Klinische Endokrinologie Und Stoffwechsel Austrian Journal of Clinical Endocrinology and Metabolism

Atypical femoral fractures – comorbidities and association with bone-specific therapies. Introduction: Although atypical femoral fractures (AFF) are generally rare events, several studies have indicated a potential link between AFF and long-term bone specific therapies (BST). The aim of this study was to analyze the frequency of AFF and potential associations with prior or ongoing BST. Methods: 8.851 caucasian female and male patients with de novo hip fractures treated in the largest Austrian level 1 trauma center from 2000–2013 were selected. Results: 194 patients with a de novo lowtraumatic subtrochanteric/shaft fractures were identified: 35 atypical and 159 typical fractures. Of these patients, concomitant diseases, medication, previous fractures and survival were retrieved and analyzed. Female patients in both groups were significantly older. The median survival was significantly shorter in patients with AFF (9 vs. 18 months; p < 0.0001). Cardiovascular disease, sarcopenia, chronic kidney disease, type 2 diabetes, smoking (past or current history) and prevalent fragility fractures were more frequent in AFF patients, as well as the concomitant use of phenprocoumon, furosemide, and sulfonylurea. Though the number of patients with current BST was low in (14.5%) both groups, more patients in the AFF group were previously treated with BST (71% vs 49%; p = 0.016), and they received these therapies for a longer time period. Discussion: A combination of severe comorbidities, long-term pharmaceutical therapies and a history of previous or ongoing BST were associated with an increased individual risk for AFF. J Klin Endokrinol Stoffw 2016; 9 (3): 71–7.