Etiological, clinical characteristics, and treatment of atypical femur fracture: A retrospective study

This study aims to determine the etiology, clinical characteristics, and treatment of atypical femur fractures (AFFs). Clinical data from patients with an AFF who were treated in our hospital from January 2017 to June 2021 were retrospectively reviewed. The data were analyzed and summarized. Twenty-one patients (17 females and 4 males; average age, 66.59 ± 13.52 years; age range, 32-85 years) with AFFs (27 femurs [6 bilateral femurs]) were included in the current study. Based on relative risk analysis it was determined that the long-term use of bisphosphonates was a risk factor for AFFs. Using principal components analysis, severe osteoporosis, hip joint dysfunction, and structural abnormalities of the femur were shown to be risk factors for AFFs. Four femurs received non-surgical treatment, of which 2 were cured and the remaining 2 underwent surgical treatment. Twenty-five femurs received surgical treatment, of which 21 had intramedullary nail fixation and 4 had plate fixation. All fractures healed. The etiologic factors for AFFs are complex. Severe osteoporosis, hip joint dysfunction, and structural abnormalities of the femur were shown to be risk factors for AFFs based on principal components analysis. The appropriate treatment will be determined according to the characteristics of the fracture.