp.151~164 (2007)
- Carpintero P, "Simultaneous bilateral fracture of femoral neck in elderly patients: report on two cases", Eur J Orthop Surg Traumatol, 16, pp.172~174 (2006)