Document Detail


Incidence and demography of femur fractures with and without atypical features.
MedLine Citation:
PMID:  22275107     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The case definition, community incidence, and characteristics of atypical femoral shaft fractures (FSF) are poorly understood. This retrospective study utilized electronic medical records and radiograph review among women ≥ age 50 and men ≥ age 65 from January 1996-June 2009 at Kaiser Permanente Northwest to describe the incidence rates and characteristics of subgroups of femur fractures. Fractures were categorized based on the ASBMR atypical fracture major features [AFM] (low force, shaft location, transverse or short oblique, non-comminuted) and additional minor radiograph atypical features [AFMm] (beaking, cortical thickening or stress fracture). Total fractures were N = 5034. The incidence rates of FSFs (without atypical features) and AFMs appeared flat (cumulative incidence: 18.2 per 100,000 person-years [95% CI= 16.0-20.7]; 5.9 per 100,000 person-years [95% CI= 4.6-7.4] respectively) with 1,271,575 person-years observed. The proportion of AFMs that were AFMms increased over time. Thirty percent of AFMs had any dispensing of a bisphosphonate prior to the fracture, compared to 15.8% of the non-atypical FSFs. Years of oral glucocorticosteroid dispensing appeared highest in AFM and AFMm fractures. Those with AFMs only were older and had a lower frequency of bisphosphonate dispensing compared to those with AFMms. We conclude that rates of FSFs, with and without atypia, were low and stable over 13.5 years. Patients with only AFMs appear to be different from those with AFMms; it may be that only the latter group is atypical. There appear to be multiple associated risk factors for AFMm fractures. © 2012 American Society for Bone and Mineral Research.
Authors:
Adrianne Feldstein; Dennis Black; Nancy Perrin; A Gabriela Rosales; Darin Friess; David Boardman; Richard Dell; Arthur Santora; Julie M Chandler; Mary M Rix; Eric Orwoll
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-24
Journal Detail:
Title:  Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research     Volume:  -     ISSN:  1523-4681     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610640     Medline TA:  J Bone Miner Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Society for Bone and Mineral Research.
Affiliation:
Kaiser Permanente Center for Health Research, Portland, Oregon; Kaiser Permanente Northwest, Portland, Oregon. adrianne.c.feldstein@kpchr.org.
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