与抗吸收疗法相关的非经典部位的非典型骨折:系统性审查
Lucy Collins1,2,3, Alec Ronan2, Evelyn Hutcheon4
1Department of Medicine, School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, VIC, 3168, Australia.
概括
治疗骨质疏松症的抗吸收药物可能会在股骨之外的部位引起罕见的非典型骨折. 临床医生应该监测这些骨折,即使它们发生在非经典的骨位置.
科学领域:
- 整形外科 整形外科 整形外科
- 药理学 药理学是指药理学的学科.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 骨质疏松症影响全球超过20%的女性和6%的50岁以上男性.
- 抗吸收药物,如双酸盐和德诺苏马布,是骨质疏松症的标准治疗方法.
- 罕见的并发症包括下巴骨 necrosis 和非典型的股骨骨折 (AFF).
研究的目的:
- 系统地识别ASBMR AFF案例定义之外的非典型骨折.
- 分析3年以上服用抗吸收药物的患者的病例.
- 为了告知非经典部位骨折的临床意识.
主要方法:
- 在主要电子数据库 (PubMed,Medline,Embase,Cochrane,Web of Science) 的系统文献搜索.
- 在会议摘要中进行手动搜索.
- 包括英语全文文章,涉及18岁以上患者的非典型骨折,接受抗吸收疗法超过3年.
- 数据提取和分析由两个独立的审查员.
主要成果:
- 在114名从66篇文章中确定的115例非典型骨折病例.
- 最常见的骨折部位是骨和骨.
- 骨折通常是横向的 (95%),发生在最小的创伤 (96%),没有断裂 (98%),并与皮质加厚 (69%) 相关.
- 阿伦德罗纳特单独治疗是最常见的治疗方法 (44%).
结论:
- 非经典部位的非典型骨折与长期的抗复苏疗法有关.
- 这些骨折很罕见,不应该排除适当的骨质疏松症治疗.
- 临床医生应考虑大腿骨以外部位的非典型骨折,可能需要更新病例定义.
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