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Atypische distale Tibiaschaftfrakturen bei liegenden KTEP beidseits unter antiresorptiver Therapie

Atypical distal tibial shaft fractures in a patient with bilateral TKA and antiresorptive treatment

An Erratum to this article was published on 10 March 2022

This article has been updated

Zusammenfassung

In der Literatur lassen sich viele beschriebene Fälle von atypischen Femurfrakturen unter antiresorptiver Therapie finden. Andere Lokalisationen von Frakturen dieser Genese, zudem bilateral aufgetreten, sind Raritäten. Dieser Fall berichtet über Diagnostik, Therapie und Verlauf bei einer 76-jährigen Patientin, welche nach jahrelanger Therapie mit Bisphosphonaten, Strontiumranelat und Denosumab binnen 4 Monaten beidseits distale Tibiaschaftquerfrakturen ohne adäquates Trauma erlitt.

Abstract

There are many cases in the literature that describe atypical femur fractures under antiresorptive therapy. Other localizations of fractures of this genesis, especially if occurring bilaterally, are rare. This case reports about the diagnosis, treatment and process of a 76-year old patient, who within a 4‑month period suffered from bilateral distal tibial shaft fractures, after years of treatment with bisphosphonates, strontium ranelate and denosumab.

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Change history

Abbreviations

KFI:

Kleinfragmentinstrumentarium

KTEP:

Knietotalendoprothese

Literatur

  1. Bissonnette L, April P‑M, Dumais R, Boire G, Roux S (2013) Atypical fracture of the tibial diaphysis associated with bisphosphonate therapy: a case report. Bone 56(2):406–409. https://doi.org/10.1016/j.bone.2013.07.012

    Article  PubMed  Google Scholar 

  2. Bogdan Y, Tornetta P, Einhorn TA, Guy P, Leveille L, Robinson J, Bosse MJ, Haines N, Horwitz D, Jones C, Schemitsch E, Sagi C, Thomas B, Stahl D, Ricci W, Brady M, Sanders D, Kain M, Higgins TF, Collinge C, Kottmeier S, Friess D (2016) Healing time and complications in operatively treated atypical femur fractures associated with bisphosphonate use. A multicenter retrospective cohort. J Orthop Trauma 30(4):177–181. https://doi.org/10.1097/BOT.0000000000000516

    Article  PubMed  Google Scholar 

  3. Breglia MD, Carter JD (2010) Atypical insufficiency fracture of the tibia associated with long-term bisphosphonate therapy. J Clin Rheumatol 16(2):76–78. https://doi.org/10.1097/RHU.0b013e3181cf3e3d

    Article  PubMed  Google Scholar 

  4. Dachverband Osteologie e. V. (2014) S3-Leitlinie zur Prophylaxe, Diagnostik und Therapie der Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen. Kurzfassung und Langfassung

    Google Scholar 

  5. Feron J‑M, Cambon-Binder A (2017) Medication management after intramedullary nailing of atypical fractures. Injury 48(Suppl 1):S15–S17. https://doi.org/10.1016/j.injury.2017.04.030

    Article  PubMed  Google Scholar 

  6. Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136. https://doi.org/10.1007/s11657-013-0136-1

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  7. Imbuldeniya AM, Jiwa N, Murphy JP (2012) Bilateral atypical insufficiency fractures of the proximal tibia and a unilateral distal femoral fracture associated with long-term intravenous bisphosphonate therapy: a case report. J Med Case Rep 6:50. https://doi.org/10.1186/1752-1947-6-50

    Article  PubMed  PubMed Central  Google Scholar 

  8. van de Laarschot DM, Zillikens MC (2016) Atypical femur fracture in an adolescent boy treated with bisphosphonates for X‑linked osteoporosis based on PLS3 mutation. Bone 91:148–151. https://doi.org/10.1016/j.bone.2016.07.022

    Article  PubMed  Google Scholar 

  9. Miller PD, Derman RJ (2010) What is the best balance of benefits and risks among anti-resorptive therapies for postmenopausal osteoporosis? Osteoporos Int 21(11):1793–1802. https://doi.org/10.1007/s00198-010-1208-3

    CAS  Article  PubMed  Google Scholar 

  10. Nguyen HH, Milat F, Ebeling PR (2017) A new contralateral atypical femoral fracture despite sequential therapy with teriparatide and strontium ranelate. Bone Rep 6:34–37. https://doi.org/10.1016/j.bonr.2017.01.002

    Article  PubMed  PubMed Central  Google Scholar 

  11. Papapoulos S, Lippuner K, Roux C, Lin CJF, Kendler DL, Lewiecki EM, Brandi ML, Czerwiński E, Franek E, Lakatos P, Mautalen C, Minisola S, Reginster JY, Jensen S, Daizadeh NS, Wang A, Gavin M, Libanati C, Wagman RB, Bone HG (2015) The effect of 8 or 5 years of denosumab treatment in postmenopausal women with osteoporosis: results from the FREEDOM Extension study. Osteoporos Int 26(12):2773–2783. https://doi.org/10.1007/s00198-015-3234-7

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  12. Paparodis R, Buehring B, Pelley EM, Binkley N (2013) A case of an unusual subtrochanteric fracture in a patient receiving denosumab. Endocr Pract 19(3):8. https://doi.org/10.4158/EP12367.CR

    Article  Google Scholar 

  13. Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster DW, Ebeling PR, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O’Keefe R, Papapoulos S, Howe TS, van der Meulen MC, Marjolein CH, Weinstein RS, Whyte MP (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 29(1):1–23. https://doi.org/10.1002/jbmr.1998

    Article  PubMed  Google Scholar 

  14. Sobotta H‑P, Gosling T (2017) Atypische subtrochantare Femurfraktur unter Alendronsauretherapie trotz intramedullarem Implantat. Unfallchirurg 120(2):171–175. https://doi.org/10.1007/s00113-016-0270-5

    Article  PubMed  Google Scholar 

  15. Vun SH, Husami Y, Shareef S, Bramley D (2014) Acute nontraumatic clavicle fracture associated with long-term bisphosphonate therapy. Case Rep Orthop. https://doi.org/10.1155/2014/986718

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to R. Schimpf.

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R. Schimpf, H. Siekmann, C. Bauer und F. Radetzki geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

Additional information

The original online version of this article was revised: Klinik für Orthopädie und Unfallchirurgie, Städtisches Klinikum Dessau, Medizinische Hochschule Brandenburg Theodor Fontane, Dessau, Deutschland

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Schimpf, R., Siekmann, H., Bauer, C. et al. Atypische distale Tibiaschaftfrakturen bei liegenden KTEP beidseits unter antiresorptiver Therapie. Orthopäde 47, 688–691 (2018). https://doi.org/10.1007/s00132-018-3596-6

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  • DOI: https://doi.org/10.1007/s00132-018-3596-6

Schlüsselwörter

  • Antiresorptive Medikamente
  • Bisphosphonate
  • Denosumab
  • Knietotalendoprothese
  • Osteoporose

Keywords

  • Antiresorptive drugs
  • Bisphosphonates
  • Denosumab
  • Knee arthroplasty, total
  • Osteoporosis