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多施設共同研究による非定型大腿骨骨折の検討
https://uoeh-u.repo.nii.ac.jp/records/746
https://uoeh-u.repo.nii.ac.jp/records/74650143819-ac33-46be-b61d-642778e36b01
名前 / ファイル | ライセンス | アクション |
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S00038302 (3.5 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2020-08-03 | |||||
タイトル | ||||||
タイトル | 多施設共同研究による非定型大腿骨骨折の検討 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Study of Atypical Femoral Fracture Cases Coupled in a Multicenter Study | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 非定型大腿骨骨折 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 多施設共同研究 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | ビスフォスフォネート | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 大腿骨外弯 | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | 多因子関与 | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | atypical femoral fracture | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | multicenter study | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | bisphosphonate | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | lateral bowing | |||||
キーワード | ||||||
言語 | en | |||||
主題Scheme | Other | |||||
主題 | multifactorial | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
善家 , 雄吉
× 善家 , 雄吉× 池田 , 聡× 福田 , 文雄× 田中 , 正宏× 田中 , 秀敏× 平野 , 文崇× 酒井, 昭典× Zenke, Yukichi× Ikeda, Satoshi× Fukuda, Fumio× Tanaka, Masahiro× Tanaka, Hidetoshi× Hirano, Fumitaka× Sakai, Akinori |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 非定型大腿骨骨折(atypical femoral fracture : AFF)は,ビスフォスフォネート(BP)製剤の長期使用,あるいは日本人高齢者における外弯した大腿骨におけるストレス骨折など幾つかの要因が関与している.しかしながら,各施設単独では,まとまった症例数を経験することができないため,当院および関連施設において過去に発生したAFF症例を多施設共同研究として集積した.本研究の目的は,そのデータを解析し,特徴を分類化することである.対象は,多施設で発生したAFF24症例34骨折(両側8例),男性1例,女性23例で,平均年齢73.0歳である.評価項目は,ビスフォスフォネート(BP)製剤使用の有無と使用期間,その他薬剤使用歴,合併症の有無,骨折部位,大腿骨外弯の有無,骨生検パラメータ,骨癒合期間などとした.結果は,BP製剤使用例は19例,投与期間は平均6.1年であった.骨折部位は,転子下16,骨幹部18であり,完全骨折22,不全骨折12であった.また大腿骨外弯ありは16例で,すべて骨幹部に発生していた.骨癒合期間は平均9.0ヶ月であり,完全骨折が平均11.3ヶ月であったのに対し,不全骨折は平均3.7ヶ月であった.全症例をBP関連型:2例,薬剤・合併症型:3例,外弯型:2例,混合型:17例に分類した.本骨折の成因は単一のみでは説明し難く,相互作用による骨質の劣化や,機械的ストレスが絡んだ多因子関与であった. There are several causes of atypical femoral fractures (AFF) in elderly Japanese patients, including longterm bisphosphonate (BP) use or bowed femoral shaft stress fractures, but the available sample size for examining AFF etiology in a single institution is limited. The purpose of this study was to categorize the characteristics of AFF by analyzing the data compiled on patients treated at our hospital and at affiliated institutes. This multicenter, retrospective, observational study included 34 AFF cases (bilateral AFF 10) in one male and 23 female patients (age range 30–90 years, mean age 73.0 years). Evaluation measures included the presence/absence of BP use, duration of BP use, history of other drug use, presence/absence of comorbidities, fracture site, presence/absence of femoral lateral bowing, bone biopsy parameters, and time to bone union. Nineteen patients were prescribed BP for osteoporosis (duration range 4–10 years, mean duration 6.1 years). Subtrochanteric and femoral shaft fractures were seen in 16 and 18 cases, respectively (complete fractures 22, incomplete fractures 12). Femoral lateral bowing (n = 16) occurred with femoral shaft fractures. Mean time to bone union was 9.0 months (complete fractures 11.3 months, incomplete fractures 3.7 months). AFF could be substantially caused by three factors: BP use, drugs other than BP/comorbidity, and femoral lateral bowing. Twenty four patients were classified as having BP-related-type (n = 2), drug/comorbidity-type (n = 3), lateral bowing-type (n = 2), or mixed-type (n = 17) AFF. AFF etiology cannot be explained by a single cause; thus, a multifactorial etiology, including poor bone quality due to mutual interactions and mechanical stress, seems to be responsible for the occurrence of AFF. \nLevel of evidence: Ⅳ diagnostic |
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書誌情報 |
産業医科大学雑誌 en : Journal of UOEH 巻 38, 号 3, p. 207-214, 発行日 2020-09-01 |
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出版者 | ||||||
出版者 | 産業医科大学(産業医科大学学会) | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | ISSN 0387-821X(PRINT), ISSN 2187-2864(ONLINE) | |||||
関連サイト | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://www.uoeh-u.ac.jp/kouza/journal/intro_e.html | |||||
関連名称 | Journal of UOEH | |||||
関連サイト | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://www.uoeh-u.ac.jp/kouza/journal/intro_j.html | |||||
関連名称 | 産業医科大学雑誌 | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 |