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Management of atypical femoral fracture in a patient with osteogenesis imperfecta.
Tan, Jing Yuan; Seow, Cherng Jye.
Affiliation
  • Tan JY; Endocrinology, National University Singapore Yong Loo Lin School of Medicine, Singapore, Singapore.
  • Seow CJ; Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore.
BMJ Case Rep ; 20172017 Dec 20.
Article in En | MEDLINE | ID: mdl-29269360
ABSTRACT
Osteogenesis imperfecta (OI) is a generalised connective tissue disorder associated with low bone mass, bone fragility and increased susceptibility to fractures. First-line treatment to improve bone mineral density (BMD) is usually with bisphosphonates but long-term usage has been associated with uncommon complications such as atypical femoral fractures (AFF). Treatment with teriparatide in this situation has been reported with positive outcomes. However, choice of treatment after 2 years of teriparatide has not been well studied or reported. We describe a patient with OI treated with bisphosphonates for 9 years, who then suffered a spontaneous AFF, was subsequently started on teriparatide for 2 years followed by 6 monthly Denosumab. 1 year post-treatment with Denosumab, there was significant improvement in BMD, good fracture healing and no new fractures. This case highlights the potential use of denosumab following 2 years of teriparatide treatment in patients with OI with AFF.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Osteogenesis Imperfecta / Bone Density / Diphosphonates / Bone Density Conservation Agents / Femoral Fractures / Fractures, Spontaneous Limits: Humans / Male / Middle aged Language: En Journal: BMJ Case Rep Year: 2017 Document type: Article Affiliation country: Singapore

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Osteogenesis Imperfecta / Bone Density / Diphosphonates / Bone Density Conservation Agents / Femoral Fractures / Fractures, Spontaneous Limits: Humans / Male / Middle aged Language: En Journal: BMJ Case Rep Year: 2017 Document type: Article Affiliation country: Singapore