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DOI: 10.1055/s-0043-1770906
Atypical Metatarsal Fractures: Report of Five Clinical Cases
Article in several languages: português | EnglishFinancial Support The authors declare that they have received no financial support from public, commercial, or non-profit sources.
Abstract
Atypical fractures are well elucidated when they occur in the femur and are related to the use of bisphosphonates. Prolonged therapy with this drug leads to excessive suppression of bone remodeling, which makes the bone more brittle. In general, they are caused by minimal trauma or are atraumatic. This type of fracture is also reported in other bony sites, such as the metatarsus. Some reports and studies on atypical metatarsal fractures have been published, but further investigations are required to better understand this type of fracture and establish the proper diagnosis, treatment and conduct.
The present study is a report of five cases of patients who presented metatarsal fractures during therapy with bisphosphonates. All patients were female, had osteoporosis as a preexisting disease, were taking bisphosphonates, presented fractures that were either atraumatic or caused by minimal trauma, and the imaging examination showed a transverse meta-diaphyseal fracture of the fifth metatarsal shaft with thickening of the lateral cortex, image characteristics similar to the criteria used by the American Society for Bone and Mineral Research (ASMBR) to define atypical femur fractures.
Study carried out at the School of Medicine at Universidade Federal do Maranhão, São Luís, MA, Brazil.
Publication History
Received: 05 March 2022
Accepted: 27 October 2022
Article published online:
19 April 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Referências
- 1 Toro G, Ojeda-Thies C, Calabrò G. et al. Management of atypical femoral fracture: a scoping review and comprehensive algorithm. BMC Musculoskelet Disord 2016; 17: 227
- 2 Shane E, Burr D, Abrahamsen B. et al. Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2014; 29 (01) 1-23
- 3 Corrarino JE. Bisphosphonates and atypical femoral fractures. J Nurse Pract 2015; 11 (04) 389-396
- 4 Bissonnette L, April PM, Dumais R, Boire G, Roux S. Atypical fracture of the tibial diaphysis associated with bisphosphonate therapy: a case report. Bone 2013; 56 (02) 406-409
- 5 Schneider JP. Should bisphosphonates be continued indefinitely? An unusual fracture in a healthy woman on long-term alendronate. Geriatrics 2006; 61 (01) 31-33
- 6 West TA, Pollard JD, Chandra M. et al. The Epidemiology of Metatarsal Fractures Among Older Females With Bisphosphonate Exposure. J Foot Ankle Surg 2020; 59 (02) 269-273
- 7 Ott SM. Long-term safety of bisphosphonates. J Clin Endocrinol Metab 2005; 90 (03) 1897-1899
- 8 Marshall RA, Mandell JC, Weaver MJ, Ferrone M, Sodickson A, Khurana B. Imaging Features and Management of Stress, Atypical, and Pathologic Fractures. Radiographics 2018; 38 (07) 2173-2192
- 9 Brown JP, Morin S, Leslie W. et al. Bisphosphonates for treatment of osteoporosis: expected benefits, potential harms, and drug holidays. Can Fam Physician 2014; 60 (04) 324-333
- 10 Unnanuntana A, Saleh A, Mensah KA, Kleimeyer JP, Lane JM. Atypical femoral fractures: what do we know about them?: AAOS Exhibit Selection. J Bone Joint Surg Am 2013; 95 (02) e8-e13 , 1–13