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Localization of Atypical Femoral Fracture on Straight and Bowed Femurs

 Young-Chang Park  ;  Soon-Phil Yoon  ;  Kyu Hyun Yang 
 JBM : Journal of Bone Metabolism, Vol.26(2) : 123-131, 2019 
Journal Title
JBM : Journal of Bone Metabolism
Issue Date
Femoral fractures ; Osteoporosis ; Stress, mechanical
Background: To elucidate the effect of anterolateral bowing on the fracture height of atypical femoral fractures (AFFs), we separated the AFFs into 2 groups according to the presence of anterolateral femoral bowing (straight group and bowing group) and analyzed the fracture height. The aims of this study were to evaluate the clinical and radiological features of AFFs in the straight group and bowing group, and to determine which factors were associated with the fracture height of AFFs in the total cohort and each subgroup.

Methods: Ninety-nine patients with AFFs were included in this study (43 patients in the bowing group and 56 patients in the straight group). Clinical and radiological characteristics were compared between the groups. Multivariable linear regression analysis was performed to determine the effect of factors on fracture height.

Results: Patients in the straight group were younger, heavier, and taller, and had a higher bone mineral density, smaller anterior and lateral bowing angles, and more proximal fracture height than those in the bowing group. Multivariable analysis showed that the presence of anterolateral bowing itself and height were associated with fracture height in the total cohort. In the subgroup analysis, the lateral bowing angle in the straight group and the estimated apex height in the bowing group were associated with fracture height. The lateral bowing angle was not significantly associated with fracture height in the total cohort and the bowing group.

Conclusions: The presence of anterolateral bowing and the level of the apex of the bowed femur were important factors for the fracture height of AFFs.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Young Chang(박영창)
Yang, Kyu Hyun(양규현) ORCID logo https://orcid.org/0000-0001-7183-588X
Yoon, Soon-Phil(윤순필)
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