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Delayed union, 12% failure rate seen after surgery of femur fractures linked with bisphosphonate use
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Results from this study showed a 12% rate of failure and delayed union among patients with bisphosphonate-related femur fractures treated with surgery.
Researchers reviewed information for 179 patients with bisphosphonate-related fractures, as defined by 2010 America Society of Bone and Mineral Research taskforce criteria, treated at 17 centers. The average patient follow-up was 17 months. Investigators collected data including patient demographics, medication history, prodromal history, injury and surgery characteristics, complications, revision surgery and time to union.
Findings showed 98% of patients were ambulatory prior to injury, 28% used assisted devices and 88% lived independently prior to fracture. Overall, 21% of patients had a history of a previous fragility fracture. In addition, investigators noted 21% of patients had contralateral femur fractures at an average of 20 months after the index surgery.
According to researchers, the most common surgical fixation was performed with cephalomedullary nails, intramedullary nails or plates. The most common complications postoperatively included death, pulmonary embolism and wound infection.
At an average of 11 months, 20 patients needed revision surgery due to nonunion. The average time to union was 5.2 months in those who did not need revision surgery; whereas for those who needed revision surgery, it was 10.2 months after the revision procedure. Discontinuation of bisphosphonates was not significantly correlated with union time or the need for revision surgery. ‒ by Monica Jaramillo
Disclosures: Bogdan reports she is a board or committee member for the Orthopaedic Trauma Association. Please see the full study for a list of all other authors’ relevant financial disclosures.
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