caa a22 4500 605463190 CHVBK 20210128100252.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00774-014-0591-9 doi (NATIONALLICENCE)springer-10.1007/s00774-014-0591-9 The incidence of and risk factors for developing atypical femoral fractures in Japan [Elektronische Daten] [Yoshitomo Saita, Muneaki Ishijima, Atsuhiko Mogami, Mitsuaki Kubota, Tomonori Baba, Takefumi Kaketa, Masashi Nagao, Yuko Sakamoto, Kensuke Sakai, Yasuhiro Homma, Rui Kato, Nana Nagura, Kei Miyagawa, Tomoki Wada, Lizu Liu, Joe Matsuoka, Osamu Obayashi, Katsuo Shitoto, Masahiko Nozawa, Hajime Kajihara, Hogaku Gen, Kazuo Kaneko] The long-term treatment with anti-resorptive drugs for osteoporotic patients is suggested to be associated with an increase in atypical femoral fractures (AFFs). However, their incidence, patient characteristics, and risk factors have not been fully elucidated especially in Asian countries. This retrospective observational cohort study found fourteen AFFs in ten patients (four bilateral fractures) among 2,238 hip and femoral shaft fractures treated in our associated hospitals between 2005 and 2010; this incidence (0.63%) was similar to Caucasians. Of the ten patients with AFFs, nine (90%) and six (60%) were using bisphosphonates (BPs) and glucocorticoids (GCs), respectively, compared to 14.3 and 8.6% for patients with typical femoral fractures who were using these agents. As comorbid conditions, five patients had collagen disease (CD) and two had diabetes. A fracture location-, age- and gender-matched (1:3) case-control study revealed that administration of BPs, GCs, and suffering from collagen disease (CD) were significant risk factors for developing AFFs [odds ratios 36.0 (95% confidence intervals 3.8-342.2), 13.0 (2.3-74.1) and 9.0 (1.6-50.3), respectively]. Interestingly, all of the patients with atypical subtrochanteric femoral fractures, defined as those within 5cm of the lesser trochanter, were taking GCs due to CD, and the age of these patients (average of 54.8years) was significantly younger than those with atypical diaphyseal femoral fractures (average of 77.2years, p<0.05). In conclusion, the incidence of AFFs in the Japanese population was similar to that of Caucasians, and taking BPs and GCs and suffering from CD were risk factors for developing AFFs. The Japanese Society for Bone and Mineral Research and Springer Japan, 2014 Atypical femoral fracture (AFF) nationallicence Osteoporosis nationallicence Bisphosphonate nationallicence Glucocorticoid nationallicence Collagen disease nationallicence Saita Yoshitomo Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut Ishijima Muneaki Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut Mogami Atsuhiko Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut Kubota Mitsuaki Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut Baba Tomonori Department of Orthopaedic Surgery, Juntendo Urayasu Hospital, Chiba, Japan aut Kaketa Takefumi Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut Nagao Masashi Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut Sakamoto Yuko Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut Sakai Kensuke Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut Homma Yasuhiro Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut Kato Rui Department of Orthopaedic Surgery, Koto Hospital, Tokyo, Japan aut Nagura Nana Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut Miyagawa Kei Department of Orthopaedic Surgery, Chiba Central Medical Center, Chiba, Japan aut Wada Tomoki Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut Liu Lizu Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut Matsuoka Joe Juntendo Clinical Research Center, Juntendo University, Tokyo, Japan aut Obayashi Osamu Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut Shitoto Katsuo Department of Orthopaedic Surgery, Juntendo Urayasu Hospital, Chiba, Japan aut Nozawa Masahiko Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut Kajihara Hajime Department of Orthopaedic Surgery, Koto Hospital, Tokyo, Japan aut Gen Hogaku Department of Orthopaedic Surgery, Chiba Central Medical Center, Chiba, Japan aut Kaneko Kazuo Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut Journal of Bone and Mineral Metabolism Springer Japan 33/3(2015-05-01), 311-318 0914-8779 33:3<311 2015 33 774 https://doi.org/10.1007/s00774-014-0591-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00774-014-0591-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Saita Yoshitomo Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Ishijima Muneaki Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Mogami Atsuhiko Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut NATIONALLICENCE 700 1- Kubota Mitsuaki Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Baba Tomonori Department of Orthopaedic Surgery, Juntendo Urayasu Hospital, Chiba, Japan aut NATIONALLICENCE 700 1- Kaketa Takefumi Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Nagao Masashi Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Sakamoto Yuko Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Sakai Kensuke Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Homma Yasuhiro Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut NATIONALLICENCE 700 1- Kato Rui Department of Orthopaedic Surgery, Koto Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Nagura Nana Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut NATIONALLICENCE 700 1- Miyagawa Kei Department of Orthopaedic Surgery, Chiba Central Medical Center, Chiba, Japan aut NATIONALLICENCE 700 1- Wada Tomoki Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut NATIONALLICENCE 700 1- Liu Lizu Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Matsuoka Joe Juntendo Clinical Research Center, Juntendo University, Tokyo, Japan aut NATIONALLICENCE 700 1- Obayashi Osamu Department of Orthopaedic Surgery, Juntendo Shizuoka Hospital, Shizuoka, Japan aut NATIONALLICENCE 700 1- Shitoto Katsuo Department of Orthopaedic Surgery, Juntendo Urayasu Hospital, Chiba, Japan aut NATIONALLICENCE 700 1- Nozawa Masahiko Department of Orthopaedic Surgery, Juntendo Nerima Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Kajihara Hajime Department of Orthopaedic Surgery, Koto Hospital, Tokyo, Japan aut NATIONALLICENCE 700 1- Gen Hogaku Department of Orthopaedic Surgery, Chiba Central Medical Center, Chiba, Japan aut NATIONALLICENCE 700 1- Kaneko Kazuo Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo, Japan aut NATIONALLICENCE 773 0- Journal of Bone and Mineral Metabolism Springer Japan 33/3(2015-05-01), 311-318 0914-8779 33:3<311 2015 33 774