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Atypical fractures do not have a thicker cortex
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
2012 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 23, no 12, 2893-2896 p.Article in journal (Refereed) Published
Abstract [en]

An association between atypical fractures and general cortical thickness of the femoral shaft is often suggested in the literature. Our radiographic measurements of 59 atypical and 218 ordinary fractures now exclude a difference larger than 10 % in mean femoral cortical thickness (sum of lateral and medial) with 95 % confidence. less thanbrgreater than less thanbrgreater thanAn increased general cortical thickness in patients with fatigue fracture of the femoral shaft (atypical fractures) is commonly suggested. However, there are scarce data to support this. less thanbrgreater than less thanbrgreater thanIn a published nationwide Swedish study, we identified by radiographic review 59 women with an atypical fracture during 2008. The femoral cortical thickness index (thickness/femoral diameter) of these women was now compared with the 218 ordinary fractures that occurred in the same region of the femur in a case-control design. The cortical thickness index 5 cm below the lesser trochanter was the primary variable. less thanbrgreater than less thanbrgreater thanPatients with atypical fractures were younger. Without correction for age, they had a thicker cortex (i.e., higher index). However, the difference in cortical thickness disappeared after age correction. The 95 % CI excludes a group mean difference exceeding 10 % of total mean thickness. Similarly, there was no significant difference in cortical thickness between patients with or without bisphosphonate treatment or between the ipsi- and contralateral femurs in patients with an atypical fracture. less thanbrgreater than less thanbrgreater thanThe concept of a generally increased cortical thickness in patients with atypical fractures should be reconsidered.

Place, publisher, year, edition, pages
Springer Verlag (Germany) , 2012. Vol. 23, no 12, 2893-2896 p.
Keyword [en]
Bisphosphonates, Femoral fracture, Fractures stress, Osteoporosis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-86631DOI: 10.1007/s00198-012-2173-9ISI: 000311403700016OAI: oai:DiVA.org:liu-86631DiVA: diva2:580112
Note

Funding Agencies|Swedish Research Council|VR 2009-6725|Linkoping University||Ostergotland County Council||King Gustaf V and Queen Victoria Free Mason Foundation||Eli Lilly Co.||

Available from: 2012-12-20 Created: 2012-12-20 Last updated: 2017-12-06

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Schilcher, JörgAspenberg, Per

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Department of Clinical and Experimental MedicineFaculty of Health SciencesOrthopaedics and Sports MedicineDepartment of Orthopaedics in Linköping
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