• 作者：J.R. Caeiro-Rey^a ; ^d ; ^{jrcaeiro@telefonica.net} ; I. Etxebarria-Foronda^b ; ^d ; M. Mesa-Ramos^c ; ^d
• 关键词：Bifosfonatos ; Fracturas atí ; picas ; Fracturas por estré ; s ; Fracturas por insuficiencia ; Fracturas subtrocanté ; ricas ; Fracturas diafisarias de fé ; mur
• 刊名：Revista Espa帽ola de Cirug铆a Ortop茅dica y Traumatolog铆a
• 出版年：2011
• 期刊代码：pca311_18884415
• 类别：med
• 出版时间：September-October 2011
• 卷：55
• 期：5
• 页码：392-404
• 文件大小：412 K

Bisphosphonates are currently considered first choice treatment of osteoporotic disease. Its proven anti-fracture effect in all types of osteoporosis and its presence on the market for many years, make them the most widely used drugs for the treatment of this disease. A number of adverse effects associated with this medication have appeared over the past 10 years or so have caused concern on whether or not to maintain a continued treatment with these drugs over a long period of time. These side effects include a series of fractures, considered atypical because of their location and radiological appearance, which occur in patients treated long-term with bisphosphonates. These fractures, that share a number of common clinical features, do not meet the classic profile of osteoporotic fragility fractures. Prolonged inhibition of bone remodelling could be the pathophysiological basis for his explanation, although this causal relationship is not yet clearly established. The objective of this paper is two-fold, on the one hand to present four clinical cases of atypical fractures related with long-term administration of these drugs and, on the other, to perform a literature review of this pathological entity, in an attempt to clarify what is the real status of this problem and whether it is necessary to establish both surgical and non-surgical therapeutic recommendations for these types of fractures.