Surgical strategy of the treatment of atypical femoral fractures  

作　　者：Bum-Jin Shim Heejae Won Shin-Yoon Kim Seung-Hoon Baek 

机构地区：[1]Department of Orthopedic Surgery,Kyungpook National University Chilgok Hospital,Daegu 41404,South Korea [2]Department of Orthopedic Surgery,Kyungpook National University,College of Medincine,Daegu 41944,South Korea [3]Department of Orthopedic Surgery,Kyungpook National University Hospital,Kyungpook National University,College of Medincine,Daegu 41944,South Korea

出　　处：《World Journal of Orthopedics》2023年第5期302-311,共10页世界骨科杂志（英文版）

基　　金：Supported by Korean Fund for Regenerative Medicine(KFRM)grant funded by the Korea Government(the Ministry of Science and ICT,the Ministry of Health&Welfare),No.22D0801L1 and No.22C0604L1。

摘　　要：The atypical femoral fracture(AFF)has been attracting significant attention because of its increasing incidence;additionally,its treatment is challenging from biological and mechanical aspects.Although surgery is often required to manage complete AFFs,clear guidelines for the surgical treatment of AFFs are currently sparse.We reviewed and described the surgical treatment of AFFs and the surveillance of the contralateral femur.For complete AFFs,cephalomedullary intramedullary nailing spanning the entire length of the femur can be used.Various surgical techniques to overcome the femoral bowing common in AFFs include a lateral entry point,external rotation of the nail,and the use of a nail with a small radius of curvature,or a contralateral nail.In the case of a narrow medullary canal,severe femoral bowing,or pre-existing implants,plate fixation may be considered as an alternative.For incomplete AFFs,prophylactic fixation depends on several risk factors,such as a subtrochanteric location,presence of a radiolucent line,functional pain,and condition of the contralateral femur;the same surgical principles as those in complete AFFs can be applied.Finally,once AFF is diagnosed,clinicians should recognize the increased risk of contralateral AFFs,and close surveillance of the contralateral femur is recommended.

关 键 词：Atypical femoral fracture Surgical treatment SURVEILLANCE Contralateral femur Femoral bowing 

分 类 号：R687.3[医药卫生—骨科学]