The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Incidence of atypical nontraumatic diaphyseal fractures of the femur
Abstract
Bisphosphonates reduce the rate of osteoporotic fractures in clinical trials and community practice. “Atypical” nontraumatic fractures of the diaphyseal (subtrochanteric or shaft) part of the femur have been observed in patients taking bisphosphonates. We calculated the incidence of these fractures within a defined population and examined the incidence rates according to duration of bisphosphonate use. We identified all femur fractures from January 1, 2007 until December 31, 2011 in 1,835,116 patients older than 45 years who were enrolled in the Healthy Bones Program at Kaiser Southern California, an integrated health care provider. Potential atypical fractures were identified by diagnostic or procedure codes and adjudicated by examination of radiographs. Bisphosphonate exposure was derived from internal pharmacy records. The results showed that 142 patients had atypical fractures; of these, 128 had bisphosphonate exposure. There was no significant correlation between duration of use (5.5 ± 3.4 years) and age (69.3 ± 8.6 years) or bone density (T-score −2.1 ± 1.0). There were 188,814 patients who had used bisphosphonates. The age-adjusted incidence rates for an atypical fracture were 1.78/100,000/year (95% confidence interval [CI], 1.5–2.0) with exposure from 0.1 to 1.9 years, and increased to 113.1/100,000/year (95% CI, 69.3–156.8) with exposure from 8 to 9.9 years. We conclude that the incidence of atypical fractures of the femur increases with longer duration of bisphosphonate use. The rate is much lower than the expected rate of devastating hip fractures in elderly osteoporotic patients. Patients at risk for osteoporotic fractures should not be discouraged from initiating bisphosphonates, because clinical trials have documented that these medicines can substantially reduce the incidence of typical hip fractures. The increased risk of atypical fractures should be taken into consideration when continuing bisphosphonates beyond 5 years. © 2012 American Society for Bone and Mineral Research.
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Black, D. M., Cummings, S. R., Karpf, D. B., Cauley, J. A., Thompson, D. E., Nevitt, M. C., Bauer, D. C., Genant, H. K., Haskell, W. L., Marcus, R., et al. (1996) · The Lancet · doi:10.1016/s0140-6736(96)07088-2 · Cited by 3,846
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Black, D. M., Delmas, P. D., Eastell, R., Reid, I. R., Boonen, S., Cauley, J. A., Cosman, F., Lakatos, P., Leung, P. C., Man, Z., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa067312 · Cited by 2,986
Shane, E., Burr, D., Abrahamsen, B., Adler, R. A., Brown, T. D., Cheung, A. M., Cosman, F., Curtis, J. R., Dell, R., Dempster, D. W., et al. (2014) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1998 · Cited by 2,147
Self-citationEffect of Risedronate on the Risk of Hip Fracture in Elderly Women
McClung, M. R., Geusens, P., Miller, P. D., Zippel, H., Bensen, W. G., Roux, C., Adami, S., Fogelman, I., Diamond, T., Eastell, R., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200102013440503 · Cited by 1,918
Black, D. M., Schwartz, A. V., Ensrud, K. E., Cauley, J. A., Levis, S., Quandt, S. A., Satterfield, S., Wallace, R. B., Bauer, D. C., Palermo, L., et al. (2006) · JAMA · doi:10.1001/jama.296.24.2927 · Cited by 1,407
Ten Years' Experience with Alendronate for Osteoporosis in Postmenopausal Women
Bone, H. G., Hosking, D., Devogelaer, J.-P., Tucci, J. R., Emkey, R. D., Tonino, R. P., Rodriguez-Portales, J. A., Downs, R. W., Gupta, J., Santora, A. C., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa030897 · Cited by 1,347
Shane, E., Burr, D., Ebeling, P. R., Abrahamsen, B., Adler, R. A., Brown, T. D., Cheung, A. M., Cosman, F., Curtis, J. R., Dell, R., et al. (2010) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.253 · Cited by 1,116
Self-citationBisphosphonate Use and Atypical Fractures of the Femoral Shaft
Schilcher, J., Michaëlsson, K., & Aspenberg, P. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1010650 · Cited by 695
CONFIDENCE INTERVALS FOR DIRECTLY STANDARDIZED RATES: A METHOD BASED ON THE GAMMA DISTRIBUTION
FAY, M. P., & FEUER, E. J. (1997) · Statistics in Medicine · doi:10.1002/(sici)1097-0258(19970415)16:7<791::aid-sim500>3.0.co;2-# · Cited by 643
Low-Energy Femoral Shaft Fractures Associated With Alendronate Use
Neviaser, A. S., Lane, J. M., Lenart, B. A., Edobor-Osula, F., & Lorich, D. G. (2008) · Journal of Orthopaedic Trauma · doi:10.1097/bot.0b013e318172841c · Cited by 526
Cited by
Shane, E., Burr, D., Abrahamsen, B., Adler, R. A., Brown, T. D., Cheung, A. M., Cosman, F., Curtis, J. R., Dell, R., Dempster, D. W., et al. (2014) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1998 · Cited by 2,147
Self-citationThe clinician's guide to prevention and treatment of osteoporosis
LeBoff, M. S., Greenspan, S. L., Insogna, K. L., Lewiecki, E. M., Saag, K. G., Singer, A. J., & Siris, E. S. (2022) · Osteoporosis International · doi:10.1007/s00198-021-05900-y · Cited by 1,487
Eastell, R., Rosen, C. J., Black, D. M., Cheung, A. M., Murad, M. H., & Shoback, D. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2019-00221 · Cited by 868
Qaseem, A., Forciea, M. A., McLean, R. M., Denberg, T. D., & for the Clinical Guidelines Committee of the American College of Physicians* (2017) · Annals of Internal Medicine · doi:10.7326/m15-1361 · Cited by 676
Bisphosphonate Therapy for Osteoporosis: Benefits, Risks, and Drug Holiday
McClung, M., Harris, S. T., Miller, P. D., Bauer, D. C., Davison, K. S., Dian, L., Hanley, D. A., Kendler, D. L., Yuen, C. K., & Lewiecki, E. M. (2013) · The American Journal of Medicine · doi:10.1016/j.amjmed.2012.06.023 · Cited by 451
Metadata
- Authors
- Dell, R. M., Adams, A. L., Greene, D. F., Funahashi, T. T., Silverman, S. L., Eisemon, E. O., Zhou, H., Burchette, R. J., & Ott, S. M.
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-07-26
- Volume
- 27
- Issue
- 12
- Pages
- 2544-2550
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- OpenAlex
- W2019292020
- Cited by
- 441
- References
- 30
- FWCI
- 39.51
- Type
- journal article
- Language
- en
- Open access
- closed
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